The possibilities of objectification of inflammatory-destructive process in psoriatic arthritis
Summary. The level of laboratory markers of connective tissue destruction and the effect of leflunomide (LF) as monotherapy and in combination of basic therapy (CBT) on the degradation of connective tissue in patients with psoriatic arthritis (PsA) were studied in 60 patients with PsA and 30 patients with osteoarthritis (OA). In patients with PsA levels of connective tissue destruction marker matrix metalloproteinase-3 (MMP-3) are two times higher in comparison to OA patients, indicating that this enzyme is involved in connective tissue inflammation and degradation in patients with PsA. Under the influence of LF after 12 weeks serum levels of MMP-3 and pyridinoline were significantly reduced respectively 19.8% and 8.7%, indicating a decrease in inflammatory-destructive process activity in the connective tissue and the bone destruction intensity in PsA. Reliable changes in MMP-3 simultaneously with the change of activity total index of the joints and skin lesions occurred only in the group of respondents according to PsARC and the general cohort of patients with PsA, but changes in the C-reactive protein (CRP) level were likely in the group «non-respondents». The MMP-3 level was the only laboratory parameters the which dynamics significantly correlated with the of articular status dynamics (number of swollen joints and morning stiffness). These results suggest the possibility of using MMP-3 to determine the treatment efficiency in PsA patients.
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