Department of General and Experimental Pathology, Medical University of Bialystok, Bialystok, Poland.
Clin Rheumatol. 2010 Feb;29(2):175-80. doi: 10.1007/s10067-009-1308-7. Epub 2009 Nov 12.
The aim of the study was to evaluate the correlation between selected serum endothelial cell activation markers such as vascular endothelial growth factor (VEGF), endothelin-1 (ET-1), soluble thrombomodulin (sTM), soluble E-selectin (sE-selectin), disease activity, and microvascular changes determined by nailfold capillaroscopy in patients with systemic lupus erythematosus (SLE). Serum levels of VEGF, ET-1, sTM, and sE-selectin were determined by an enzyme-linked immunosorbent assay in 80 SLE patients. The disease activity was measured with Systemic Lupus Erythematosus Disease Activity Index score. Nailfold capillaroscopy was performed in all patients. Positive correlation was found between VEGF and both ET-1 (r = 0.294, p < 0.01) and sE-selectin (r = 0.274, p < 0.05) serum levels as well as between sTM and ET-1 (r = 0.273, p < 0.05) serum concentrations. We noticed also positive correlation between VEGF (r = 0.224, p < 0.05) and ET-1 (r = 0.471, p < 0.001) serum levels and disease activity, and also between VEGF serum concentration and grade of morphological changes observed by nailfold capillaroscopy (r = 0.458, p < 0.001). There was also positive correlation between capillaroscopic score and disease activity (r = 0.339, p < 0.01). Our data suggest that correlation between VEGF and both ET-1 and E-selectin serum levels as well as between sTM and ET-1 serum concentrations may reflect their participation in the pathogenesis of SLE. VEGF seems to reflect changes in microcirculation in the course of SLE, visualised by nailfold capillaroscopy. The relationship between changes in nailfold capillaroscopy, endothelial cell activation markers, and the clinical activity of SLE points to an important role of microvascular abnormalities in the clinical manifestation of the disease.
本研究旨在评估血清内皮细胞激活标志物（如血管内皮生长因子 [VEGF]、内皮素-1 [ET-1]、可溶性血栓调节蛋白 [sTM]、可溶性 E-选择素 [sE-选择素]）与系统性红斑狼疮（SLE）患者疾病活动度和甲襞毛细血管显微镜检查确定的微血管变化之间的相关性。通过酶联免疫吸附试验在 80 例 SLE 患者中测定 VEGF、ET-1、sTM 和 sE-选择素的血清水平。采用系统性红斑狼疮疾病活动指数评分测量疾病活动度。所有患者均行甲襞毛细血管显微镜检查。VEGF 与 ET-1（r = 0.294，p < 0.01）和 sE-选择素（r = 0.274，p < 0.05）血清水平以及 sTM 与 ET-1（r = 0.273，p < 0.05）血清浓度呈正相关。我们还注意到 VEGF（r = 0.224，p < 0.05）和 ET-1（r = 0.471，p < 0.001）血清水平与疾病活动度之间存在正相关，以及 VEGF 血清浓度与甲襞毛细血管显微镜检查观察到的形态学变化程度之间存在正相关（r = 0.458，p < 0.001）。毛细血管显微镜评分与疾病活动度之间也存在正相关（r = 0.339，p < 0.01）。我们的数据表明，VEGF 与 ET-1 和 E-选择素血清水平之间以及 sTM 与 ET-1 血清浓度之间的相关性可能反映了它们在 SLE 发病机制中的参与。VEGF 似乎反映了 SLE 过程中小血管循环的变化，通过甲襞毛细血管显微镜检查观察到。甲襞毛细血管显微镜检查、内皮细胞激活标志物和 SLE 临床活动之间的变化关系表明微血管异常在疾病临床表现中起着重要作用。
