循环血管内皮生长因子水平与自身免疫性疾病的关联：系统评价和荟萃分析。

Association of Circulating Vascular Endothelial Growth Factor Levels With Autoimmune Diseases: A Systematic Review and Meta-Analysis.

机构信息

Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Department, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

出版信息

Front Immunol. 2021 May 27;12:674343. doi: 10.3389/fimmu.2021.674343. eCollection 2021.

DOI:10.3389/fimmu.2021.674343

PMID:34122433

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8191579/

Abstract

BACKGROUND

Autoimmune diseases (ADs) are characterized by immune-mediated tissue damage, in which angiogenesis is a prominent pathogenic mechanism. Vascular endothelial growth factor (VEGF), an angiogenesis modulator, is significantly elevated in several ADs including rheumatoid arthritis (RA), systemic sclerosis (SSc), and systemic lupus erythematosus (SLE). We determined whether circulating VEGF levels were associated with ADs based on pooled evidence.

METHODS

The analyses included 165 studies from the PubMed, EMBASE, Cochrane Library, and Web of Science databases and fulfilled the study criteria. Comparisons of circulating VEGF levels between patients with ADs and healthy controls were performed by determining pooled standard mean differences (SMDs) with 95% confidence intervals (CIs) in a random-effect model using STATA 16.0. Subgroup, sensitivity, and meta-regression analyses were performed to determine heterogeneity and to test robustness.

RESULTS

Compared with healthy subjects, circulating VEGF levels were significantly higher in patients with SLE (SMD 0.84, 95% CI 0.25-1.44, = 0.0056), RA (SMD 1.48, 95% CI 0.82-2.15, 0.0001), SSc (SMD 0.56, 95% CI 0.36-0.75, 0.0001), Behcet's disease (SMD 1.65, 95% CI 0.88-2.41, P <0.0001), Kawasaki disease (SMD 2.41, 95% CI 0.10-4.72, P = 0.0406), ankylosing spondylitis (SMD 0.78, 95% CI 0.23-1.33, P = 0.0052), inflammatory bowel disease (SMD 0.57, 95% CI 0.43-0.71, P <0.0001), psoriasis (SMD 0.98, 95% CI 0.62-1.34, P <0.0001), and Graves' disease (SMD 0.69, 95% CI 0.20-1.19, P = 0.0056). Circulating VEGF levels correlated with disease activity and hematological parameters in ADs.

CONCLUSION

Circulating VEGF levels were associated with ADs and could predict disease manifestations, severity and activity in patients with ADs.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO, identifier CRD42021227843.

摘要

背景

自身免疫性疾病（ADs）的特征是免疫介导的组织损伤，其中血管生成是一个突出的致病机制。血管内皮生长因子（VEGF）是一种血管生成调节剂，在包括类风湿关节炎（RA）、系统性硬皮病（SSc）和系统性红斑狼疮（SLE）在内的几种 AD 中显著升高。我们根据汇总证据确定了循环 VEGF 水平是否与 ADs 相关。

方法

分析包括来自 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 数据库的 165 项研究，并符合研究标准。使用 STATA 16.0 中的随机效应模型，通过确定汇总标准均数差值（SMD）及其 95%置信区间（CI）来比较 AD 患者和健康对照组之间的循环 VEGF 水平。进行亚组、敏感性和荟萃回归分析，以确定异质性并检验稳健性。

结果

与健康受试者相比，SLE 患者（SMD 0.84，95%CI 0.25-1.44， = 0.0056）、RA 患者（SMD 1.48，95%CI 0.82-2.15，0.0001）、SSc 患者（SMD 0.56，95%CI 0.36-0.75，0.0001）、贝赫切特病患者（SMD 1.65，95%CI 0.88-2.41，<0.0001）、川崎病患者（SMD 2.41，95%CI 0.10-4.72，P = 0.0406）、强直性脊柱炎患者（SMD 0.78，95%CI 0.23-1.33，P = 0.0052）、炎症性肠病患者（SMD 0.57，95%CI 0.43-0.71，<0.0001）、银屑病患者（SMD 0.98，95%CI 0.62-1.34，<0.0001）和格雷夫斯病患者（SMD 0.69，95%CI 0.20-1.19，P = 0.0056）的循环 VEGF 水平明显升高。循环 VEGF 水平与 AD 中的疾病活动和血液学参数相关。