Assessment of vascular endothelial growth factor in systemic lupus erythematosus patients with anti-phospholipid syndrome

Abstract

Aim of the work: The aim of the present study was to assess the serum vascular endothelial growth factor (VEGF) in systemic lupus erythematosus (SLE) patients with and without antiphospholipid syndrome (APS). Relation of the VEGF to the clinical characteristics and laboratory investigations were well thought out. Patients and methods: The study included 84 female SLE patients; 37 with APS and 47 without as well as 33 matched control. Disease activity was estimated using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and damage index evaluated. Serum VEGF level was quantified using ELISA. Results: The mean age of the SLE patients was 29.03 ± 5.4 years with disease duration of 5.2 ± 3.1 years. The VEGF was signficantly higher in the SLE patients (417.1 ± 410.4 pg/ml) compared to the control (76.5 ± 33.01 pg/ml) (p < 0.0001) and was comparable between those with and without APS. VEGF was signficantly higher in those with a positive anti-ds DNA (n = 53) (471.8 ± 431.7 pg/ml) compared to those with a negative test (223.9 ± 234.8 pg/ml) (p = 0.005). The serum VEGF level signficantly correlatied with the SLEDAI (r = 0.34, p = 0.001) and steroid dose (r = 0.27, p = 0.02). On regression analysis, VEGF was not a signficant predictor of disease activity (p = 0.46). A cut off value of 126 pg/ml showed a good sensitivity (72%) and specificity (60%) predicting anti-dsDNA positivity (p = 0.02). Conclusion: Serum VEGF was remarkably increased in SLE patients with no special relation to APS and may be considered a potential marker of disease activity. Further insights on its relation with anti-ds DNA and genotypic expression in SLE are warranted. Keywords: Vascular endothelial growth factor, Systemic lupus erythematosus, Anti-phospholipid syndrome, SLEDAI, SLICC DI, Anti-ds DN