Does vascular endothelial growth factor in the rheumatoid synovium predict joint destruction? A clinical, radiological, and pathological study in 12 patients monitored for 10 years.
OBJECTIVE
Synovial angiogenesis is at the epicenter of rheumatoid pannus development and is largely dependent on vascular endothelial growth factor (VEGF). We sought to determine whether the VEGF level in rheumatoid synovial tissue is a marker for disease severity.


METHODS
Twelve patients with rheumatoid arthritis (RA) underwent a clinical and radiological evaluation at the time of a synovial biopsy done during joint surgery required by RA progression (T1) and, on average, 10 years later (T2). Immunohistochemistry was used to detect and quantitate VEGF in the synovial biopsy taken at T1.


RESULTS
VEGF labeling was seen on endothelial cells and macrophages in all 12 synovial biopsies. The amount of endothelial-cell VEGF labeling (assessed semi-quantitatively) was significantly correlated with Larsen score progression during the 10-year follow-up. The amounts of endothelial cell or macrophage VEGF labeling was not correlated with the joint count, radiological stage of the biopsied joint or progression of this stage, Larsen scores at T1 or T2, presence of rheumatoid factor, or presence of extra-articular manifestations.


CONCLUSIONS
Our results suggest that the amount of VEGF in the rheumatoid synovium may be a marker for joint destruction in patients with RA.
Latour
F
F
Rheumatology Clinic, CHU Purpan, Toulouse, France.
Zabraniecki
L
L
Dromer
C
C
Brouchet
A
A
Durroux
R
R
Fournié
B
B
D000293:Adolescent; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D001175:Arthrography; D015415:Biomarkers / Q000032:analysis; D002467:Cell Nucleus / Q000378:metabolism / Q000473:pathology; D016228:Endothelial Growth Factors / Q000378:metabolism*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007596:Joints / Q000378:metabolism* / Q000473:pathology; D008222:Lymphokines / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000378:metabolism* / Q000473:pathology; D020033:Protein Isoforms / Q000378:metabolism*; D012189:Retrospective Studies; D013583:Synovial Membrane / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D015415:Biomarkers; D016228:Endothelial Growth Factors; D008222:Lymphokines; D020033:Protein Isoforms; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors