Abstract
The current clinical and laboratory parameters of Takayasu arteritis (TA) are insufficient for proper assessment of disease activity. The aims of this study were to investigate the markers of endothelial injury and repair, including circulating endothelial cell (CEC), circulating endothelial progenitor cell (CEPC) and vascular endothelial growth factor (VEGF), and evaluate their associations with disease activity in patients with TA. Thirty-two patients with TA and 30 healthy age- and sex-matched controls were included in this study. Disease activity was assessed in TA patients using various tools, including Kerr’s criteria, the Indian Takayasu’s Arteritis Scoring (ITAS2010) and physician’s global assessment (PGA). CECs and CEPCs were measured by flow cytometry, and VEGF was measured using an enzyme-linked immunosorbent assay. The CEC level was found to be higher in TA patients than in the healthy controls (HC) (p < 0.001). There was no significant difference in CEC level between the active and inactive patients, but its level was slightly correlated with C-reactive protein (CRP) level. CEPC and VEGF levels in TA patients with active disease were higher than those in the inactive patients and HC. CEPC and VEGF levels were positively correlated with ITAS-CRP and PGA scores. This study shows increased level of CEC in patients with TA. It also suggests that the CEPC and VEGF levels may be correlated with disease activity.
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Jennette JC, Falk RJ, Andrassy K, Bacon PA, Churg J, Gross WL et al (1994) Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum 37:187–192
Morrissey NJ, Goldman J, Fallon JT, Faries PL, Marin ML, Hollier LH (2003) Endovascular aortic biopsy in the diagnosis of Takayasu arteritis. J Endovasc Ther 10:136–140
Hata A, Numano F (1995) Magnetic resonance imaging of vascular changes in Takayasu arteritis. Int J Cardiol 10:45–52
Yamada I, Numano F, Suzuki S (1993) Takayasu arteritis: evaluation with MR imaging. Radiology 188:89–94
Kissin EY, Merkel PA (2004) Diagnostic imaging in Takayasu arteritis. Curr Opin Rheumatol 16:31–37
Kerr GS (1995) Takayasu’s arteritis. Rheum Dis Clin North Am 21:1041–1058
Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M et al (1994) Takayasu arteritis. Ann Intern Med 120:919–929
Dagna L, Salvo F, Tiraboschi M, Bozzolo EP, Franchini S, Doglioni C et al (2011) Pentraxin-3 as a marker of disease activity in Takayasu arteritis. Ann Intern Med 155:425–433
Blake DR, Winyard P, Scott DG, Brailsford S, Blann A, Lunec J (1985) Endothelial cell cytotoxicity in inflammatory vascular diseases—the possible role of oxidised lipoproteins. Ann Rheum Dis 44:176–182
Brogan PA, Shah V, Brachet C, Harnden A, Mant D, Klein N et al (2004) Endothelial and platelet microparticles in vasculitis of the young. Arthritis Rheum 50:927–936
Erdbruegger U, Haubitz M, Woywodt A (2006) Circulating endothelial cells: a novel marker of endothelial damage. Clin Chim Acta 373:17–26
Dimmeler S, Zeiher AM (2004) Vascular repair by circulating endothelial progenitor cells: the missing link in atherosclerosis? J Mol Med 82:671–677
Chavakis E, Urbich C, Dimmeler S (2008) Homing and engraftment of progenitor cells: a prerequisite for cell therapy. J Mol Cell Cardiol 45:514–522
Sabatier F, Camoin-Jau L, Anfosso F, Sampol J, Dignat-George F (2009) Circulating endothelial cells, microparticles and progenitors: key players towards the definition of vascular competence. J Cell Mol Med 13:454–471
Dang A, Wang B, Li W, Zhang P, Liu G, Zheng D et al (2000) Plasma endothelin-1 levels and circulating endothelial cells in patients with aortoarteritis. Hypertens Res 23:541–544
Xu MG, Men LN, Zhao CY, Zhao X, Wang YX, Meng XC et al (2010) The number and function of circulating endothelial progenitor cells in patients with Kawasaki disease. Eur J Pediatr 169:289–296
Haubitz M, Dhaygude A, Woywodt A (2009) Mechanisms and markers of vascular damage in ANCA-associated vasculitis. Autoimmunity 42:605–614
Woywodt A, Goldberg C, Kirsch T, de Groot K, Erdbruegger U, Haller H et al (2006) Circulating endothelial cells in relapse and limited granulomatous disease due to ANCA associated vasculitis. Ann Rheum Dis 65:164–168
Holmen C, Elsheikh E, Stenvinkel P, Qureshi AR, Pettersson E, Jalkanen S et al (2005) Circulating inflammatory endothelial cells contribute to endothelial progenitor cell dysfunction in patients with vasculitis and kidney involvement. J Am Soc Nephrol 16:3110–3120
Zavada J, Kideryova L, Pytlik R, Vankova Z, Tesar V (2008) Circulating endothelial progenitor cells in patients with ANCA-associated vasculitis. Kidney Blood Press Res 31:247–254
Nomura M, Yamagishi S, Harada S, Hayashi Y, Yamashima T, Yamashita J et al (1995) Possible participation of autocrine and paracrine vascular endothelial growth factors in hypoxia-induced proliferation of endothelial cells and pericytes. J Biol Chem 270:28316–28324
Li CG, Reynolds I, Ponting JM, Holt PJ, Hillarby MC, Kumar S (1998) Serum levels of vascular endothelial growth factor (VEGF) are markedly elevated in patients with Wegener’s granulomatosis. Br J Rheumatol 37:1303–1306
Kaiser M, Younge B, Bjornsson J, Goronzy JJ, Weyand CM (1999) Formation of new vasa vasorum in vasculitis. Production of angiogenic cytokines by multinucleated giant cells. Am J Pathol 155:765–774
Terai M, Honda T, Yasukawa K, Higashi K, Hamada H, Kohno Y (2003) Prognostic impact of vascular leakage in acute Kawasaki disease. Circulation 108:325–330
Baldini M, Maugeri N, Ramirez GA, Giacomassi C, Castiglioni A, Prieto-Gonzalez S et al (2012) Selective up-regulation of the soluble pattern-recognition receptor pentraxin 3 and of vascular endothelial growth factor in giant cell arteritis: relevance for recent optic nerve ischemia. Arthritis Rheum 64:854–865
Harada M, Yoshida H, Mitsuyama K, Sakamoto M, Koga H, Matsuo K et al (1998) Aortitis syndrome (Takayasu’s arteritis) with cataract and elevated serum level of vascular endothelial growth factor. Scand J Rheumatol 27:78–79
Kuroda T, Ueno M, Sato H, Murakami S, Sakatsume M, Nishi S et al (2006) A case of Takayasu arteritis complicated with glomerulonephropathy mimicking membranoproliferative glomerulonephritis: a case report and review of the literature. Rheumatol Int 27:103–107
Misra R, Danda D, Rajappa SM, Ghosh A, Gupta R, Mahendranath KM, Indian Rheumatology Vasculitis (IRAVAS) Group et al (2013) Development and initial validation of the Indian Takayasu Clinical Activity Score (ITAS2010). Rheumatology (Oxford) 52:1795–1801
Manzi S, Selzer F, Sutton-Tyrrell K, Fitzgerald SG, Rairie JE, Tracy RP et al (1999) Prevalence and risk factors of carotid plaque in women with systemic lupus erythematosus. Arthritis Rheum 42:51–60
Distler JH, Allanore Y, Avouac J, Giacomelli R, Guiducci S, Moritz F et al (2009) EULAR Scleroderma Trials and Research group statement and recommendations on endothelial precursor cells. Ann Rheum Dis 68:163–168
Kuwana M, Okazaki Y (2012) Quantification of circulating endothelial progenitor cells in systemic sclerosis: a direct comparison of protocols. Ann Rheum Dis 71:617–620
Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM et al (1990) The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 33:1129–1134
Robak E, Kierstan M, Cebula B, Krawczynska A, Sysa-Jedrzejowska A, Wierzbowska A et al (2009) Circulating endothelial cells and angiogenic proteins in patients with systemic lupus erythematosus. Lupus 18:332–341
Foster W, Shantsila E, Carruthers D, Lip GY, Blann AD (2009) Circulating endothelial cells and rheumatoid arthritis: relationship with plasma markers of endothelial damage/dysfunction. Rheumatology (Oxford) 48:285–288
Kikuchi K, Hoashi T, Kanazawa S, Tamaki K (2005) Angiogenic cytokines in serum and cutaneous lesions of patients with polyarteritis nodosa. J Am Acad Dermatol 53:57–61
Ozturk MA, Unverdi S, Oktar SO, Bukan N, Gulbahar O, Ureten K et al (2008) Vascular endothelial growth factor and carotid intima-media thickness in patients with Behcet’s disease. Clin Rheumatol 27:961–966
Iwakawa J, Matsuyama W, Kubota S, Mitsuyama H, Suetsugu T, Watanabe M et al (2006) Increased serum vascular endothelial growth factor levels in microscopic poly angiitis with pulmonary involvement. Respir Med 100:1724–1733
de Groot K, Goldberg C, Bahlmann FH, Woywodt A, Haller H, Fliser D et al (2007) Vascular endothelial damage and repair in antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheum 56:3847–3853
Clarke LA, Hong Y, Eleftheriou D, Shah V, Arrigoni F, Klein NJ et al (2010) Endothelial injury and repair in systemic vasculitis of the young. Arthritis Rheum 62:1770–1780
Read C, Janes S, George J, Spiro S (2006) Early lung cancer: screening and detection. Prim Care Respir J 15:332–336
George ML, Eccles SA, Tutton MG, Abulafi AM, Swift RI (2000) Correlation of plasma and serum vascular endothelial growth factor levels with platelet count in colorectal cancer: clinical evidence of platelet scavenging? Clin Cancer Res 6:3147–3152
Watts R, Al-Taiar A, Mooney J, Scott D, Macgregor A (2009) The epidemiology of Takayasu arteritis in the UK. Rheumatology (Oxford) 48:1008–1011
Kucukyavas Y, Aksu K, Solmaz D, Can G, Taylan A, Akar S, Sari I, Birlik M, Onen F, Akkoc N (2012) Prevalence of Takayasu’s Arteritis in Izmir, Turkey: a multicenter study. Annu Eur Congr Rheumatol, EULAR 2012. Berlin, Germany 2012:Abstract Book 61
Salvarani C, Cantini F, Boiardi L, Hunder GG (2003) Laboratory investigations useful in giant cell arteritis and Takayasu’s arteritis. Clin Exp Rheumatol 21(6 Suppl 32):S23–S28
Lagneau P, Michel JB, Vuong PN (1987) Surgical treatment of Takayasu’s disease. Ann Surg 205:157–166
Hoffman GS, Ahmed AE (1998) Surrogate markers of disease activity in patients with Takayasu arteritis. A preliminary report from The International Network for the Study of the Systemic Vasculitides (INSSYS). Int J Cardiol 66(Suppl 1):S191–S194 discussion S195
Akazawa H, Ikeda U, Yamamoto K, Kuroda T, Shimada K (1996) Hypercoagulable state in patients with Takayasu’s arteritis. Thromb Haemost 75:712–716
Akazawa H, Ikeda U, Kuroda T, Shimada K (1996) Plasma endothelin-1 levels in Takayasu’s arteritis. Cardiology 87:303–305
Boos CJ, Lip GY, Blann AD (2006) Circulating endothelial cells in cardiovascular disease. J Am Coll Cardiol 48:1538–1547
Urbich C, Dimmeler S (2005) Risk factors for coronary artery disease, circulating endothelial progenitor cells, and the role of HMG-CoA reductase inhibitors. Kidney Int 67:1672–1676
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Dogan, S., Piskin, O., Solmaz, D. et al. Markers of endothelial damage and repair in Takayasu arteritis: Are they associated with disease activity?. Rheumatol Int 34, 1129–1138 (2014). https://doi.org/10.1007/s00296-013-2937-3
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DOI: https://doi.org/10.1007/s00296-013-2937-3