The Role of Matrix Metalloproteinase-3 as a Biomarker for Diagnosis and Disease Activity Assessment in Patients with Ankylosing Spondylitis

Abstract

Background: Ankylosing spondylitis (AS) is a chronic, inflammatory, systemic disease, mainly affects the spine and sacroiliac joints, causing low back pain, stiffness, and spinal fusion. Matrix metalloproteinase-3 (MMP-3) is known to be an essential protease in cartilage and joint destruction due to it can cleave many ECM proteins. purpose: The purpose of this study is to assess whether MMP-3 plays an effective role in the diagnosis and evaluation of AS activity. Methods, Subject, and Methods: A case-control study included 30 patients with ankylosing spondylitis (AS), 30 patients with chronic back pain (CBP), and 28 apparently healthy persons. Furthermore, MMP-3 and CRP levels were assessed for the three groups using an ELISA technique. The study also measured the CBC and ESR levels. Results: The MMP-3 levels in AS, CBP, and healthy groups were 221.92 pg/ml±68.10, 193.29 pg/ml±25.02, and 279.17 pg/ml±80.44, respectively, with a non-significant difference between AS and CBP groups (P=0.699) and between AS and healthy groups (P=0.587). Based on ASDAS-ESR, there was a significant difference in the MMP-3 level (P=0.005). The diagnostic performance of MMP-3 for AS with the healthy group showed an AUC of 0.396, 61.8% sensitivity, and 62.5% specificity. While the diagnostic performance of MMP-3 for AS with CBP revealed an AUC of 0.400, 54.2% sensitivity, and 52.8% specificity. Implications: the findings support ASADAS-ESR as a tool for guiding treatment and highlight the need for further research on its long-term impact. Additional materials: this paper contains 18 references, 8 tables, and 7 figures. Conclusion: The findings showed that MMP-3 plays a significant role in evaluating disease activity in patients with AS based on the ASDAS-ESR index; however, it does not have a diagnostic value and is not involved in the initial diagnosis of the disease.