Disease-associated increased HIF-1, alphavbeta3 integrin, and Flt-1 do not suffice to compensate the damage-inducing loss of blood vessels in inflammatory myopathies.
OBJECTIVE
To analyze the microvascular network in skeletal muscle biopsies from patients with dermatomyositis (DM) and systemic sclerosis (SSc) compared to polymyositis (PM) and systemic lupus erythematosus (SLE), and non-inflammatory myopathies, and to clarify whether reparative angiogenesis-related factors are expressed in parallel to blood vessel damage.


METHODS
Immunohistochemical staining of muscle biopsies (10 DM, 10 SSc, 10 PM, 10 SLE, and 10 non-inflammatory myopathies) with antibodies against von Willebrand factor (vWF), hypoxia-inducible factor-1beta (HIF-1beta), beta3 integrin subunit, and vascular endothelial growth factor receptor-1 (VEGFR-1). The TechMate staining robot and biotin-streptavidin protocol were used.


RESULTS
DM and SSc muscles were characterized by endothelial damage and reduction of blood vessel network. Expression of angiogenesis-related factors (HIF-1beta, beta3, VEGFR-1) was also found in the same biopsies. In contrast, in PM and SLE muscles, vascular networks were apparently not affected and angiogenic stimuli were less expressed if at all.


CONCLUSIONS
This work demonstrates that in inflamed muscles hypoxia/ischemia induces increased expression of angiogenic factors, yet their impact is insufficient to repair disease-associated reduction of the capillary network. This leads to questions considering the usefulness of angiogenic factors in the treatment of ischemic inflammatory myopathies in DM and SSc.
D015415:Biomarkers / Q000032:analysis; D001707:Biopsy, Needle; D016022:Case-Control Studies; D004268:DNA-Binding Proteins / Q000378:metabolism*; D003882:Dermatomyositis / Q000473:pathology; D005260:Female; D006801:Humans; D051793:Hypoxia-Inducible Factor 1; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D007150:Immunohistochemistry; D039001:Integrin alpha Chains / Q000378:metabolism*; D039641:Integrin beta Chains / Q000378:metabolism*; D008180:Lupus Erythematosus, Systemic / Q000473:pathology; D008297:Male; D009135:Muscular Diseases / Q000473:pathology*; D009687:Nuclear Proteins / Q000378:metabolism*; D017285:Polymyositis / Q000473:pathology; D011379:Prognosis; D012595:Scleroderma, Systemic / Q000473:pathology; D012680:Sensitivity and Specificity; D046509:Tissue Culture Techniques; D014157:Transcription Factors / Q000378:metabolism*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000378:metabolism*
D015415:Biomarkers; D004268:DNA-Binding Proteins; C497442:HIF1A protein, human; D051793:Hypoxia-Inducible Factor 1; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D039001:Integrin alpha Chains; D039641:Integrin beta Chains; D009687:Nuclear Proteins; D014157:Transcription Factors; D040281:Vascular Endothelial Growth Factor Receptor-1