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a Department of
Orthopaedic Surgery, National Defence Medical College, b Department of
Pathology, School of Medicine, Keio University, c Biopharmaceutical Department,
Fuji Chemical Industries Ltd, d Department
of Orthopaedic Surgery, Fujita Health University, Second Hospital, e Department of Biochemistry,
School of Dentistry, Aichi-Gakuin University
Correspondence to: Dr Yasunori Okada, Department of Pathology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-0016, Japan Email: okada{at}med.keio.ac.jp
Accepted for publication 10 January 2000
OBJECTIVE
Matrix
metalloproteinases (MMPs) are expressed in joint tissues of patients
with rheumatoid arthritis (RA) and osteoarthritis (OA). The objective
of this study was to define the steady state levels of seven different
MMPs and two tissue inhibitors of metalloproteinases (TIMPs) as well as
the potential metalloproteinase activity in the synovial fluid (SF) to
provide more insight into the role of MMPs in cartilage destruction in
RA and OA.
METHODS
Levels of
MMP-1, MMP-2, MMP-3, MMP-7, MMP-8, MMP-9, MMP-13, TIMP-1, and TIMP-2 in
SF aspirated from knee joints of 97 patients with RA and 103 patients
with OA were measured by the corresponding one step sandwich enzyme
immunoassays. Proteolytic activity of MMPs in these SFs was examined in
an assay using [3H]carboxymethylated transferrin
substrate in the presence of inhibitors of serine and cysteine
proteinases after activation with
p-aminophenylmercuric acetate (APMA).
Destruction of RA knee joints was radiographically evaluated.
RESULTS
Levels of
MMP-1, MMP-2, MMP-3, MMP-8, and MMP-9 were significantly higher in RA
SF than in OA SF. MMP-7 and MMP-13 were detectable in more than 45% of
RA SFs and in less than 20% of OA SFs, respectively. Among the MMPs
examined, MMP-3 levels were extremely high compared with those of other
MMPs. Direct correlations were seen between the levels of MMP-1 and
MMP-3 and between those of MMP-8 and MMP-9 in RA SF. Although the
levels of MMP-1 and MMP-3 increased even in the early stage of RA,
those of MMP-8 and MMP-9 were low in the early stage and increased with
the progression of RA. Molar ratios of the total amounts of the MMPs to
those of the TIMPs were 5.2-fold higher in patients with RA than in OA,
which was significant. APMA-activated metalloproteinase activity in SF
showed a similar result, and a direct correlation was seen between the molar ratios and the activity in RA SF.
CONCLUSIONS
Our
results show that high levels of MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, and
TIMP-1 are present in RA SF and suggest that once these MMPs are fully
activated, they have an imbalance against TIMPs, which may contribute
to the cartilage destruction in RA.
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