PT  - JOURNAL ARTICLE
AU  - Jörg H W Distler
AU  - Tobias Strapatsas
AU  - Dörte Huscher
AU  - Clara Dees
AU  - Alfiya Akhmetshina
AU  - Hans P Kiener
AU  - Ingo H Tarner
AU  - Britta Maurer
AU  - Marcel Walder
AU  - Beat Michel
AU  - Steffen Gay
AU  - Josef S Smolen
AU  - Ulf Müller-Ladner
AU  - Georg Schett
AU  - Oliver Distler
TI  - Dysbalance of angiogenic and angiostatic mediators in patients with mixed connective tissue disease
AID  - 10.1136/ard.2010.140657
DP  - 2011 Jul 01
TA  - Annals of the Rheumatic Diseases
PG  - 1197--1202
VI  - 70
IP  - 7
4099  - http://ard.bmj.com/content/70/7/1197.short
4100  - http://ard.bmj.com/content/70/7/1197.full
SO  - Ann Rheum Dis2011 Jul 01; 70
AB  - Objective Vascular disease is common in mixed connective tissue disease (MCTD). The aim of the present study was to investigate, whether dysbalance of angiogenic and angiostatic factors occurs in MCTD. Methods In all, 38 patients with MCTD, and 40 patients with systemic sclerosis (SSc) for comparison, were included. Four centres contributed to this cross-sectional analysis. A total of 66 healthy volunteers were used as controls. The serum levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and endostatin were determined by ELISA. For comparisons between controls and patients with MCTD and detection of associations of serum levels with dichotomous clinical parameters in patients with MCTD the Mann–Whitney test was used. Results Serum levels of the angiogenic factor VEGF were significantly elevated in patients with MCTD and SSc. Significantly increased levels of the angiostatic factor endostatin were also detected in MCTD, but not in SSc. No differences were observed for bFGF. Levels of VEGF were higher in patients with MCTD with pulmonary arterial hypertension (PAH), acrosclerosis and myositis. In multivariate linear regression analysis, an additive model of PAH, myositis and lymphadenopathy accounted for 79% of the variability of the VEGF levels (r=0.889). Conclusions Molecular factors modulating angiogenic responses are dysregulated in patients with MCTD and SSc with increases of VEGF in MCTD and SSc and selective upregulation of endostatin in MCTD. Furthermore, high serum levels of VEGF might characterise patients with MCTD with a more severe course of the disease with increased prevalence of PAH and myositis.