title: Angiogenesis markers (VEGF, soluble receptor of VEGF and angiopoietin-1) in very early arthritis and their association with inflammation and joint destruction.
abstract: OBJECTIVE
  To investigate the involvement of angiogenesis markers in very early arthritis patients and their relevance to predict further joint destruction.
  
  
  METHODS
  Levels of Vascular Endothelial Growth Factor (VEGF), angiopoietin-1 (Ang-1), and soluble Fms-like tyrosine kinase-1 (sFlt-1) were measured by ELISA in serum samples from 310 patients having polyarthritis, evolving for less than 6 months (VErA cohort). Each angiogenesis marker was measured at baseline and one year later. X-rays of hands and feet were carried out at inclusion and after 1 year and read using the van der Heidje-modified Sharp method.
  
  
  RESULTS
  At baseline and after 1 year, VEGF levels were correlated with clinical and biological parameters of inflammation. We also observed a positive correlation between sFlt-1 levels and biological inflammation (Erythrocyte Sedimentation Rate (ESR): r=0.17, p=0.006; C Reactive Protein: r=0.14, p=0.02). Angiopoietin-1 levels were correlated with ESR (r=0.12, p=0.04). Interestingly, only VEGF levels measured at baseline were correlated with Disease Activity Score measured 1 year later. Relationship between angiogenesis markers and radiographic progression was also evaluated. VEGF and Ang-1 levels measured at inclusion were related with Sharp score after one year (VEGF: r=0.21, p<0.001; Ang-1: r=0.24, p<0.001; Spearman's test). Moreover, VEGF levels were higher in patients with radiographic progression (p=0.002).
  
  
  CONCLUSIONS
  Serum concentrations of VEGF, sFlt-1 and angiopoietin-1 were correlated to parameters of inflammation and to bone destruction in early arthritis. These results contribute to demonstrate that angiogenesis reflects disease severity and angiogenesis markers might become a new useful tool to evaluate disease activity and to estimate outcome for patients with inflammatory arthritis.
authors.affiliation: Inserm, ERI 18, Bobigny, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Clavel
authors.forename: Natacha
authors.initials: N
authors.lastname: Bessis
authors.forename: Delphine
authors.initials: D
authors.lastname: Lemeiter
authors.forename: Patrice
authors.initials: P
authors.lastname: Fardellone
authors.forename: Othmane
authors.initials: O
authors.lastname: Mejjad
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Ménard
authors.forename: Sophie
authors.initials: S
authors.lastname: Pouplin
authors.forename: Patrick
authors.initials: P
authors.lastname: Boumier
authors.forename: Olivier
authors.initials: O
authors.lastname: Vittecoq
authors.forename: Xavier
authors.initials: X
authors.lastname: Le Loët
authors.forename: Marie-Christophe
authors.initials: MC
authors.lastname: Boissier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042683:Angiopoietin-1 / Q000097:blood*; D001168:Arthritis / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology; D015331:Cohort Studies; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic / Q000276:immunology; D011859:Radiography; D040262:Receptors, Vascular Endothelial Growth Factor / Q000097:blood*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood
chemical_list: D042683:Angiopoietin-1; D042461:Vascular Endothelial Growth Factor A; C501162:FLT1 protein, human; D040262:Receptors, Vascular Endothelial Growth Factor; D040281:Vascular Endothelial Growth Factor Receptor-1