Salvador G, Sanmartí R, Gil-Torregrosa B, García-Peiró A, Rodríguez-Cros J R, Cañete J D
Arthritis Unit, Rheumatology Department, Hospital Clínic de Barcelona and IDIBAPS, Barcelona, Spain.
Rheumatology (Oxford). 2006 Aug;45(8):966-71. doi: 10.1093/rheumatology/kel043. Epub 2006 Feb 20.
To determine whether subgroups of rheumatoid arthritis (RA) patients classified according to their synovial vascular pattern have a different expression of angiogenic mediators or exhibit distinct clinical or biological characteristics.
Arthroscopies were performed in 27 patients with RA and synovial samples were obtained. Vascular morphology was classified in three patterns: straight (S), tortuous (T) and mixed (M). Immunostaining was performed with anti-vascular endothelial growth factor (anti-VEGF), anti-vascular endothelial growth factor receptor (VEGFR)-1, anti-VEGFR-2, anti-IL-8 and anti-TGF-beta, and measured by digital image analysis. Serum levels of VEGF, TGF-beta and IL-8, and clinical, radiographic and serological data were also analysed.
Eleven (41%) patients had the S pattern, nine (33%) the M pattern and seven (26%) the T pattern. The S and M groups had a higher prevalence of rheumatoid factor positivity and erosive disease, and higher levels of markers of systemic inflammation compared with the T group. Synovial expression of VEGF was higher in the S and T groups compared with the M group, whereas TGF-beta was higher in the T compared with the S and M groups. Distinct synovial distribution of VEGF and TGF-beta between groups was also observed.
This preliminary study suggests that RA patients with the S and M patterns share different clinical, biological and serological characteristics compared with those with the T pattern, which may constitute a group with less severe disease. Differences in the intensity and distribution of synovial expression of VEGF and TGF-beta observed between groups could have pathophysiological relevance. However, larger, prospective multicentre studies would be need to determine the clinical relevance of vascular patterns in RA.
确定根据滑膜血管模式分类的类风湿关节炎（RA）患者亚组是否具有不同的血管生成介质表达，或表现出不同的临床或生物学特征。
对27例RA患者进行关节镜检查并获取滑膜样本。血管形态分为三种模式：直线型（S）、迂曲型（T）和混合型（M）。采用抗血管内皮生长因子（抗VEGF）、抗血管内皮生长因子受体（VEGFR）-1、抗VEGFR-2、抗IL-8和抗TGF-β进行免疫染色，并通过数字图像分析进行测量。还分析了VEGF、TGF-β和IL-8的血清水平以及临床、影像学和血清学数据。
11例（41%）患者为S型，9例（33%）为M型，7例（26%）为T型。与T组相比，S组和M组类风湿因子阳性和侵蚀性疾病的患病率更高，全身炎症标志物水平更高。与M组相比，S组和T组滑膜VEGF表达更高，而与S组和M组相比，T组TGF-β更高。各组之间还观察到VEGF和TGF-β在滑膜中的不同分布。
这项初步研究表明，与T型患者相比，S型和M型RA患者具有不同的临床、生物学和血清学特征，T型患者可能构成疾病较轻的一组。各组之间观察到的VEGF和TGF-β滑膜表达强度和分布的差异可能具有病理生理学意义。然而，需要更大规模的前瞻性多中心研究来确定RA血管模式的临床相关性。
