The investigation of relationship between joint findings and serum angiogenic and inflammatory factor levels in severe hemophilia A patients.
Despite the use of primary prophylactic Factor VIII replacement in severe hemophilia A patients, bleeding into joints cannot be prevented completely and early diagnosis and treatment of the joint bleedings are important for prevention of permanent joint damage. Recent studies have shown that neoangiogenesis plays important role in development of synovitis after recurrent joint bleedings. This study aimed to investigate the relationship between joint findings and levels of serum angiogenic and inflammatory factors in severe hemophilia A patients.The patient groups consisted of 10 severe hemophilia A patients with acute joint bleeding and 25 severe hemophilia A patients without acute joint bleeding. They were all inhibitor negative. The control group consisted of 22 healthy male children. Complete blood cell count analysis, C-reactive protein (CRP), serum ferritin, lactic acid, and ELISA-based detection of vascular endothelial growth factor (VEGF), intercellular adhesion molecule-1, thrombomodulin, macrophage migration inhibitory factor (MIF), and endostatin were performed from peripheral blood of patient and the control groups. CRP and MIF levels were detected significantly higher in hemophilia patients with acute joint bleeding than patients without acute joint bleeding. There was a positive correlation between serum thrombomodulin, VEGF, and MIF levels. In this study, we demonstrated that serum CRP and MIF levels increases in acute bleeding period regardless of the presence of previous joint damage in children with severe hemophilia. CRP elevation may be a useful and rapid marker for acute bleeding in these patients.
aDepartment of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine bDepartment of Pediatric Hematology-Oncology, Ege University Faculty of Medicine cDepartment of Pediatric Hematology-Oncology, Dr Behçet Uz Training and Research Hospital dDepartment of Pediatric Hematology-Oncology, Tepecik Training and Research Hospital eDokuz Eylül University Faculty of Medicine, Hematology Laboratory, Izmir, Turkey.
Tuba H
TH
Karapnar
Nihal
N
Karadaş
Gülcihan
G
Özek
Özlem
Ö
Tüfekçi
Berna
B
Atabay
Meral
M
Türker
Faize
F
Yüksel
Deniz Y
DY
Karapınar
Canan
C
Vergin
Gülersu
G
İrken
Hale
H
Ören
D000293:Adolescent; D043925:Angiogenesis Inducing Agents / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D006395:Hemarthrosis / Q000097:blood*; D006467:Hemophilia A / Q000097:blood* / Q000473:pathology*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D019746:Intramolecular Oxidoreductases / Q000097:blood; D008263:Macrophage Migration-Inhibitory Factors / Q000097:blood; D008297:Male; D018180:Thrombomodulin / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
D043925:Angiogenesis Inducing Agents; D015415:Biomarkers; D008263:Macrophage Migration-Inhibitory Factors; C546931:THBD protein, human; D018180:Thrombomodulin; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein; D019746:Intramolecular Oxidoreductases; C515598:MIF protein, human