Plasma Matrix Metalloproteinase Concentrations and Risk of Interstitial Lung Disease in a Prospective Rheumatoid Arthritis Cohort

Arthritis Rheumatol. 2024 Jul;76(7):1013-1022. doi: 10.1002/art.42812. Epub 2024 Feb 15.

Abstract

Objective: To evaluate the associations of plasma matrix metalloproteinases (MMPs) with prevalent and incident interstitial lung disease (ILD) in people with rheumatoid arthritis (RA).

Methods: Within a multicenter, prospective cohort of US veterans with RA, we performed a cross-sectional study of prevalent ILD and cohort study of incident ILD. ILD diagnoses were validated by medical record review of provider diagnoses and chest imaging and/or pathology reports. MMP-1, 3, 7, and 9 concentrations were measured in plasma samples, then standardized and categorized into quartiles. The associations of MMPs with prevalent and incident ILD were assessed with logistic (prevalent) and Cox (incident) regression models adjusted for RA-ILD risk factors.

Results: Among 2,312 participants (88.9% male; mean age 63.8 years), 96 had prevalent ILD. Incident ILD developed in 130 participants over 17,378 person-years of follow-up (crude incidence rate 7.5/1,000 person-years). Participants with the highest quartile of MMP-7 concentrations had a nearly four-fold increased odds of prevalent ILD (adjusted odds ratio 3.78 [95% confidence interval (95% CI) 1.86-7.65]) and over two-fold increased risk of incident ILD (adjusted hazard ratio 2.33 [95% CI 1.35-4.02]). Higher MMP-9 concentrations were also associated with prevalent and incident ILD, as well as negatively correlated with forced vital capacity among those with prevalent ILD (r = -0.30, P = 0.005).

Conclusion: MMP-7 and MMP-9 were strongly associated with both prevalent and incident ILD in this large, multicenter RA cohort after adjustment for other RA-ILD risk factors. These population-level findings further support a potential pathogenic role for MMPs in RA-ILD and suggest that their measurement could facilitate RA-ILD risk stratification.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Arthritis, Rheumatoid* / blood
  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / epidemiology
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Incidence
  • Lung Diseases, Interstitial* / blood
  • Lung Diseases, Interstitial* / epidemiology
  • Male
  • Matrix Metalloproteinase 1 / blood
  • Matrix Metalloproteinase 3 / blood
  • Matrix Metalloproteinase 7* / blood
  • Matrix Metalloproteinase 9 / blood
  • Matrix Metalloproteinases / blood
  • Middle Aged
  • Prevalence
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • United States / epidemiology

Substances

  • Matrix Metalloproteinase 7
  • MMP7 protein, human
  • Matrix Metalloproteinase 1
  • Matrix Metalloproteinase 9
  • Matrix Metalloproteinase 3
  • MMP3 protein, human
  • MMP1 protein, human
  • MMP9 protein, human
  • Matrix Metalloproteinases