Background The level of vascular endothelial growth factor (VEGF) may reflect the intensity of angiogenesis, which is an important step in the initiation and development of chronic rheumatoid arthritis (RA).
Objectives to study features of VEGF level changes in the blood of RA patients, depending on the duration of the disease, the degree of activity, the level of antibodies to cyclic citrullinated peptide (anti-CCP)
Methods 194 patients were examined with a diagnosis of RA (verified according to criteria ACR/EULAR 2010), without concomitant pathology. Among the examined patients with RA women predominated 168 (86.6%), and there were 26 men (13.4%). The age of patients was 22 to 65 years (mean age 47,7±10,22 years), mean duration of the disease was 3,82±3,43 years. Assessment of RA activity was done by DAS 28 index, using blood CRP in the formula. 152 patients were positive for the presence of anti-CCP (≥20 U/ml) (78%) and 42 (22%) - negative. Serum CRP concentrations (Vector-Best, Russia), anti-CCP (Orgentec, Germany), VEGF (BCM Diagnostic, Canada) were determined by ELISA. Statistical processing of the data was performed using non-parametric methods, univariate (ANOVA) variance analysis on a personal computer using a licensed software packages (“Microsoft-Excel” and “Statistica-Stat-Soft”, USA)
Results Analysis of VEGF level changes in the blood depending on the duration of RA revealed that the measure was high in patients with small diseases duration 0–23 months (472.96 (341.1; 582.1) pg/ml) compared with the group 5 years (324.1 (199.2; 556.2) pg/ml) (p<0,04). Analysis of VEGF level in blood depending on the degree of RA activity showed that the VEGF concentration in blood increased with increasing degree of RA activity and it was the greatest - 564.4 (340.1; 758.4) pg/ml in the group with a high degree (DAS28 >5.2) compared to the minimum (DAS28 ≤3,2) - 230,5 (178,1; 385,3) pg/ml, and moderate (DAS28 3,3–5,2) - 356,4 (278 9; 553.1) pg/ml, (p<0,001; p=0,005, respectively). Using ANOVA variance analysis, it was found that the degree of RA activity influenced the VEGF levels in the blood (KW =17,37; p<0,001).
Analysis of the VEGF levels in the blood depending on the level of anti-CCP showed a significant increase in VEGF level (343.35 (190.62; 561.28) pg/ml) in the group of high positive ACCP (>60 U/ml) compared with the group of low positive ACCP (≤60 U/ml) - 470.23 (324.3, 676.85) pg/ml (p=0,005). Using ANOVA variance analysis, it was found that the level of anti-CCP in the blood of studied RA patients influences the VEGF level in blood (KW =7,88; p=0,005)
Conclusions In patients with RA duration <2 years VEGF levels in the blood was 30% higher than in patients with a prolonged course of RA. Concentration of VEGF in the blood increased 2-fold with a high degree of RA activity. Levels of VEGF in the blood were 1.5 times higher in the patients with anti-CCP levels>60 U/ml compared to low positive anti-CCP patients. The high level of VEGF may be a marker of severe clinical course of RA, the high rate of disease progression and the development of early joint destruction
Disclosure of Interest None declared