Zijlstra, J. (Jannik) (2019) (MMP) -3 and -9 are excellent independent biomarkers to distinguish between Polymyalgia Rheumatica (PMR) and Giant Cells Arteritis (GCA). thesis, Medicine.
Full text available on request.Abstract
Introduction- Polymyalgia Rheumatica (PMR) and Giant Cell Arteritis (GCA) frequently overlap. In GCA, asymptomatic aortic involvement often occurs. Hence a discriminating biomarker, detecting vasculitis in PMR and detecting aortic involvement in GCA is highly needed. Matrix Metalloproteinases (MMPs) might be useful as predicting biomarkers. Methods- Treatment-naive patients with PMR (n=35), PMR/GCA (n=10) and GCA (n=33) and 51 healthy controls (HC) were included. Baseline serum samples were analyzed using a Luminex assay for MMP-2, -3, -9 and -12. A comparison of MMP-levels between all groups was performed. Aortic diameters were measured at four predefined levels on Low-Dose Computed Tomography (LDCT). Correlations between aortic diameters and MMP-levels were calculated. Results- Compared to isolated PMR (median 24 ng/ml), levels of MMP-3 were decreased in isolated GCA (11 ng/ml, p=0.0001) and PMR/GCA (9 ng/ml, p=0.001). ROC analyses revealed excellent Area Under the Curve (AUC)-values in PMR versus GCA (0.8095, p<0.0001) and PMR versus PMR/GCA (0.8229, p=0.002). Levels of MMP-9 were increased in isolated GCA (392 ng/ml) compared to isolated PMR (245 ng/ml, p=0.0071). Levels of MMP-2 were not different between all groups. Levels of MMP-12 were undetectable and thus excluded of further analysis. Both serum MMP-2, -3 and -9 did not significantly correlate with any of the aortic diameters, C-Reactive Protein (CRP) or Erythrocyte Sedimentation Rate (ESR). Conclusion- This study revealed that MMP-3 and -9 are excellent, independent biomarkers for classifying PMR, PMR/GCA and GCA. This might aid in developing a stratifying tool for clinicians to distinguish PMR from PMR/GCA and GCA. Further research in an independent validation cohort is needed to validate these data.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Posthumus, M. (Marcel) and Brouwer, L. (Liesbeth) |
| Faculty: | Medical Sciences |
| Date Deposited: | 16 Oct 2020 07:41 |
| Last Modified: | 16 Oct 2020 07:41 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2782 |
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