Vascular endothelial growth factor (VEGF)-A and VEGF-A₁₆₅b are associated with time to remission of granulomatosis with polyangiitis in a nationwide Japanese prospective cohort study

Abstract

Background: Effective prognostic markers are needed for anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). This study evaluated the clinical associations of serum vascular endothelial growth factor-A (sVEGF-A) and sVEGF-A<sub>165</sub>b (an anti-angiogenic isoform of VEGF-A) levels with time to remission of AAV in a nationwide Japanese prospective follow-up cohort. Methods: We collected samples from patients with AAV who were enrolled in the nationwide Japanese cohort study (RemIT-JAV-RPGN). We measured sVEGF-A and sVEGF-A<sub>165</sub>b levels using enzyme-linked immunosorbent assays in 57 serum samples collected 6 months before and after initiation of AAV treatment. Patients were classified based on AAV disease subtypes: microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis (EGPA). Results: Results revealed significant reductions in sVEGF-A and sVEGF-A<sub>165</sub>b levels in patients with MPA and EGPA, respectively. However, despite the comparable levels of sVEGF-A and sVEGF-A<sub>165</sub>b during the 6 months of treatment in GPA patients, correlation analysis revealed that the differences in log2-transformed levels of sVEGF-A and sVEGF-A<sub>165</sub>b were negatively correlated with time to remission in GPA patients. Conclusion: These results suggest that sVEGF-A and sVEGF-A<sub>165</sub>b can serve as potential markers of time to remission in patients with GPA.