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Open Access Research article

Correlations between angiogenic factors and capillaroscopic patterns in systemic sclerosis

Jérôme Avouac12, Maeva Vallucci2, Vanessa Smith3, Patricia Senet4, Barbara Ruiz2, Alberto Sulli5, Carmen Pizzorni5, Camille Frances4, Gilles Chiocchia2, Maurizio Cutolo5 and Yannick Allanore12*

Author affiliations

1 Rheumatology A department, Paris Descartes University, Sorbonne Paris Cité, Cochin Hospital, rue du Faubourg Saint Jacques, 27, Paris, 75014, France

2 INSERM U1016 and CNRS UMR8104, Cochin Institute, Paris Descartes University, rue du Faubourg Saint Jacques, 27, Paris, 75014, France

3 Department of Rheumatology, Ghent University Hospital, De Pintelaan 185, Ghent, 9000 Belgium

4 Department of Dermatology, Paris X University, Tenon Hospital, Rue de la Chine, 4, Paris, 75020, France

5 Research Laboratory and Academic Unit of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Viale Benedetto XV, 6, Genova, 16132, Italy

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Citation and License

Arthritis Research & Therapy 2013, 15:R55  doi:10.1186/ar4217

Published: 19 April 2013

Abstract

Introduction

We sought to assess whether nailfold videocapillaroscopy (NVC) patterns are associated with levels of angiogenic factors in systemic sclerosis (SSc).

Methods

Circulating endothelial progenitor cells (EPCs) and circulating endothelial cells (CECs) were measured in the peripheral blood of 60 consecutive SSc patients. Serum levels of eight endothelial markers were measured first in these 60 patients, and then in an independent replication cohort of 43 SSc patients in case of association with NVC patterns. NVC patterns were determined by four independent investigators blinded to vascular markers.

Results

Patients with the late-NVC pattern exhibited lower EPC levels (P < 0.0001) and higher VEGF levels (P = 0.03). Higher VEGF levels were confirmed to be associated with the late-NVC pattern in the replication cohort (P = 0.01). By multivariate analysis focused on biomarkers, lower EPC (P = 0.03) and higher VEGF levels (P = 0.001) were independently associated with the late-NVC pattern. In an alternate multivariate model including these two factors and SSc-related disease characteristics, lower EPC counts (P = 0.005), higher VEGF levels (P = 0.01), a history of digital ulcers (P = 0.04), and a modified Rodnan skin score > 14 (P < 0.0001) were independently associated with the late-NVC pattern.

Conclusion

Our data revealed decreased EPC counts and increased VEGF levels in patients with the late-NVC pattern. Further studies are now needed to determine the role of VEGF and EPCs in endothelial injury and repair in SSc.