title: Soluble adhesion molecules (ICAM-1, VCAM-1, and E-selectin) and vascular endothelial growth factor (VEGF) in patients with distinct variants of rheumatoid synovitis.
abstract: BACKGROUND
  Cell adhesion molecules and endothelial growth factors have an important role in the infiltrating of rheumatoid synovium with mononuclear cells, leading to the initiation and progression of the disease.
  
  
  OBJECTIVE
  To investigate whether the serum profile of soluble adhesion molecules and of vascular endothelial growth factor (VEGF) is associated with the histological appearance of rheumatoid arthritis (RA).
  
  
  METHODS
  Serum levels of soluble intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), E-selectin (sE-selectin), and VEGF were assessed by enzyme linked immunosorbent assay (ELISA) in 40 patients with RA and 32 patients with osteoarthritis (OA).
  
  
  RESULTS
  Histological analysis of synovium specimens distinguished two types of rheumatoid synovitis. Twenty four RA samples presented diffuse infiltrates of mononuclear cells without any further microanatomical organisation, whereas in the remaining 16 samples lymphocytic follicles with germinal centre-like structures were identified. In comparison with patients with OA, constituting a control group, higher serum concentrations of sICAM-1 (p<0.001), sVCAM-1 (p<0.001), sE-selectin (p<0.01), and VEGF (p<0.001) were detected in patients with RA. Raised concentrations of sICAM-1, sVCAM-1, and VEGF dominated in the serum of patients with RA with follicular synovitis compared with those with diffuse synovitis (p<0.01 for all comparisons). The serum concentrations of sICAM-1, sVCAM-1, and VEGF correlated with markers of disease activity such as the erythrocyte sedimentation rate and C reactive protein levels. Furthermore, the clinical data analysed in our study indicated that patients with RA with follicular synovitis tend to have more severe disease.
  
  
  CONCLUSIONS
  The distinct histological appearances of rheumatoid synovitis associated with different serum profiles of sICAM-1, sVCAM-1, and VEGF reflect varied clinical activity of the disease and confirm RA heterogeneity. Patients with different histological forms of synovitis may respond differently to the treatment regimens.
authors.affiliation: Department of Rheumatology and Internal Diseases, Medical Academy of Bialystok, Bialystok, Poland. klimp@amb.edu.pl
authors.forename: P A
authors.initials: PA
authors.lastname: Klimiuk
authors.forename: S
authors.initials: S
authors.lastname: Sierakowski
authors.forename: R
authors.initials: R
authors.lastname: Latosiewicz
authors.forename: J P
authors.initials: JP
authors.lastname: Cylwik
authors.forename: B
authors.initials: B
authors.lastname: Cylwik
authors.forename: J
authors.initials: J
authors.lastname: Skowronski
authors.forename: J
authors.initials: J
authors.lastname: Chwiecko
mesh_terms: D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000473:pathology; D015815:Cell Adhesion Molecules / Q000097:blood*; D019040:E-Selectin / Q000097:blood; D016228:Endothelial Growth Factors / Q000097:blood*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008222:Lymphokines / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000097:blood; D013583:Synovial Membrane / Q000473:pathology; D013585:Synovitis / Q000097:blood* / Q000473:pathology; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
chemical_list: D015815:Cell Adhesion Molecules; D019040:E-Selectin; D016228:Endothelial Growth Factors; D008222:Lymphokines; D019010:Vascular Cell Adhesion Molecule-1; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D018799:Intercellular Adhesion Molecule-1