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

ABSTRACT

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