Early and accurate diagnosis of systemic sclerosis-related interstitial lung disease: matrix metalloproteinases and their inhibitors as promising biomarkers

<bold>Background:</bold> Interstitial lung disease (ILD) is the main causes of death in systemic sclerosis (SSc) patients [1]. The fibrosis development in SSc is accompanied by a dysbalanced tissue remodeling process controlled by matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs)[2]. <bold>Objective:</bold> To explore MMPs and TIMPs as potential lung fibrosis biomarkers in SSc. <bold>Methods:</bold>39 SSc-ILD⁺, 20 SSc-ILD⁻, 63 other AD-ILD⁺, and 39 idiopathic pulmonary fibrosis (IPF) patients were included. MMP-1, MMP-2, MMP-3, MMP-7, MMP-9, MMP-10, MMP-12, TIMP-1, and TIMP-2 serum levels were measured by a chemiluminescent enzyme immunoassay. <bold>Results:</bold> SSc-ILD⁺ patients displayed increased levels of MMP-2, MMP-7, MMP-3, MMP-10 and MMP-12 in relation to SSc-ILD⁻ patients (p=0.0310, p=0.0003, p<0.0001, p=0.0039, p=0.0011; respectively). Higher serum levels of MMP-1, MMP-2 and MMP-3 were found in SSc-ILD⁺ patients compared to those with other AD-ILD⁺ (p=0.0009, p=0.0334, p=0.0108; respectively). Regarding MMP-3, SSc-ILD⁺ patients exhibited lower levels than those with other AD-ILD⁺ (p=0.0005). The MMP-7, MMP-10 and MMP-12 levels were decreased in SSc-ILD⁺ patients concerning those with IPF (p=0.0189, p=0.0071, p=0.0459; respectively). About MMP-1, patients with SSc-ILD⁺ showed elevated levels compared with IPF patients (p=0.0250). No differences in TIMP-1 and TIMP-2 levels were found between SSc-ILD⁺ patients and the comparative groups. <bold>Conclusion:</bold> MMPs play a role in the remodeling of lung tissue in SSc-ILD⁺, constituting promising biomarkers of the disease. <bold>References:</bold>[1]Am J Respir Crit Care Med.2020;201(6):650-660;[2]Ann Rheum Dis. 2012;71(6):1064-72