DETECTION OF SERUM LEVEL CHANGES OF MATRIX METALLOPROTIENASE-13 AND
INTER LEUKIN-1 BETA DURING REMISSION AND FLARE-UPS OF PRIMARY
OSTEOARTHRITIS OF THE KNEES.
Y. ABDEL MOTALEB GAZAR *, H. BASSIOUNI *, K.ZAKI*, A. ALY*
*Rheumatology Dept, Faculty of medicine, AL-AZHAR  university, Egypt.
introduction:
The diagnosis of osteoarthritis is currently based on radiographic criteria (eg , joint space width) and
Clinical symptoms (eg, pain and loss of function).The evaluation of new disease-modifying osteoarthritis
drugs (DMOADs) is performed on the same basis, since the regulatory bodies currently require evidence
for an impact on radiographic joint space narrowing ( JSN) and an impact on symptoms However, the
limitations of radiography have led to research into alternative parameters for monitoring osteoarthritis
that could serve as biomarkers in drug development.
Aim of the work:
Detection the serum level of MMP-13 and IL-1 βIn OA of the knee during remission and exacerbation and if these Biomarkers can be validated as gold biomarkers in assessing OA progression and drug development in OA.
Methods:
This study was performed on 60 patients with knee osteoarthritis,
18 males (30%) and 42 females(70%), all diagnosed as osteoarthritis of one or both knees. Their ages
ranged from ( 40 -65) years. The duration of their disease ranged from one to 15years.
 The control groups were 8 males(32%) and 17 females(68%). their ages ranged from(40-65)years.
 We have excluded :
-Significant conditions of the spine, hips, or feet that affect the ability to walk.
- Significant medical conditions that affect the ability to walk and function.
- Inflammatory arthritis, such as rheumatoid or gouty arthritis 
-Degenerative arthritis secondary to other conditions, such as hemochromatosis, Wilson´s
disease, or ochronosis.
- Current significant soft tissue rheumatism such as fibromyalgia, or trochanteric bursitis.
- significant trauma and surgery (including arthroscopy) or intra-articular corticosteroid injection
to the index knee within 6 months of enrollment.
 The patients were allowed to continue on the medications that they have proinflammatory cytokines (IL-1β) and degradative enzymes (MMP-13) are measured Asssesing the flare-ups using Knee Osteoarthritis Flare Ups Score (KOFUS)
- Results
Patients who had 3 flare-ups showed the statistically significantly highest mean IL-1β & MMP13 level.
There was no statistically significant difference between patients with no flare-up, 1 flare-up and 2 flare ups; all of them showed statistically significantly lower mean levels. 
Control group showed the statistically significantly lowest mean IL-1β level.
 There was a statistically significant positive (direct) correlation between IL-1β, disease duration, KL, VAS, stiffness score, pain score, functional score, WOMAC and KOFUS.
 An increase in all these variables is associated with an increase in IL-1β & MMP13.
- Conclusion:
*There is a potential role for IL-1β and MMP 13 biomarkers in assessing the development in
osteoarthritis.
* IL-1β  and MMP 13 were founded to be correlated positively in patients with knee OA this
correlation sounded right as the expression of MMP 13 depends on the level of IL-1β.
*Although all medications groups failed to lower the level of IL-1β and MMP 13, yet there was a numerical difference in favor of Diacerine and NSAID .
*Patients on both diacerine and NSAID had the lowest rate of flare ups
*It is recommended that the early measurement of biomarkers may detect cases to progress and thus aggressive lines of  treatment may be given for these groups.

DETECTION OF SERUM LEVEL CHANGES OF MATRIX METALLOPROTIENASE-13 AND INTER LEUKIN-1 BETA DURING REMISSION AND FLARE-UPS OF PRIMARY OSTEOARTHRITIS OF THE KNEES