Abstract
ObjectiveTo evaluate whether serum matrix metalloproteinase-9 (MMP-9) is associated with peripheral neuropathy (PN) in patients with systemic lupus erythematosus (SLE) and to determine the relationship between MMP-9 serum level and SLE disease activity, lupus manifestations, and laboratory markers.Patients and methodsA total of 30 patients with SLE with PN, 30 patients with SLE without PN, and 20 healthy controls were included in this study. SLE clinical manifestations, Systemic Lupus Activity Measure (SLAM) index, and laboratory markers were evaluated. All the data were compared and correlated with serum MMP-9 level.ResultsMMP-9 showed a significant increase in frequency in SLE with PN group compared with SLE without PN group (P1=0.037), SLE with PN group compared with control group (P2<0.001), and SLE without PN group compared with control group (P3<0.001). In comparison between SLE with normal MMP-9 group versus SLE with high MMP-9 group, it showed no statistically significant difference between the two groups regarding demographic data, SLAM index, Erythrocytes sedimentation rate (ESR), C-reactive protein (CRP), Antinuclear antibodies (ANA), Antiphospholipid antibodies (APL), C3, C4, anti-double-stranded DNA, and lupus clinical features, except malar rash and lupus nephritis, which showed significant increase in SLE with high MMP-9 group compared with SLE with normal MMP-9 group (P=0.042 for each). A significant positive correlation was detected between MMP-9 serum level and SLAM index (P=0.037), whereas anti-double-stranded DNA did not show significant correlation. There was a significant relation between increasing the risk of PN and MMP-9 (odds ratio=4.031).ConclusionSignificant elevation of serum MMP-9 may increase the risk of PN in patients with SLE, and it may correlate with disease activity, lupus nephritis, and skin involvement.
Highlights
Matrix metalloproteinases (MMPs) are a group of zinccontaining endoproteinases that can corrupt an assortment of extracellular matrix components [1]
Significant elevation of serum matrix metalloproteinase-9 (MMP-9) may increase the risk of peripheral neuropathy (PN) in patients with systemic lupus erythematosus (SLE), and it may correlate with disease activity, lupus nephritis, and skin involvement
The number of patients with high serum MMP-9 level was statistically higher in group I compared with group II (P1=0.037), and there was a statistically significant increase in the number of patients with high serum MMP-9 levels in group I compared with group III (P2
Summary
Matrix metalloproteinases (MMPs) are a group of zinccontaining endoproteinases that can corrupt an assortment of extracellular matrix components [1]. Increased activity of MMPs has been involved in various illness forms, including cardiovascular diseases and autoimmune diseases such as multiple sclerosis, Guillain–Barré syndrome, systemic lupus erythematosus (SLE), rheumatoid arthritis, and malignancies [4,5], for instance, MMPs have a role in other rheumatological diseases, as elevated serum and synovial MMP-3 levels reflect disease activity in patients with rheumatoid arthritis [6]. Multiple studies analyzed MMP-9 activity in the sera of patients with active and inactive SLE to evaluate its ease as well as its diagnostic value. MMP-9 activity was significantly higher in the sera of patients with SLE compared with those of healthy controls [7,8,9]. The high levels of MMP-9 and its correlation to disease activity indices are controversial [10,11,12]
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