Abstract

BackgroundSynovial angiogenesis is a component of rheumatoid pannus and considered to be an important early step in the pathogenesis of rheumatoid arthritis (RA).ObjectivesThe aim of this study was to evaluate the serum levels of angiopoietin-1 (Ang1), angiopoietin-2 (Ang2), as well as the significance of the Ang2/Ang1 ratio in RA in relation to the joints’ blood flow signals and RA activity parameters. In addition, we studied their relevance in predicting the state of angiogenesis.Patients and methodsThis study was carried out on 65 consecutive very early RA patients. Power Doppler ultrasonography was performed in a total of 10 joints. The blood flow signals of each joint were scored on a three-grade scaling system. The total of the scores of the 10 joints was defined as the total signal score (TSS). On the same day, serum variables including vascular endothelial growth factor (VEGF), Ang1 and Ang2 levels, and clinical disease activity were evaluated. All the parameters measured were reassessed after 1 month.ResultsSerum VEGF, Ang2 levels, and Ang2/Ang1 ratio were significantly correlated with C-reactive protein, DAS28-CRP, and TSS at baseline and after 1 month. Moreover, significant correlations were observed between serum VEGF and Ang2 levels and Ang2/Ang1 ratio both at baseline and 1 month later. Interestingly, baseline serum VEGF level and Ang2/Ang1 ratio were significantly correlated with TSS after 1 month.ConclusionSerum concentrations of VEGF and Ang2 as well as Ang2/Ang1 ratio were correlated with parameters of inflammation in early RA. Elevated serum VEGF and Ang2/Ang1 ratio (in favor of Ang2) could reflect a phase of vigorous angiogenesis.

Highlights

  • The inflammatory process in rheumatoid arthritis (RA) is characterized by excessive, tumor-like proliferation of synoviocytes, which is associated with an increase in the vasculature needed to support metabolic requirements

  • Serum vascular endothelial growth factor (VEGF) concentrations were significantly higher in patients with early RA than in the controls

  • Kurosaka et al [14] found that serum Ang2 levels are correlated with serum C-reactive protein (CRP) but not with DAS28CRP; they reported a relationship between serum VEGF and Ang2 levels, but not Ang1, with synovial blood flow signals

Read more

Summary

Introduction

The inflammatory process in rheumatoid arthritis (RA) is characterized by excessive, tumor-like proliferation of synoviocytes, which is associated with an increase in the vasculature needed to support metabolic requirements. Neovascularization is a complex process in which new blood vessels develop from the existing microvascular bed; it involves endothelial cell division, selective degradation of vascular basement membranes and the surrounding extracellular matrix, and endothelial cell migration [1]. This process is driven by a combination of upregulation of angiogenesis promoters and downregulation of inhibitors [2]. By inhibiting Tie-2 signaling, Ang leads to a loosening of cell matrix and cell–cell interactions [5,6,7] This antagonistic effect is considered to be a requirement for the sensitivity of endothelial cells to other angiogenic factors such as VEGF. Baseline serum VEGF level and Ang2/Ang ratio were significantly correlated with TSS after 1 month

Objectives
Methods
Results
Discussion
Conclusion

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.