Clinical Study On Changes Of Serum Vascular Endothelial Growth Factor And Transforming Growth Factor β1 In Patients With Active Rheumatoid Arthritis

Objective: RA (rheumatoid arthritis) is an autoimmune chronic systemic disease, characterized by inflammation, self-immune and the hyperplastic synovial pannus. Its main pathological changes are synovitis and pannus. Cytokines are the important regulators of inflammation and destruction of joits. It has proved that various of cytokines involved in RA. But the pathogenetic mechanisms of these cytokines in RA are incompletely understand. Among these cytokines, vascular endothelial growth factor (VEGF) and transforming growth factorpl(TGFpl) are the most important. So in order to determine serum VEGF and TGFpl correlations in patients with active rheumatoid arthritis (RA), we carried out a pilot study.Methods: The serum concentration of vascular endothelial growth factor and transforming growth factorpi were detected by enzyme-linked immunosorbent assay(ELISA). Our objectives included 40 active RA patients, 36 AS patients and 20 healthy controls. In addition, serum VEGF and TGFpl concentration of 28 RA patientspre- and posttreatment were detected. The groups were as follows: 14 RA patients were treated by plasmapheresis and 14 RA patients were treated by conventional drugs. Statistical analysis was performed using SPSS software (version 10.0). P values less than 0.05 were considered to be statistically significant.Results:Serum VEGF levels were elevated in the active RA patients (54.80 + 21.55) pg/ml with healthy controls(35.92+20.63)pg/ml (P<0.01); Serum TGF01 levels were (21.77+14.44)ng/ml, significantly lower than healthy controls(31.37 + 7.27)ng/ml (P<0.01).(2) Serum VEGF levels in the AS patients were (51.14 + 17.71)pg/ml and higher than healthy controls(P<0.05),but there were not significant with RA. (3) The differences between pre- and posttreatment were significant(VEGF: t=9.119, P<0.001, TGFpl: t=l0.881,P<0.05). The differences of serum RF, ESR, CRP, PLT ,stiff time and Ritchie index, et al between pre- and posttreatment were significant (P<0.05). 甋erum VEGF levels in active RA had not a correlation with serum TGFP1 levels (r=-0.301,P>0.05); Serum VEGF levels had correlations with CEP, ESR, RF and PLT et al(P<0.05). Serum TGFpl levels had correlations with CEP, ESR, RF and PLT et al(P<0.05).Conclusion: 1. The elevated serum VEGF levels and decreased TGFpl levels may be useful markers for disease activity and effeciacy in active RA . 2. Platelet may be asource of serum VEGF. 3. Serum VEGF levels and TGF01 levels are not specific diagnostic index. 4. Plasmapheresis and immunosuppression may indirectly decreased serum VEGF, suggesting that it may be a effective treatment. 5. Serum VEGF and TGF01 may play crucial roles in pathogenesis of active RA, respectively.