August 2016 Vol. 4 No.8

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Original Research Article

VEGF - a vasculitis marker in rheumatoid arthritis patients

Julia Petrova¹, Victor Manolov^2*, Veneta Paskaleva-Peycheva³, Savina Hadjidekova⁴, Georgi Dimitrov⁵, Rumiana Tarnovska-Kadreva⁵, Theodora Yaneva-Sirakova⁵, Vasil Vasilev², Borislav Marinov⁶, Radoslava Emilova⁷, Ivo Bogov⁸ and Kamen Tzatchev²

¹Medical University – Sofia, Bulgaria, Dept. of Neurology
²Medical University – Sofia, Bulgaria, Dept. of Clinical Laboratory and Clinical Immunology
³Medical University - Sofia, Dept. of internal diseases; “Sv. Ivan Rilski” Hospital, Clinic of Rheumatology
⁴Medical University – Sofia, Bulgaria, Dept. of Medical Genetics
⁵Medical University – Sofia, Bulgaria, Dept. of Cardiology
⁶University Hospital “Maichin Dom” – Sofia
⁷Specialized Hospital for Active Treatment in Pediatrics – Sofia
⁸National Cardiological Hospital – Sofia

*Corresponding Author’s E-mail: victhedoc2@yahoo.com
Tel. +359 2 9230 928

Accepted August 03, 2016

Abstract

Vasculitis is one of the most common complications in rheumatoid arthritis. Vascular endothelial growth factor, a potent growth factor for endothelial cells and inducer of angiogenesis, is important for endothelial integrity and thus for vascular function. Iron homeostasis differs in rheumatoid arthritis according to inflammation and disease activity status. We included 86 female patients with rheumatoid arthritis. They were separated into three groups according to RA activity – 29 with RA and ACD, 30 with RA and IDA, and 27 with RA no anemia (used as a control group). All included groups were analyzed for laboratory parameters: hepcidin, iron and TIBC, ferritin, CBC including CHr, CRP, liver enzymes, serum creatinine, blood glucose, selenium. Patients were diagnosed for RA in University hospital “Ivan Rilski”, Department of Internal diseases. They were monitored for vasculitis in University hospital “Aleksandrovska”, Department of Neurology. Patients from the control group showed hepcidin and VEGF concentrations into the reference ranges (hepcidin 14.6 ± 1.5 µg/L; VEGF 23.7 ± 1.5 pg/mL). The RA with ACD group shows elevated serum hepcidin and VEGF levels (hepcidin 53.9 ± 5.2 µg/L; VEGF 38.5 ± 2.4 pg/mL). The RA with IDA group has decreased iron regulatory hormone and slightly elevated vasculitis marker (hepcidin 1.8 ± 1.0 µg/L; VEGF 29.1 ± 1.6 pg/mL). We found a high positive correlation between serum hepcidin and VEGF levels in RA with ACD (r = 0.677, p < 0.001) and RA with IDA patients (r = 0.549, p < 0.001). Development of vasculitis in rheumatoid arthritis patients leads to elevated serum VEGF levels. Along with hepcidin changes in some cases it might cause oxidative stress and deterioration of patient’s status.

Keywords: Anemia of chronic disease, Hepcidin, Iron deficiency anemia, Rheumatoid arthritis, Selenium, Vasculitis, VEGF