Background Rheumatoid arthritis (RA) is associated with an unexplained increased cardiovascular risk. Matrix metalloproteinase-3 (MMP-3) is the most important protease involved in RA inflammation which may play a role in the development of cardiovascular events. Antibodies against oxidized low-density lipoprotein (oxLDL) are known to be involved in the development of inflammation and atherosclerosis. Specific role of MMP-3 and antibodies against oxLDL in cardiac pathology in RA patients (pts) is not well investigated.
Objectives To compare MMP-3 and oxLDL-IgG antibody levels, as well as lipid profiles in pts with active RA and healthy controls.
Methods Thirty nine RA pts (33 women and 6 men, median age 56,5 [49; 65] years), with active arthritis (mean disease duration 96 [48; 190] months; DAS28 5,8 [5,3;6,3]; HAQ 1,8 [1,3; 2,2]) were enrolled in the study. Twenty three pts (59%) received methotrexate, 5 (13%) – the combination of methotrexate with oral glucocorticoids, 10 (26%) - oral glucocorticoids monotherapy.
The control group consisted of 29 volunteers (21 women and 8 men, median age 58,5 [53; 62] years). Serum MMP-3 and oxLDL-IgG levels were measured by enzyme-linked immunosorbent assay (ELISA).
Results Elevated MMP-3 levels were detected more frequently in RA pts (31/39 (79%)) vs healthy controls (2/29 (7%), p<0,0001). MMP-3 concentrations were higher in RA pts (57,0 [36,6; 114,3ng/ml), than in the control group subjects (13,4 [9,9; 20,4]mg/ml, p <0,0001). MMP-3 levels demonstrated significant correlation with ESR (r =0,64, p <0,05) and CRP (r =0,52, p<0,05) values.
OxLDL-IgG levels in RA pts and healthy controls did not differ significantly (290,3 [111,3; 608,6] mU/ml, and 228,1 [125,1; 338,8] mU/ml, respectively p>0,05). Rates of dyslipidemia were similar in RA pts (23/39 (59%) and control group subjects (15/29 (52%). Concentrations of lipids were also similar in both groups and were as follows: total cholesterol was 5,2 [4,9; 6,2] mmol/l in RA pts and 6,3 [5,1; 6,6] mmol/l in the control group; HDL cholesterol - 1,7 [1,4; 2,0] mmol/l and 1,7 [1,5; 2,1] mmol/l, LDL cholesterol - 3,3 [2,8; 4,0] mmol/l and 3,6 [3,0; 4,0] mmol/l, triglycerides - 1,3 [1,0; 1,6] mmol/l and 1,4[1,1; 1,8] mmol/l, the atherogenic index of plasma - 2,4 [1,8; 2,8] and 2,4 [1,9; 3,0], respectively. Showed no correlation between the levels of oxLDL-IgG and lipids in both groups. In the RA group, concentrations of HDL cholesterol were negatively correlated with MMP-3 (r=-0,5, p<0,05), C-reactive protein (r=-0,53, p<0,05), and DAS28 (r=-0,4, p<0,05).
Conclusions RA pts exhibited higher serum MMP-3 levels than healthy individuals. OxLDL-IgG levels were similar in RA pts and healthy subjects. Obtained results suggest that MMP-3 and CRP may produce a negative impact on HDL-cholesterol levels in patients with active RA.
Disclosure of Interest None declared