Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Angiogenic Factors in Early Inflammatory Arthritis.
Mancarella1, Luana, Addimanda1, Olga, Pulsatelli1, Lia, Dolzani1, Paolo, Assirelli1, Elisa, Brusi1, Veronica, Galletti1, Stefano
Angiogenesis is an important event in rheumatoid synovitis, with an increase in immature and destabilized vessels. Fibroblast growth factor-2 (FGF2) and vascular endothelial growth factor (VEGF) play a major role in angiogenesis. PTX3 (long pentraxin-3) is an acute phase glycoprotein produced by several cell types in response to primary inflammatory signals (e.g. Toll-like receptor, TNF, IL-1 but not IL-6). It interacts directly with FGF2 and inhibits its angiogenic activity (1). PTX3 systemic levels have been shown to be elevated in patients with some vascular and inflammatory disorders and seem to correlate with clinical outcome and disease activity (2). The aim of our study was to evaluate the serum concentrations of some angiogenic factors and other biomarkers in patients with early inflammatory arthritis (IA) and their possible relationship with disease activity and ultrasound (US) features.
We analyzed 37 patients with early inflammatory arthritis (IA) with at least one swollen joint and who had had symptoms for less than one year (except for 4 patients who had had symptoms for more than one year); we compared this group with 24 age- and sex-matched healthy controls (HC). VEGF, vascular cell adhesion molecule-1 (VCAM-1), FGF2, IL-6, and soluble IL-6 receptor and PTX3 levels in peripheral blood samples were determined by ELISA. Demographic (gender, age), clinical (disease duration, tender and swollen joints count, Health Assessment Questionnaire score, 100 mm visual analogue scales for pain and global health status), laboratory (erythrocyte sedimentation rate, C reactive protein, presence or absence of rheumatoid factor and anti-CCP antibodies) data were collected. US scans with 7.515 MHz linear array (to assess synovial thickness, power Doppler signal PDS, and erosions) were carried out and a Disease Activity Score for 28 joints (DAS28) was calculated. Data were analysed using analysis of variance (ANOVA) or the Mann-Whitney U Test (to compare variables not normally distributed). Fisher's exact test was used to compare categorical variables. Pearson's correlation coefficient (r) (for linear relationship), otherwise Spearman's rank correlation (rho) to assess correlations. The level of significance was p<0.05.
A mean age of 57.2 ± 14.5 yrs was found, a disease duration of 32.4 ± 47.7 weeks and a moderate disease activity (DAS28 of 4.8 ± 1.2). 97% of patients had PDS positivity on US examination and 22% had erosive features. VCAM-1 were higher (p=0.002), and PTX3 lower (p<0.0005) in patients compared to HCs. We found a statistically significant positive correlation between VEGF and IL-6 levels and DAS28 (r=0.374, p=0.03 and rho= 0.45, p=0.02, respectively). At 3rd month of follow up, basal FGF levels had a positive trend with DAS28 (p=0.08); patients who continued to show PDS positivity, tended to have higher basal levels of IL-6 and VCAM-1 compared to PDS negative patients (p=0.06 and p=0.07, respectively).
Our preliminary results show increased VCAM-1 and decreased PTX3 (an anti-angiogenic factor) levels in early IA. Angiogenic factors and IL-6 show a positive trend with disease activity and its persistence.
To cite this abstract, please use the following information:
Mancarella, Luana, Addimanda, Olga, Pulsatelli, Lia, Dolzani, Paolo, Assirelli, Elisa, Brusi, Veronica, et al; Angiogenic Factors in Early Inflammatory Arthritis. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :33