Circulating matrix metalloproteinase profile in early-stage primary biliary cholangitis

Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease with progressive bile duct injury, inflammation, and fibrosis. Matrix metalloproteinases (MMPs) contribute to extracellular matrix remodeling but their circulating profile and clinical relevance in early-stage PBC remain incompletely defined. We characterized circulating MMPs in early-stage PBC and related them to non-invasive fibrosis and portal hemodynamics. Forty-six patients with early-stage PBC and 31 healthy controls were studied. Plasma MMP-2, -3, -7, -9, -10, and -26 were quantified by ELISA; liver stiffness was measured by point shear-wave elastography and portal flow indices by Doppler ultrasound. Compared with controls, PBC patients showed higher MMP-7 ( p < 0.0001), MMP-2 ( p = 0.0007), and MMP-10 ( p = 0.046). MMP-7 correlated with liver stiffness ( R = 0.68, p < 0.001) and demonstrated the highest discriminatory performance for significant fibrosis defined as LSM > 5.56 kPa (AUC = 0.800, p < 0.001). In exploratory regression analyses, higher MMP-7 concentrations remained associated with significant fibrosis after adjustment for age, whereas APRI and FIB-4 did not show significant discriminatory performance in ROC analysis. Early-stage PBC is therefore associated with a distinct plasma MMP profile, and MMP-7 may serve as a practical biomarker of fibrogenesis, supporting its use for monitoring disease progression.