Background Angiopoetin-2 (ANG-2) is one of the main angiogenesis modulators. As synovial angiogenesis is considered to be an important early step in the course and pathogenesis of juvenile idiopathic arthritis (JIA), it may be a valuable marker of activity of the disease.
Objectives To evaluate ANG-2 serum and synovial fluid levels in JIA patients and its possible correlation with disease activity and the degree of ultrasound-detected synovial angiogenesis.
Methods Serum levels of vascular markers were measured in 63 patients with JIA (aged 1,5–17) and 31 age-matched healthy controls. Synovial fluid was collected from 17 JIA patients. Disease activity (low, medium and high) was assessed by JADAS-27 scale. Ultrasound examination of inflamed joints was performed in each JIA patient and synovial angiogenesis was evaluated by means of Power Doppler ultrasonography (PDUS) and the 4th grade vascularity scale (0–3).
Results ANG-2 serum levels were higher in children with JIA comparing to the healthy controls (5,5±1,2 ng/ml vs. 1.9±1.4 ng/ml). Serum concentration of ANG-2 in JIA children increased with disease activity (1,4±0,9 ng/ml vs. 1,4±1,0 ng/ml vs. 1,8±2,2 ng/ml), whereas Ang-2 levels in the synovial fluid were the highest in the high disease activity (3,4±2,5 ng vs. 12,5±9,5 ng/ml vs. 26,4±9,0 ng/ml, p<0,05). Concentration of ANG-2 in serum correlate with the synovial vascularization obtained by PDUS (0–3, accordingly 1,5±0,8 ng/ml vs. 1,3±0,9 ng/ml vs. 1,5±1,0 ng/ml vs. 13,2±8,7 ng/ml, p<0,01) The same pattern was observed for ANG-2 levels in synovial fluid and PDUS grade (0–3, accordingly 3,8±1,0 ng/ml vs. 5,1±4,1 ng/ml vs. 13,5±2,0 ng/ml, p<0,01).
Conclusions ANG-2 might be a valuable marker in JIA children with high disease activity. Together with ultrasound examination, it may add more information about disease severity, what may be helpful in introducing the correct therapy.
Disclosure of Interest None declared