Angiogenic and angiostatic factors in systemic sclerosis: increased levels of vascular endothelial growth factor are a feature of the earliest disease stages and are associated with the absence of fingertip ulcers

To examine whether the lack of sufficient neoangiogenesis in systemic sclerosis (SSc) is caused by a decrease in angiogenic factors and/or an increase in angiostatic factors, the potent proangiogenic molecules vascular endothelial growth factor (VEGF) and basic fibroblast growth factor, and the angi...

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Published in:Arthritis research 2002-01, Vol.4 (6), p.R11-R11, Article R11
Main Authors: Distler, Oliver, Del Rosso, Angela, Giacomelli, Roberto, Cipriani, Paola, Conforti, Maria L, Guiducci, Serena, Gay, Renate E, Michel, Beat A, Brühlmann, Pius, Müller-Ladner, Ulf, Gay, Steffen, Matucci-Cerinic, Marco
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Analysis
Angiogenesis Inducing Agents - blood
Angiogenesis inhibitors
Angiogenesis Inhibitors - blood
Autoantigens - immunology
Capillaries - growth & development
Capillaries - pathology
Care and treatment
Collagen - blood
Diagnosis
Dosage and administration
Endostatins
Endothelial Growth Factors - blood
Enzyme-Linked Immunosorbent Assay
Female
Fibroblast Growth Factor 2 - blood
Fingers
Histology, Pathological
Humans
Intercellular Signaling Peptides and Proteins - blood
Lymphokines - blood
Male
Microscopic Angioscopy
Middle Aged
Nails - blood supply
Nails - pathology
Nuclear Proteins - immunology
Peptide Fragments - blood
Scleroderma (Disease)
Scleroderma, Systemic - blood
Scleroderma, Systemic - complications
Scleroderma, Systemic - pathology
Skin Ulcer - etiology
Skin Ulcer - pathology
Systemic scleroderma
Vascular endothelial growth factor
Vascular Endothelial Growth Factor A
Vascular Endothelial Growth Factors
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Summary:To examine whether the lack of sufficient neoangiogenesis in systemic sclerosis (SSc) is caused by a decrease in angiogenic factors and/or an increase in angiostatic factors, the potent proangiogenic molecules vascular endothelial growth factor (VEGF) and basic fibroblast growth factor, and the angiostatic factor endostatin were determined in patients with SSc and in healthy controls. Forty-three patients with established SSc and nine patients with pre-SSc were included in the study. Serum levels of VEGF, basic fibroblast growth factor and endostatin were measured by ELISA. Age-matched and sex-matched healthy volunteers were used as controls. Highly significant differences were found in serum levels of VEGF between SSc patients and healthy controls, whereas no differences could be detected for endostatin and basic fibroblast growth factor. Significantly higher levels of VEGF were detected in patients with Scl-70 autoantibodies and in patients with diffuse SSc. Patients with pre-SSc and short disease duration showed significant higher levels of VEGF than healthy controls, indicating that elevated serum levels of VEGF are a feature of the earliest disease stages. Patients without fingertip ulcers were found to have higher levels of VEGF than patients with fingertip ulcers. Levels of endostatin were associated with the presence of giant capillaries in nailfold capillaroscopy, but not with any other clinical parameter. The results show that the concentration of VEGF is already increased in the serum of SSc patients at the earliest stages of the disease. VEGF appears to be protective against ischemic manifestations when concentrations of VEGF exceed a certain threshold level.
ISSN:1465-9905
1478-6362
1478-6354
1465-9913
1478-6362
DOI:10.1186/ar596