Skip to main content
Egyptian Rheumatology and Rehabilitation
Download PDF
  • Original article
  • Open access
  • Published:

Serum matrix metalloproteinase-9 level in systemic lupus erythematosus with peripheral neuropathy

Egyptian Rheumatology and Rehabilitation volume 46, pages 211–220 (2019)Cite this article

Abstract

Objective

To 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 methods

A 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.

Results

MMP-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).

Conclusion

Significant 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.

References

  1. Lijnen HR. Plasmin and matrix metalloproteinases in vascular remodeling. Thromb Haemost 2001; 86:324–333.

    Article  CAS  Google Scholar 

  2. Kalela A. Factors affecting serum matrix metalloproteinase 9 with special reference to atherosclerosis. Acta Univ Tamper 2002; 886:23–30.

    Google Scholar 

  3. Girolamo N, Indoh I, Jackson N, Wakefield D, McNeil P, Yan W, et al. Human mast cell-derived gelatinase B (matrix metalloproteinase-9) is regulated by inflammatory cytokines: role in cell migration. J Immunol 2006; 177:2638–2650.

    Article  Google Scholar 

  4. Sharshar T, Durand MC, Lefaucheur JP, Lofaso F, Raphaël JC, Gherardi RK, et al. MMP-9 correlates with electrophysiologic abnormalities in Guillain-Barré syndrome. Neurology 2002; 59:1649–1651.

    Article  CAS  Google Scholar 

  5. ItohT, Matsuda H,Tanioka M, Kuwabara K, Itohara S, Suzuki R. The role of matrix metalloproteinase-2 and matrix metalloproteinase-9 in antibody-induced arthritis. J Immunol 2002; 169:2643–2647.

    Article  CAS  Google Scholar 

  6. Fawzy RM, Abdel Hamid YA, Albehesy MM, Aboelmaged RF. Serum and synovial matrix metalloproteinase-3 as markers of disease activity in early rheumatoid arthritis. Egypt Rheumatol Rehabil 2016; 43:178–183.

    Article  Google Scholar 

  7. Liu Y, Tie N, Bai L. Serum levels of MDC and MMP-9 and the relationship between serum levels and disease activity in the patients with systemic lupus erythematosus. Pak J Med Sci 2015; 31:803–806.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Ertugrul G, Keles D, Oktay G, Aktan S. Matrix metalloproteinase-2 and -9 activity levels increase in cutaneous lupus erythematosus lesions and correlate with disease severity. Arch Dermatol Res 2018; 310:173–179.

    Article  CAS  Google Scholar 

  9. Makowski S, Ramsby L. Concentrations of circulating matrix metalloproteinase 9 inversely correlate with autoimmune antibodies to double stranded DNA: implications for monitoring disease activity in systemic lupus erythematosus. Mol Pathol 2003; 56:244–247.

    Article  CAS  Google Scholar 

  10. Faber-Elmann A, Sthoeger Z, Tcherniack A, Dayan M, Mozes E. Activity of matrix metalloproteinase-9 is elevated in sera of patients with systemic lupus erythematosus. Clin Exp Immunol 2002; 127:393–398.

    Article  CAS  Google Scholar 

  11. Ainiala H, Hietaharju A, Dastidar P, Loukkola J, Lehtimäki T, Peltola J, et al. Increased serum matrix metalloproteinase 9 levels in systemic lupus erythematosus patients with neuropsychiatric manifestations and brain magnetic resonance imaging abnormalities. Arthritis Rheum 2004; 50:858–865.

    Article  CAS  Google Scholar 

  12. Phillips M, Fadia M, Lea-Henry N, Smiles J, Walters D, Jiang H. MMP2 and MMP-9 associate with crescentic glomerulonephritis. Clin Kidney J 2017; 10:215–220.

    CAS  PubMed  Google Scholar 

  13. Mawrin C, Brunn A, Röcken C, Schröder M. Peripheral neuropathy in systemic lupus erythematosus: pathomorphological features and distribution pattern of matrix metalloproteinases. Acta Neuropathol 2003; 105:365–372.

    Article  CAS  Google Scholar 

  14. Gurer G, Erdem S, Kocaefe C, Ozgüç M, Tan E. Expression of matrix metalloproteinases in vasculitic neuropathy. Rheumatol Int 2004; 24:255–259.

    Article  CAS  Google Scholar 

  15. Petri M, Orbai AM, Alarcon GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012; 64:2677–2686.

    Article  Google Scholar 

  16. [No authors listed]. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum 1999; 42:599–608.

  17. Mikdashi J, Nived O. Measuring disease activity in adults with systemic lupus erythematosus: the challenges of administrative burden and responsiveness to patient concerns in clinical research. Arthritis Res Ther 2015; 17:183.

    Article  Google Scholar 

  18. Abd El-Aziz GA, Darwish HM, Morsy Amal AA, Mousa SG. Serum level of matrix metalloproteinase-9 in patients with systemic lupus erythematosus. Egypt J Hosp Med 2005; 20:1–7.

    CAS  Google Scholar 

  19. Mao YM, Wang S, Zhao CN, Wu Q, Dan YL, Guan SY, et al. Circulating matrix metalloproteinase-9 levels in patients with systemic lupus erythematosus: a meta-analysis. Curr Pharm Des 2018; 24:1780–1787.

    Article  CAS  Google Scholar 

  20. Berzal E, Boon L, Martens E, Vandooren J, Benedicte C, Opdenakker G. Matrix metalloproteinase-9/MMP-9/gelatinase b in systemic lupus erythematosus (SLE). Lupus Sci Med 2017; 4:A54.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physical Medicine, Rheumatology and Rehabilitation clinic, Faculty of Medicine, Alexandria University, Egypt

    Mohamed Hassan Imam, Hamdy Khamis Koriem, Marwa Mohamed Hassan &  Niveen Abdallah Ibrahim MBBCh (Master of Physical Medicine, Rheumatology and Rehabilitation)

  2. Department of Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Egypt

    Abeer Shawky El-Hadidi

Authors
  1. Mohamed Hassan Imam
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hamdy Khamis Koriem
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marwa Mohamed Hassan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Abeer Shawky El-Hadidi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Niveen Abdallah Ibrahim MBBCh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Niveen Abdallah Ibrahim MBBCh.

Additional information

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Imam, M.H., Koriem, H.K., Hassan, M.M. et al. Serum matrix metalloproteinase-9 level in systemic lupus erythematosus with peripheral neuropathy. Egypt Rheumatol Rehabil 46, 211–220 (2019). https://doi.org/10.4103/err.err_45_19

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/err.err_45_19

Keywords