title: Lymphatic endothelial progenitor cells and vascular endothelial growth factor-C in spondyloarthritis and Crohn's disease: two overlapping diseases?
abstract: OBJECTIVE
  The role of the lymphatic system in the connection between spondyloarthritis (SpA) and Crohn's disease (CD) remains yet to be elucidated. The aim of the present study was to investigate the circulating levels of lymphatic endothelial progenitor cells (LEPCs) and vascular endothelial growth factor-C (VEGF-C) and their possible correlation with clinical parameters in SpA, SpA associated with CD (SC), and CD.
  
  
  METHODS
  Peripheral blood samples from SpA (n=36), SC (n=20) and CD (n=28) patients and 20 age- and sex-matched healthy controls were collected and used for quantification of circulating LEPCs and VEGF-C. LEPCs were identified by fluorescence-activated cell sorting using FITC-CD34, APC-CD133 and PE-VEGFR-3 antibodies. Serum levels of VEGF-C were measured by enzyme-linked immunosorbent assay. The possible correlations between disease duration (< or >10 years; < or >20 years) and clinical activity (BASDAI for SpA or CDAI for CD) and LEPC counts and VEGF-C levels were analysed.
  
  
  RESULTS
  Circulating LEPC levels were significantly increased in SpA (p=0.0006) and SC (p=0.0058) patients compared with controls. In CD patients, LEPC counts negatively correlated with disease duration, with lower levels in longstanding disease (>20 years, p=0.018), but were not different from controls. No significant difference in VEGF-C levels was found in SpA, SC and CD compared with controls. Both LEPC and VEGF-C levels were independent of BASDAI and CDAI.
  
  
  CONCLUSIONS
  On the basis of our observations, an active mobilisation of lymphatic endothelial cell precursors was observed only for spondylitis involvement.
authors: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors: Francesca
authors: F
authors: Bandinelli
authors: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors: Anna Franca
authors: AF
authors: Milia
authors: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors: Mirko
authors: M
authors: Manetti
authors: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors: Elena
authors: E
authors: Lastraioli
authors: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors: Massimo
authors: M
authors: D' Amico
authors: General, Emergency and Mininvasive Surgery I, Azienda Ospedaliero-Universitaria Careggi (AOUC), Florence, Italy.
authors: Pietro
authors: P
authors: Tonelli
authors: Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
authors: Marilena
authors: M
authors: Fazi
authors: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors: Annarosa
authors: A
authors: Arcangeli
authors: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors: Marco
authors: M
authors: Matucci-Cerinic
authors: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors: Lidia
authors: L
authors: Ibba-Manneschi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002452:Cell Count; D002469:Cell Separation / Q000379:methods; D003424:Crohn Disease / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D066026:Endothelial Progenitor Cells / Q000473:pathology*; D004729:Endothelium, Lymphatic / Q000473:pathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D025241:Spondylarthritis / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D011795:Surveys and Questionnaires; D013997:Time Factors; D042582:Vascular Endothelial Growth Factor C / Q000097:blood*
chemical_list: D015415:Biomarkers; C467486:VEGFC protein, human; D042582:Vascular Endothelial Growth Factor C