Background Synovial angiogenesis, defined as a complex process of developing new blood vessels from the existing microvascular bed, is considered to be an important early step in the course and pathogenesis of juvenile idiopathic arthritis (JIA).
Objectives To investigate the involvement of angiogenesis markers (VEGF, sVEGF-R1, sVEGF-R2, angiopoetin-1, angiopoetin-2) in early juvenile idiopathic arthritis and its possible relevance to disease activity and the degree of ultrasound-detected synovial inflammation and angiogenesis.
Methods Serum levels of vascular markers were measured in 17 patients with juvenile idiopathic arthritis (aged 1,5-17) and 19 age-matched healthy controls. Ultrasound examination of inflamed joints was performed in each JIA patient and synovial angiogenesis was assessed by means of Power Doppler ultrasonography (PDUS) and the 4th grade vascularity scale.
Results VEGF serum levels were significantly higher in JIA patients than in healthy controls (0,42±0,39 ng/ml vs 0,20±0,16 ng/ml; p<0,05). The same sequence was observed for sVEGF-R1 and sVEGF-R2. Large variation of angiopoetin-1 and -2 levels in serum was observed in JIA patients and healthy controls. PDUS examination evaluated increased synovial microvascular blood flow in 16 of 17 patients (94%)
Conclusions This pilot study has shown the high correlation between PDUS synovial microvascular blood flow, serum angiogenesis markers and clinical synovitis in JIA patients. It may indicate important role of synovial angiogenesis in pathogenetic mechanism of JIA.
Clavel G, Bessis N, Lemeiter D, et al. Angiogenesis markers (VEGF, soluble receptor of VEGF and angiopoietin-1) in very early arthritis and their association with inflammation and joint destruction, Clin Immunol. 2007 Aug;124(2):158-64
Spârchez M, Fodor D, Miu N. The role of Power Doppler ultrasonography in comparison with biological markers in the evaluation of disease activity in Juvenile Idiopathic Arthritis, Med Ultrason. 2010 Jun;12(2):97-103
Taylor PC. Serum vascular markers and vascular imaging in assessment of rheumatoid arthritis disease activity and response to therapy, Rheumatology. 2005 Jun;44(6):721-8
Salvador G, Sanmartí R, Gil-Torregrosa B, et al. Synovial vascular patterns and angiogenic factors expression in synovial tissue and serum of patients with rheumatoid arthritis, Rheumatology (Oxford). 2006 Aug;45(8):966-71
Strunk J, Heinemann E, Neeck G, et al. A new approach to studying angiogenesis in rheumatoid arthritis by means of power Doppler ultrasonography and measurement of serum vascular endothelial growth factor, Rheumatology 2004 September;43(12):1480-83
Ohrndorf S, Backhaus M. Advances in sonographic scoring of rheumatoid arthritis, Ann Rheum Dis. 2013 Apr;72 Suppl 2:ii69-75
Disclosure of Interest None declared