Background The major angiogenic mediator in Rheumatoid Arthritis (RA) is the vascular endothelial growth factor (VEGF), which correlates with disease activity. High frecuency ultrasonography and power Doppler are sensitive tools for evaluate synovial vascularization.

Objectives To evaluate correlation of DAS28-CRP, VEGF and German ultrasound score of 7 joints (GUS7).

Methods We included 29 RA patients, 8 patients in remission, 3 with mild activity, 14 with moderate activity and 4 with severe activity. Clinical evaluation included DAS28-CRP assessment and serum VEGF levels by ELISA where obtained; 48 hours after the GUS7 was realized with a Esaote MyLab 25 device with a 18 MHz linear transducer in the dominants hand and foot; synovitis grayscale and power Doppler signal (DP) were evaluated in a semiquantitative scale.

Results The trial involved 28 female and 1 male, average age 44 years. The median DAS28-CRP was 3.78, PCR 0.07 mg/L and VEGF 691.17 pg /L. Evaluation by GUS7 median DP was 0 (positive activity in one or more joints in 12 patients) and median overall score was 8. DAS28-CRP positive correlation was found with VEGF 0.441 (p<0.05).

Conclusions Elevations of serum VEGF levels according to RA activity by DAS28-CRP are similar in those reported in previous studies. No statistical significance was found during correlation between VEGF and Power Doppler, unlike those reported by other authors. Although this is the first study that points to the association between VEGF and GUS7, the negative correlation between clinical and ultrasonographic findings in our study may be due to non-controlled factors that influentiates Power Doppler signal.

References

1. Ewa M Paleolog. Angiogenesis in rheumatoid arthritis. Arthritis Res 2002, 4 (suppl 3):S81-S90.

2. Neufeld G, Cohen T, Gengrinovitch S, Poltorak Z: Vascular endothelial growth factor (VEGF) and its receptors. FASEB J 1999, 13:9-22.

3. Ferrara N: Role of vascular endothelial growth factor in regulation of physiological angiogenesis. Am J Physiol Cell Physiol 2001, 280:C1358-1366.

4. Zoltán Szekanecz, Alisa E. Koch. Angiogenesis and its targeting in rheumatoid arthritis. Vascular Pharmacology 51 (2009): 1–7.

5. Brennan, F., Beech, J. Update on cytokines in rheumatoid arthritis. Curr. Opin. Rheumatol. 2007: 19, 296–301.

6. Liu, L.X., Lu, H., Luo, Y., Date, T., Belanger, A.J., Vincent, K.A., Akita, G.Y., Goldberg, M.,Cheng, S.H., Gregory, R.J., Jiang, C. Stabilization of vascular endothelial growth factor mRNA by hypoxia-inducible factor 1. Biochem. Biophys., 2002 Res. Commun. 291, 908–914.

Disclosure of Interest None declared