Clinical Science
Vascular endothelial growth factor production in polymyalgia rheumatica
Riccardo Meliconi,
Lia Pulsatelli, Paolo Dolzani, Luigi Boiardi,
Pierluigi Macchioni,
Carlo Salvarani,
Tania Silvestri, Luigi Frizziero, Andrea Facchini,
Riccardo Meliconi
University of Bologna, and Istituti Ortopedici Rizzoli, Bologna, Italy
Search for more papers by this authorLuigi Boiardi
Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
Search for more papers by this authorPierluigi Macchioni
Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
Search for more papers by this authorCarlo Salvarani
Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
Search for more papers by this authorCorresponding Author
Andrea Facchini
University of Bologna, and Istituti Ortopedici Rizzoli, Bologna, Italy
Laboratorio di Immunologia e Genetica, Istituto di Ricerca Codivilla-Putti, I.O.R., Via di Barbiano 1/10, 40136 Bologna, ItalySearch for more papers by this authorRiccardo Meliconi,
Lia Pulsatelli, Paolo Dolzani, Luigi Boiardi,
Pierluigi Macchioni,
Carlo Salvarani,
Tania Silvestri, Luigi Frizziero, Andrea Facchini,
Riccardo Meliconi
University of Bologna, and Istituti Ortopedici Rizzoli, Bologna, Italy
Search for more papers by this authorLuigi Boiardi
Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
Search for more papers by this authorPierluigi Macchioni
Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
Search for more papers by this authorCarlo Salvarani
Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
Search for more papers by this authorCorresponding Author
Andrea Facchini
University of Bologna, and Istituti Ortopedici Rizzoli, Bologna, Italy
Laboratorio di Immunologia e Genetica, Istituto di Ricerca Codivilla-Putti, I.O.R., Via di Barbiano 1/10, 40136 Bologna, ItalySearch for more papers by this authorFirst published: 26 March 2001
Citations: 27
Abstract
Objective
To evaluate peripheral production and synovial expression of vascular endothelial growth factor (VEGF) in polymyalgia rheumatica (PMR).
Methods
Circulating levels of VEGF in PMR (serum concentration and in vitro release by peripheral blood mononuclear cells [PBMC]) were investigated by enzyme-linked immunosorbent assay. Local expression of VEGF in shoulder synovial tissue was investigated by immunohistochemical analysis. Investigations were performed in patients with active, untreated disease and in patients treated with corticosteroids.
Results
VEGF serum concentrations were significantly higher in untreated PMR patients than in normal control subjects. During steroid treatment, VEGF serum concentrations reached their lowest level after the sixth month of treatment. PBMC isolated from untreated PMR patients spontaneously secreted a higher amount of VEGF compared with PBMC from control subjects. Corticosteroid therapy did not affect the ability of PBMC to produce VEGF. Immunohistochemical staining performed on shoulder synovial tissue showed VEGF expression in both the lining layer and the sublining area. In 3 of 4 treated patients, no VEGF staining was found in synovial tissue during corticosteroid therapy. VEGF expression correlated with vessel density, but was not associated with αvβ3 and αvβ5 integrin expression.
Conclusion
Peripheral and local VEGF releases have different responses to steroid treatment in PMR. The lack of response to corticosteroids by peripheral VEGF production supports the hypothesis that systemic involvement is dominant in PMR. At the synovial level, VEGF production is linked to vascular proliferation and is thus directly involved in the pathogenesis of synovitis.
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