The relationship between arterial stiffness, VEGF and E-selectin levels and disease activity relation in patients with rheumatic diseases

Aim and Hypothesis: The endothelial damage, changes in vascular permeability and plaque formation are caused by the action of cytokines and chemokines which plays role in chronic inflammation in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). In studies, it has been reported that arterial stiffness and the level of cell adhesion molecules were affected by inflammation. In this study, we aimed to determine the changes levels of VEGF, E-selectin, arterial stiffness and disease activity with inflammation in RA and AS patients who had active period of disease. Methods: 13 patients diagnosed with AS, 28 patients diagnosed with RA and 30 healthy controls were enrolled to the study. Arterial stiffness, VEGF and E-selectin, ESR and CRP were evaluated in all patients and healthy control group. BASDAI and DAS-28 scores were calculated in patients with rheumatic diseases. The level of serum VEGF and E-selectin were determined by ELISA, and arterial stiffness was measured by oscillometric method. The datas were statistically evaluated by using Student's T Test, Mann-Whitney-U Test and Wilcoxon Test. Results: DAS-28 and BASDAI score, ESR and CRP levels were significantly decreased on the 3th month of treatment in all patients (p<0,001). Increase in VEGF and E-selectin levels and decrease in pulse wave velocity (PWV) and augmentation index (Alx) parameters was observed with treatment. But these changes were not statistically significant. While the level of PWV was stable, Alx was decreased on the 3th months of treatment in RA patients treated with non-TNF. Conclusion: Disease activity score, ESR and CRP are decreased with the reduction of inflammation in RA and AS patients with treatment. PWV and Alx as arterial stiffness parameters decreased after 3 months of treatment, but they did not reach to statistical significance. Arterial stiffness and cardiovascular risk are expected to be reduced significantly ongoing treatment process.