Department of Clinical Biochemistry, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
Department of Clinical Biochemistry, Ankara City Hospital, Ankara, Turkey.
Int J Rheum Dis. 2021 Jun;24(6):789-794. doi: 10.1111/1756-185X.14115. Epub 2021 Apr 22.
Immunoglobulin A vasculitis (IgAV) is classified as a leukocytoclastic vasculitis characterized by immune deposits in endothelial walls of small vessels causing vascular endothelial injury. The aim of the present study is to evaluate levels of vascular endothelial growth factor-A (VEGF-A) and VEGF receptor-1 (VEGFR-1) levels in adult IgAV patients.
Thirty-seven adult IgAV patients admitted to the Rheumatology Clinic meeting the IgAV American College of Rheumatology (ACR) criteria and 32 control subjects were enrolled in the study. Disease activity was categorized as "remission" or "active" according to Birmingham Vasculitis Activity Score (BVAS). Serum VEGF-A, VEGFR-1 levels and VEGFR-1/VEGF-A ratio were evaluated in patient and control groups.
Serum median VEGF-A, VEGFR-1 and VEGFR-1/VEGF-A ratios were significantly higher in the patient group when compared to controls (235.9 [155-308.4] pg/mL vs. 78.8 [29.7-210.3] pg/mL, 400 [277.2-724.3] pg/mL vs. 31.5 [12.5-214.4] pg/mL and 1.85 [0.57-2.97] vs. 0.46 [0.38-0.63] respectively, all P values <.001). VEGFR-1 had the strongest predictive value with a cut-off value of 0.6 with 75% sensitivity and 73% specificity (P < .001).
This study is the first report indicating elevated serum VEGF-A, VEGFR-1, and more importantly VEGFR-1/VEGF-A ratio can be good representatives of the inflammatory processes together with vascular endothelial injury in adult IgAV patients. VEGFR-1 seems to be a more important indicator of the ongoing inflammation.
免疫球蛋白 A 血管炎（IgAV）被归类为白细胞碎裂性血管炎，其特征是小血管内皮壁中有免疫沉积物，导致血管内皮损伤。本研究旨在评估成人 IgAV 患者血管内皮生长因子-A（VEGF-A）和血管内皮生长因子受体-1（VEGFR-1）水平。
本研究纳入了 37 名符合 IgAV 美国风湿病学会（ACR）标准并入住风湿病诊所的成人 IgAV 患者和 32 名对照者。根据伯明翰血管炎活动评分（BVAS）将疾病活动分为“缓解”或“活动”。评估患者组和对照组的血清 VEGF-A、VEGFR-1 水平和 VEGFR-1/VEGF-A 比值。
与对照组相比，患者组的血清中位 VEGF-A、VEGFR-1 和 VEGFR-1/VEGF-A 比值显著升高（235.9 [155-308.4] pg/mL 比 78.8 [29.7-210.3] pg/mL，400 [277.2-724.3] pg/mL 比 31.5 [12.5-214.4] pg/mL 和 1.85 [0.57-2.97] 比 0.46 [0.38-0.63]，所有 P 值均<.001）。VEGFR-1 的截断值为 0.6，具有 75%的敏感性和 73%的特异性（P<.001），是预测价值最强的指标。
本研究首次报道，血清 VEGF-A、VEGFR-1 水平升高，更重要的是，VEGFR-1/VEGF-A 比值可作为成人 IgAV 患者炎症过程和血管内皮损伤的良好代表。VEGFR-1 似乎是反映持续炎症的更重要指标。
