VEGF與endostatin在不同關節炎關節液的分析

Vascular endothelial growth factor and endostatin in synovial fluid of various arthritic conditions

目的：研類風濕性關節炎、僵直性脊椎炎、退化性關節炎和痛風都是常見的關節炎，血管新生跟關節發炎有關聯，而血管新生又和調節細胞激素或血管抑制激素有關，此實驗就是為了去評估血管內皮生長激素（VEGF）跟抑制血管激素（endostatin）在不同關節炎關節液中的表現。方法：從四種關節炎的病患當中收集關節液，用酵素連結免疫吸附分析法（ELISA）去評估VEGF和endostatin的濃度，與關節液及血中白血球、ESR及CRP的相關性。結果：VEGF在類風濕性關節炎當中最高，其次為痛風、僵直性脊椎炎和退化性關節炎。Endostatin在痛風最高，其次為僵直性脊椎炎、類風性關節炎及退化性關節炎；VEGF和關節液中的白血球高低有明顯正相關，而endostatin則跟關節液中的白血球有負相關。兩者與ESR和CRP沒有關聯性。結論：不同關節炎的關節液中，其VEGF的確會有不同濃度，跟發炎程度應有關聯。

Introduction: Rheumatoid arthritis (RA), ankylosing spondylitis (AS), osteoarthritis (OA), and gout are common forms of arthritic conditions. Angiogenesis via involvement of many regulatory cytokines and angiogenesis inhibitors is important in the pathogenesis of arthritis. The goal of this study is to compare two major angiogenetic factors, vascular endothelial growth factor (VEGF) and endostatin, in synovial fluid (SF) among various arthritic conditions. Patients and Methods: We collected SF through arthrocentesis of knees in patients with RA, AS, OA and gout. The concentrations of VEGF and endostatin in synovial fluid were analyzed using enzyme-linked immunosorbent assay. The influence of disease activity at the time of arthrocentesis was assessed by comparing peripheral blood white blood cell count (WBC), synovial WBC (SWBC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) with levels of VEGF and endostatin. Results: Synovial VEGF was the highest in RA, followed by gout, AS, and OA; however, endostatin was the highest in gout, then AS, RA, and OA. VEGF had positive correlation with SWBC and endostatin had negative correlation with SWBC. However, there was no correlation between either synovial VEGF or endostatin and ESR or CRP level. Conclusion: The concentrations of VEGF and endostatin in synovial fluid varied among different inflammatory forms of arthritis, and were related with inflammation status.