"Matrix Metalloproteinases 7 and 9 in Rheumatoid Arthritis Patients With Interstitial Lung Disease"

Aim of the study

* To assess the matrix metalloproteinase 7 and 9 (MMP7,9) as a screening tool for interstitial lung disease in rheumatoid arthritis patients and to assess for correlation with RA-disease activity. * To investigate whether certain MMPs could be potential biomarkers reflecting the lung fibrotic process in RA patients. * To assess the capillaroscopy changes in RA and RA-ILD. * To detect correlation between MMPs and capillaroscopic changes in RA patients. This case control study will be done at Rheumatology Department, Assiut University Hospital. It will include RA patients fulfilling the American College of Rheumatology and European League against Rheumatism (ACR / EULAR) 2010 classification criteria.

The patients will be divided into 3 groups:

Group (1): RA patients with ILD. Group (2): RA patients without ILD Group (3): Healthy controls

All patients will be subjected to:

A- Complete medical history:

Detailed medical history will be taken including demographic data (age, sex, disease duration, morning stiffness, joint involvement, smoking, habits of medical importance), articular and extra articular manifestations. Detailed respiratory manifestations as (dyspnea, cough, chest wheeze, others)

B- Clinical examination:

* General and local rheumatological examination. * Local chest examination (inspection, palpation, percussion, auscultation). * Assessment of RA disease activity using DAS 28 ESR. Score interpretation <2.6 suggests disease remission. 2.6-3.2 suggests low disease activity 3.2-5.1 suggests moderate disease activity >5.1 suggest high disease activity

C- Laboratory investigations:

Peripheral venous blood samples for CBC, C-reactive protein, erythrocyte sedimentation rate, antibody status.

D- Radiology and PFT:

PFTs and HRCT chest patterns will be done for patients.

E- MMP measurement:

Serum samples will be collected at the time of registry enrollment, MMP 7 and 9 concentrations will be measured using enzyme-linked immunosorbent assas.

This ELISA kit uses the Sandwich-ELISA principle.