The Relationship Between Serum Angiogenic Factor Levels and Disease Activity in Rheumatoid Arthritis

Abstract

Objectives: This study aims to evaluate the relationship between serum angiogenic factor levels and disease activity in patients with rheumatoid arthritis (RA) using both clinical and dynamic wrist magnetic resonance imaging (MRI) data. Patients and methods: Simultaneous serum angiogenesis markers [vascular endothelial growth factor (VEGF), angiopoietin-1 (ANG1), ANG2, and tyrosine-protein kinase receptor for angiopoietin (Tie-2)] were studied in 40 patients with RA (13 males, 27 females; mean age 51.1±10.8 years; range, 23 to 69 years) and 20 healthy controls (11 males, 9 females; mean age 47.3±12.8 years; range, 29 to 69 years) and dynamic contrast-enhanced wrist MRI was performed in 40 RA patients and seven controls. Rate of early in 55 th second (REE) and Relative enhancement (REt) values were calculated from the signal time curve values obtained from the analysis of images. In clinical assessment, duration of morning stiffness, patient pain assessment [visual analog scale (VAS)], physician and patient global assessments (VAS) were recorded. The number of tender joints and swollen joints were determined. Disease activity score 28 and Ritchie scores were calculated. Health assessment questionnaire was used for functional evaluation. Anti-cyclic citrullinated peptide, rheumatoid factor, erythrocyte sedimentation rate and high sensitive C-reactive protein analyses were performed. Results: Serum VEGF, REE and REt values were significantly higher in RA patients than healthy controls (p=0.002, p=0.00, p=0.00, respectively). There was no significant correlation between serum angiogenesis markers and clinical parameters or REE and REt (p>0.05). VEGF value correlated positively with disease duration (p=0.024). Conclusion: Serum VEGF was higher in RA patients. While its level was associated with disease duration, no significant correlation was found with disease activity. As a diagnostic test, dynamic contrast-enhanced MRI was a valuable method for showing disease activity.

VEGF Profile in Early Undifferentiated Arthritis Cohort

“…These data suggest that VEGF may be one more serological inflammatory marker of autoimmune arthritis activity, and may possibly play a role in the differential diagnosis of early UA. Similar to our results, other studies confirmed no significant association between VEGF levels and DAS 28, HAQ, and VAS, the duration of morning stiffness, or the number of tender joints [83,84]. In this study, we demonstrated that patients who had a higher number of swollen joints (both 66 SJC and 28 SJC) and higher scores of synovitis and PD seen on US had statistically higher VEGF levels.…”

“…A tendency was seen in that anti-CCP positive patients had higher VEGF values compared with negative, but they were not significant. Some authors confirmed a significant correlation between anti-CCP and VEGF [83,84], but there are also studies that detected no significant difference between VEGF levels and anti-CCP-positive and anti-CCP-negative RA patients [84]. These data suggest that VEGF may be one more serological inflammatory marker of autoimmune arthritis activity, and may possibly play a role in the differential diagnosis of early UA.…”

Angiopoietin-2, vascular endothelial growth factor family, and heparin binding endothelial growth factor are associated with subclinical atherosclerosis in rheumatoid arthritis

“…Moreover, the VEGF family has also been linked to inflammation, even in healthy individuals [54] . However, another recent publication did not find any significant correlation between VEGF and disease activity, leading to uncertain conclusions [55] . Nevertheless, our group of patients underwent extensive treatment at the time of inclusion, which may have influenced our results.…”