Correlation Between Serum 25（OH）D₃、MMP-3 Levels And Auto Antibodies And Rheumatoid Arthritis Activity

BackgroundRheumatoid arthritis is a common clinical autoimmune disease,mainly involving the body joints,causing bone destruction.At present,the detailed pathogenesis of RA is not clear,most studys believe that the main pathogenesis of RA is immune disorders,especially abnormal expression of immune cells.Vitamin D₃ and MMP-3 are involved in the immune response in many paths,and whether serum levels of vitamin D₃ and MMP-3affect the development of RA has not been determined.ObjectiveThe serum levels of 25 hydroxyvitamin D3（25（OH）D3）,MMP-3 and related autoantibodies in RA patients were measured by enzyme-linked immunosorbent assay（ELISA）and electrochemiluminescence.The correlation between 25（OH）D₃,MMP-3 and disease activity and autoantibodies was analyzed.The role of related immune indexes,25（OH）D₃ and MMP-3 in the occurrence and development of RA and their significance in disease activity were discussed,it provides a new idea for the prevention and treatment of RA.Methods1.Objects:According to the diagnostic criteria of the American College of Rheumatology（ACR）and the European Leagues Against Rheumatism（EULAR）in 2010,between Oct 2018 and May 2019,we enrolled and assessed 138 rheumatoid patients who were followed up in the rheumatology department of the First Affiliated Hospital of Xinxiang Medical College.According to the DAS28 score,the experimental group was divided into high activity（33cases）,middle activity（36 cases）,low activity（34 cases）and stable group（35 cases）.In addition,according to the level of 25（OH）D₃,the experimental group was divided into deficient group（36 cases）,the insufficient group（55 cases）and the normal group（47 cases）.The control group consisted of 120 healthy individuals with no autoimmune disease and no rheumatoid disease matched with the rheumatoid group.2.Detection Methods:Blood samples were collected from all subjects.Anti CCP,ACPA,Carp,RF and MMP-3 were detected by ELISA,AKA by IIF,ESR by Wei’s method,CRP by immunoturbidimetry,25（OH）D₃ was detected by electrochemiluminescence.3.Statistics:SPSS 20.0（IBM）statistical software was used to analyze the data.The measurement data were calculated by means of mean±standard deviation（?x±s）,and independent sample t test was used for comparison between two groups of samples;Kruskal Wallis test was used for comparison between multiple groups;Chi square test was used for classification variables.Pearson correlation analysis was used in correlation analysis.P<0.05 was defined as statistically significant.Results1.Detection indexs of RA group and control group:The levels of ESR,CRP,RF,Anti-CCP and MMP-3 in RA group were significantly higher than those in the control group（P<0.05）;25（OH）D₃ level was lower in RA group.The number of AKA antibody positive cases（84 cases）,ACPA antibody positive cases（77 cases）and Carp antibody positive cases（70 cases）in RA group were significantly higher than those in control group（P<0.05）.2.Experimental indexes in different activity groups:The levels of ESR,CRP,RF and MMP-3 in high activity group,middle activity group and low activity group respectively were higher than those in stable group（P<0.05）.The levels of ESR,CRP,RF and MMP-3 in high activity group were higher than those in low activity group（P<0.05）.The level of 25（OH）D₃ in high actively group was lower than stable group and low actively group,and in middle actively group was also lower than that in stable group（P<0.05）.The number of AKA,ACPA and Carp positive cases in high mobility group was significantly higher than stable group（P<0.05）,in addition the number of AKA positive cases in middle mobility group was significantly higher than that in stable group（P<0.05）.3.Correlation analysis with the level of 25（OH）D₃ in the degree of rheumatoid disease:Compared with the other two groups,the deficiency group cases were older and longer duration of disease（P<0.05）;compared with the normal group,the deficiency group had more joint swelling and higher DAS28 score（P<0.05）;the insufficient group had older,longer course of disease,and more joint tenderness compared with normal group（P<0.05）.The level of 25（OH）D₃ was negatively correlated with the course of disease and the number of joint swelling（r values were-0.71 and-0.62,respectively,P<0.05）.4.Correlation between the level of serum 25（OH）D₃ and other experimental indexes:The level of ESR,CRP,RF,Anti-CCP,MMP-3 were detected differences between the three groups（P<0.05）.The levels of ESR,RF,CRP,Anti-CCP and MMP-3 in deficiency group were higher than that in normal group（P<0.05）,and ESR in deficiency group was higher than that in insufficient group（P<0.05）.25（OH）D₃ levels were negatively correlated with Anti-CCP,AKA,Carp and MMP-3（r values were-0.68,-0.63,-0.52,-0.54,respectively;P<0.05）.ConclusionThe decrease of 25（OH）D₃ level and increasing of MMP-3 concentration may trigger the occurrence and aggravation the autoimmune reaction of RA.The determination of serum levels of 25（OH）D₃ and MMP-3 has an auxiliary evaculation value for the disease activity of RA patients.