Possible role of serum levels of vascular endothelial growth factor and endostatin in rheumatoid arthritis angiogenesis imbalance

To measure serum levels of the main angiogenic inducer marker [VEGF] and the main angiogenic inhibitor marker [endostatin] in rheumatoid arthritis patients. Also, to study their correlation to clinical and laboratory variables of the disease in an attempt to provide more insight regarding their possible role in the angiogenesis imbalance and pathogenesis of RA. Twenty RA patients and fifteen age and sex matched healthy persons served as a control group underwent full history taking, thorough clinical examination, and routine rheumatological profile. Measurement of serum VEGF and endostatin levels were done using enzyme linked immunosorbent assay [ELISA] in rheumatoid arthritis patients and compared with controls. Comparison between patients with or without systemic involvement regarding serum level of VEGF was done. Correlations between serum levels of VEGF and signs of disease activity were also done. A highly significant increase in the mean values of serum VEGF was found in RA patients compared to control subjects [t=11.83, p<0.00l], while there was no statistically significant difference between both RA and control groups regarding mean values of endostatin [t=0.06, p>0.05]. In addition a highly significant increase in the mean values of serum VEGF was found in RA Patients with extra-articular manifestation [EAM] compared to Patients without EAM [t=2.98, p<0.0l]. Serum VEGF was positively correlated with ESR, DAS, and CRP [r =8.48, p<0.01; r = 0.542, p< 0.5; and r = 0.49, p< 0.5] respectively. We found an imbalance between the production of angiogenic growth factors and angiogenic inhibitors in RA. This may play an important role in the angiogenesis imbalance and pathogenesis of RA. In addition we conclude that VEGF level is related to disease activity and extra-articular manifestation of RA, so it can be considered a good indicator for evaluation of disease activity, systemic organ involvement and planning treatment strategies

Clinical significance of vascular endothelial growth factor [VEGF] in sera of patients with pediatric malignancies

Angiogenesis is essential for solid tumor growth. It is induced by tumor cells through stimulatory angiogenic peptides, one such peptide is vascular endothelial growth factor [VEGF]. The ultimate aim of the work is to investigate the possible role of VEGF as an early biomolecule involved in the progression of pediatric malignant tumors with high metastatic potential. Forty-five pediatric patients were studied. They included four groups with malignant solid tumors suffering from Ewing's sarcoma, osteosarcoma, neuroblastoma and rhabdomyosarcoma. In addition, a healthy control group including fifteen age and sex matched children was included in the study. Serum VEGF levels were determined by ELISA technique. The level of VEGF was significantly higher in all types of solid tumors compared to normal healthy children. The mean values obtained for patients and controls were 429.44 +/- 258.55 pg/ml and 79.36 +/- 63.81 pg/ml, respectively. No significant difference was detected in the level of VEGF among males and females. Also, no statistically significant difference was detected among the different types of malignant tumors. However, a marked significant difference was elucidated between metastatic and non-metastatic cancer patients, the values recorded were 753.33 +/- 173.64 pg/ml and 267.5 +/- 75.54 pg/ml, respectively [p <0.001]. Furthermore, the results showed that 207 pg/ml of serum level of VEGF is the optimal cutoff value [mean +/- 2 SD of control] with sensitivity of 87% and specificity of 100%. Using the receiver operating characteristic [ROC] curve analysis, the area under the curve [0.917] indicated the validity of using serum VEGF level in the diagnosis of all different types of pediatric malignant solid tumors with high potentiality to metastasis. VEGF is an angiogenic stimulatory peptide. Its serum level colud be a reliable marker in assessing pediatric malignancies with high metastatic potentials