Recent data on the role for angiogenesis in rheumatoid arthritis.
Angiogenesis is central to the development and perpetuation of rheumatoid synovitis. Vascular endothelial growth factor (VEGF), the main mediator of angiogenesis, is found in the synovial fluid and serum of patients with rheumatoid arthritis (RA), and its expression is correlated with disease severity. Compelling evidence that VEGF is involved in synovitis has been obtained from experimental models of RA. In particular, VEGF inhibition by synthetic compounds (e.g. TNP-470) or by naturally occurring factors (e.g., the soluble VEGF receptor) produce therapeutic effects. Angiopoietin-1, a recently discovered growth factor specific for neovascularization, is expressed within the rheumatoid synovium and may be stimulated by TNF-alpha. Other compounds, including integrins, fibroblast growth factor, and proinflammatory cytokines contribute to joint angiogenesis and, therefore, to the development of rheumatoid synovitis. Assessing vascularity may prove useful for evaluating or even predicting bone destruction. Furthermore, inhibition of angiogenesis may prove useful as an adjunct to current anti-inflammatory treatments.
Clavel
Gaëlle
G
Service de Rhumatologie, CHU Nord, Place Victor Pauchet, 80054 Amiens cedex 1, France. clavel.gaelle@chu-amiens.fr
Bessis
Natacha
N
Boissier
Marie-Christophe
MC
D001172:Arthritis, Rheumatoid / Q000276:immunology* / Q000503:physiopathology*; D016207:Cytokines / Q000276:immunology; D006801:Humans; D016023:Integrins / Q000276:immunology; D009389:Neovascularization, Pathologic / Q000276:immunology*; D013582:Synovial Fluid / Q000737:chemistry / Q000276:immunology; D013583:Synovial Membrane / Q000098:blood supply*; D013585:Synovitis / Q000276:immunology*; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis / Q000276:immunology
D016207:Cytokines; D016023:Integrins; D042461:Vascular Endothelial Growth Factor A