ORIGINAL ARTICLEDoes vascular endothelial growth factor in the rheumatoid synovium predict joint destruction? A clinical, radiological, and pathological study in 12 patients monitored for 10 years
Section snippets
Study design
We retrospectively reviewed clinical, radiological, and pathological data from 12 RA patients from whom synovial membrane biopsies had been harvested during surgery for rheumatoid joint lesions (at time-point T1). These biopsies were preserved. A technique for detecting intrasynovial VEGF became available about 10 years later. This technique was used to examine the biopsies (time-point T2).
Patients
All 12 patients met American College of Rheumatology criteria for RA. There were ten women and two men,
Results
Table I reports all findings at T1 and T2.
The joint count and radiological score increased from T1 to T2 in all patients. Mean increases were 8 for the joint count and 48.2 for the Larsen score (see table I). All synovial biopsies (collected at T1) showed florid, active synovitis typical of progressive RA (figure 1). VEGF labeling of macrophages and endothelial cells was a consistent finding (figure 3 and 4). All specimens in the ‘diffuse macrophage labeling’ category showed strong endothelial
Discussion
VEGF (or vascular permeability factor, VPF) is a pro-angiogenic factor that has been studied in many angiogenesis-dependent conditions. VEGF is produced by various cell types including macrophages, mastocytes, fibroblasts, keratinocytes, and smooth muscle cells. Neutrophils contain VEGF stores available for immediate release 〚5〛. Endothelial cells do not produce VEGF but carry receptors for VEGF. VEGF production is increased by hypoxia and by certain cytokines, including angiogenesis growth
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