Correlation of Matrix Metalloproteinase-9 Level, Erythrocyte Sedimentation Rate, Rheumatoid Factor, and the Duration of Illness with Radiological Findings in Rheumatoid Arthritis Patients

Background: Rheumatoid arthritis (RA) is a common autoimmune disease of the joint indicated by chronic inflammation of synovium, cartilage destruction, and osteopenia. The end results of RA are joint deformity and disability that will decrease the quality of life ofthe patients. Until now there is not a specifi c marker to assess the process of joint and bone damage in RA. Available markers such as C-reactive protein and erythrocyte sedimentation rate (ESR) indicate more about the infl ammatory status of the patient. Thediscovery of matrix metalloproteinases (MMPs) enzyme overexpression in RA has brought a new hope for the discovery of more specifi c markers of joint damage.Objective: To study the correlation of MMP-9 level, ESR, rheumatoid factor (RF), and the duration of illness with joint damage in RA patients.Methods: A cross-sectional study was conducted on RA outpatients in rheumatology clinic at Cipto Mangunkusumo General Hospital, Jakarta from January to October 2009. From the patients who fulfilled the inclusion criteria and did not fulfi ll the exclusion criteria, blood sample was collected for MMP-9 level, RF, and ESR examinations; hand radiography (posterior-anterior view) was also taken. Results: From the study of 46 patients, we found a significant correlation between MMP-9 level and radiographic feature of bone erosion (r = 0.3, p = 0.02) and between the duration of illness and Sharp score (r = 0.36, p = 0.014). There was no correlation between ESR and radiological fi ndings nor between RF and radiological fi ndings. Linear regression analysis showed the duration of illness as the most infl uencing factor toradiological fi ndings in RA patients.Conclusion: We found a signifi cant correlation between MMP-9 level and radiographic feature of bone erosion, and between the duration of illness and radiological fi ndings in RA patients

Correlation of Interleukin-17 with Disease Activity and Hand Joint Damage in Patients with Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) is a disease involving various types of cytokines. One of them is interleukin-17 (IL-17), which is known to have a pleiotropic effect on various of cells and is thought to be a cytokine effector contributing to the pathogeniccondition in RA.Methods: The study was conducted on 46 RA patients at rheumatology clinic at the Cipto Mangunkusumo General Hospital who were diagnosed based on the 1987 American College of Rheumatology criteria. Sample selection was done using consecutive sampling. Tests on patients were conducted to collect data needed to obtain the scores for 28-joint Disease Activity Score (DAS28), global health visual analogue scale, swollen joint count, tender joint count, sedimentation rate, Sharp score (radiograph of both hands), and the IL-17 level.The correlation between IL-17 level and DAS28 was calculated using the Pearson's correlation test while the correlation between IL-17 level and Sharp score was calculated using the Spearman's test.Results: The majority of patients (87%) were women. The largest percentage was in the 51- to 60-year-old group (39.1%). Most patients (43.1%) had moderate disease activity. There were 27 patients (58.69%) with positive rheumatoid factor. The mean IL-17 level was17.28 pg/mL with a standard deviation of 11.43 pg/mL. There was no correlation of IL-17 level with disease activity (p = 0.446, r = 0.021) and Sharp score (p = 0.304, r = 0.077) in subjects of this study.Conclusion: There was no signifi cant correlation of IL-17 with disease activity and joint damage