clinical utility of vascular endothelial growth factor as predictive marker for systemic lupus erythematosus activity in children and adolescents

ABSTRACT

Angiogenesis plays an important role in the pathogenesis and progression of collagen diseases. Vascular endothelial growth factor [VEGF] is a potent stimulating factor for angiogenesis and vascular permeability. To asses for changes of VEGF in lupus patients in childhood and adolescents and its relation to lupus activity and to demonstrate the possible correlation between the serum level of VEGF and certain clinical and laboratory parameters and disease activity score. We investigated the serum concentration of VEGF using an enzyme-linked immunosorbent assay [ELISA] in a group of 35 children and adolescents with systemic lupus erythematosus [SLE] and 25 healthy controls. All cases were recruited from Kasr El Aini Hospital. VEGF was detectable in all patients with SLE, and in all normal individuals. The level of serum VEGF in lupus patients was higher than control, also its level in active SLE was higher than inactive disease or in controls. We found that serum levels of VEGF was significantly higher in patients with renal involvement than those with no renal involvement [p < 0.003]. It was also higher in SLE patients with moderate to sever skin disease neurological and joint involvement compared with patients with no or mild skin disease, no neurological and no joint involvement respectively but the differences were statistically insignificant. A positive correlation was detected between higher VEGF serum levels and ESR and SLAM score [p < 0.01 and < 0.04 respectively], on the other hand VEGF was negatively correlated to platelets count and complement level [C3] [p < 0.05 and < 0.01 respectively]. VEGF serum levels are higher in children and adolescents with SLE patients especially active lupus. Also its level is correlated to many of clinical and laboratory parameter of lupus. So it may be a useful marker of disease activity