The association of subclinical atherosclerosis in rheumatoid arthritis with circulating MMP-9 concentrations and karotid artery intima media thickness

The Association Of Subclinical Atherosclerosis İn Rheumatoid Arthritis WithCirculating MMP-9 Concentrations And Karotid Artery İntima Media ThicknessDr.Serhat IşıkABSTRACTRheumatoid arthritis (RA) is a chronic systemic autoimmune rheumatic disorder,characterized by inflammation, synovial hyperplasia and destruction of the affectedjoints. The cellular activation of aggressively growing, matrix-degrading synovialfibroblasts is a prominent feature in the pathobiology of RA. Many cellular and molecularpathways are also involved in the genesis and activity course of the disease. Jointdestruction in RA is mediated by the attacks of numerous enzymes such as serineproteases, cathepsins, and the matrix metalloproteinases (MMPs). MMPs are a family ofenzymes that degrade different components of extracellular matrix. They play animportant role in normal physiologic processes of maintaining tissue integrity andremodeling, as in wound healing, processes of development, and regeneration. On theother hand, excessive expression of MMPs degrade non-collagen matrix components ofthe joints as in RA.Atherosclerosis is an ongoing long-term pathological process associated with theinflammatory disease course of RA. Patients with RA have a two to five times increasedrisk of developing premature cardiovascular diseases, although the classical risk factorsprecipitating the atherosclerotic lesions are often absent. Excessive degradation of matrixcomponents via MMPs occurs in the pathologic tissue destruction as in atherosclerosis.Human carotid atherosclerotic plaques are rich in foamy macrophages, which were alsoobserved in the lining layers and sublining areas of RA synovium. The macrophages areinvolved in the pathogenesis of inflammatory diseases, and MMP-9 induction, which willcontribute to cartilage destruction of RA or extracellular matrix degradation ofatherosclerosis. The aim of this study is to search potential implication of MMP-9 in thedevelopment of accelerated atherogenesis and active systemic inflammation of RA.Circulating MMP-9 levels together with the information on carotid ultrasonography inRA patients with active disease state were examined in comparison with the age- and sex-matched healthy adults as kontrols for this aim.