title: Serum Angiogenesis Markers and Their Correlation with Ultrasound-Detected Synovitis in Juvenile Idiopathic Arthritis.
abstract: Synovial angiogenesis is considered to be an important early step in the pathogenesis of juvenile idiopathic arthritis (JIA). In this study we assessed levels of angiogenic markers in serum or synovial fluid and their possible relevance to disease activity or degree of ultrasound signs of synovial inflammation and angiogenesis in early JIA. The concentration of vascular endothelial growth factor (VEGF), its soluble receptors 1 and 2 (sVEGF-R1, sVEGF-R2), and angiopoietins 1 and 2 (ANG-1, ANG-2) were evaluated in 43 JIA patients and 23 healthy controls. Synovial angiogenesis was assessed by means of Power-Doppler Ultrasonography (PDUS), according to the fourth-grade vascularity scale. VEGF and its receptors' (sVEGF-R1, sVEGF-R2) serum levels were significantly higher in JIA patients (p = 0.002). We found large variation in serum ANG-1 and ANG-2 levels. The PDUS imaging identified increased synovial microvascular blood flow in 15 (35.7%) examined JIA children. Intensity of joint vascularization correlated with higher serum VEGF and its levels was lowest in grade 0 and highest in grade 3 (p < 0.007 and p < 0.001, resp.). In conclusion, the high correlation between synovial microvascular blood flow, serum angiogenic proteins, and symptoms of synovitis may indicate its important role in pathogenesis of JIA.
authors.affiliation: Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, 91-738 Lodz, Poland.
authors.forename: Joanna
authors.identifier: 0000-0003-3915-9775
authors.initials: J
authors.lastname: Świdrowska
authors.affiliation: Department of Experimental Hematology, Medical University of Lodz, 93-513 Lodz, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Smolewski
authors.affiliation: Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, 91-738 Lodz, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Stańczyk
authors.affiliation: Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, 91-738 Lodz, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Smolewska
mesh_terms: D000293:Adolescent; D042682:Angiopoietins / Q000097:blood; D001171:Arthritis, Juvenile / Q000097:blood* / Q000473:pathology*; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000097:blood / Q000473:pathology; D008297:Male; D009389:Neovascularization, Pathologic / Q000097:blood* / Q000473:pathology; D012720:Severity of Illness Index; D013582:Synovial Fluid / Q000378:metabolism; D013583:Synovial Membrane / Q000378:metabolism / Q000473:pathology; D013585:Synovitis / Q000097:blood* / Q000473:pathology*; D018608:Ultrasonography, Doppler / Q000379:methods; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000097:blood
chemical_list: D042682:Angiopoietins; D015415:Biomarkers; D042461:Vascular Endothelial Growth Factor A; D040281:Vascular Endothelial Growth Factor Receptor-1; D040301:Vascular Endothelial Growth Factor Receptor-2