AB0974-AHP   ANTIPHOSPHOLIPID ANTIBODIES AND VASCULAR ENDOTHELIAL GROWTH FACTOR IN SYSTEMIC LUPUS ERYTHEMATOSUS, RHEUMATOIDARTHRITIS AND SYSTEMIC SCLEROSIS

N. A. Fathi*1, T. H. Sleem2, S. A. El-Gammal3, N. S. Ahmed4, S. S. Seif El-Din5, L. Abu El-Dahab6, S. S. El-Gendi7
1Rheumatology and Reabilitation, 2Biochemistry,, 3Clinical Pathology, Assiut University hospital, Assiut, 4Biochemistry,, Sohage university, Sohage, 5Microbiology and Immunology, Assiut University hospital, Assiut, 6Internal Medicine, Sohage university, Sohage, 7Internal Medicine, Assiut University hospital, Assiut, Egypt

Background: Systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and systemic sclerosis (SSc) are inflammatory diseases of unknown aetiology. Vascular endothelial growth factor (VEGF) is a cytokine participating in the inflammatory process. Antiphospholipid antibodies (aPL) may have a role in development of thrombosis.
Objectives: To investigate the role of aPL and VEGF in different rheumatic disease and their relation to clinical manifestations and disease activity scores.
Methods: Forty four patients were included in this study fifteen with SLE, 15 with RA and 15 with SSc, in addition to 15 healthy controls. All patients were subjected to complete history, clinical and joint examination and calculation of disease activity scores. Lupus anticoagulant (LAC), anticardiolipin (aCL) anti beta 2 glycoprotein-1 antibodies (anti 2GPI) IgM and IgG isotypes and VEGF were measured in all subjects. Also complete blood picture, prothrombin time and concentration, activated partial thromboplastin time, rheumatoid factor and antinuclear factor were performed.
Results: the frequency of LAC was 13.3% in RA, 53.3% in SLE and 0% in SSc. The frequency of aCL was 53.3% in RA, 86.7% in SLE and 13.3% in SSc while frequency of anti 2GP1 (IgG) was 26.7% in RA, 40% in SLE and 0% in SSc, the titre of LAC, aCL were higher in all groups than controls while IgG anti 2GPI antibody was higher in SLE than controls the titre of these antibodies were higher in SLE with manifestations of antiphospholipid syndrome than without (P<0.001 for LAC and <0.05 for and IgG anti 2GP1. Also presence of three aPL increase risk of APS OR16 (1.09-234). VEGF were significantly higher in all studied groups than controls (P<0.001 for all). By bivariate analysis positive correlations were found between VEGF and disease activity scores while no correlations were found between VEGF and aPL.

Conclusion: : The frequency of aPL was high in rheumatic diseases. The titres of aPL were higher in rheumatic diseases than controls and in patients with APS manifestations than without. A full positive profile with high titres more likely identified patients at higher risk of APS related events. VEGF may play a role in pathogenesis and activity of rheumatic diseases, however, its role of development in APS requires further studies.
Keywords: aPL-VEGF – rheumatic diseases.

References: 1.Abo SM, DeBari VA. Laboratory evaluation of the antiphospholipid syndrome (2007): 1: Ann Clin Lab Sci Winter; 37 (1): 3-14.
2.Cuadrado MJ., Buendia P., Velasco F., Aguirre MA., Barbarroja N., Torres LA., Khamashta M., Lopez-Pedrera C. (2006): Vascular endothelial growth factor expression in monocytes from patients with primary antiphospholipid syndrome. J. Thromb Haemost; Nov. 4(11): 2461-9.