Background Tumor necrosis factor α (TNFα) inhibitors in juvenile idiopathic arthritis (JIA) decrease synoviocyte proliferation and block a cascade of secondary mediators which play a part in the recruitment of inflammatory cells. By directly affecting endothelial cells and by inhibiting the production of proangiogenetic factors it suppress angiogenesis and reduces vascularization of inflamed joints.
Objectives To compare the neovascularization process by investigating serum angiogenesis markers (VEGF, sVEGF-R1, sVEGF-R2, ANG-1, ANG-2) in children with JIA receiving no treatment (new-diagnosed) and treated with TNFα inhibitors.
Methods Forty three patients with new-diagnosed active JIA and eleven JIA patients treated with TNFα inhibitors (etanercept or adalimumab) plus methotrexate were studied. Serum levels of vascular markers were measured in each patient serum sample with a standard quantitative sandwich ELISA method and compared.
Results Levels of all of the studied serum vascular markers were lower in TNFα inhibitors-treated JIA patients than in new-diagnosed. The significant difference was observed in VEGF-R1 levels (0,07±0,02ng/ml vs. 0,1±0,03ng/ml; p<0,05) and VEGF-R2 levels (7,94±1,56ng/ml vs. 15,92±7,09ng/ml; p<0,001).
Conclusions The study shows the important influence of TNFα inhibitors on angiogenesis in rheumatoid process. The blockade of VEGF receptors and VEGF activity might be of therapeutic benefit in JIA.
Disclosure of Interest None declared
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