SAT0096 CORRELATION OF GROWTH FACTORS WITH RHEUMATOID ARTHRITIS CLINICAL COURSE INDICATORS
Authors: Elena Komarova, Boris Rebrov, Anna Blagodarenko, Natalia Bludova, Galina Belkina
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The evaluation of early destruction markers in rheumatoid arthritis (RA) is of significant clinical importance for improving the patient`s life quality. One of the immunological markers of RA early diagnosis and of severe disease is antibodies to cyclic citrullinated peptide (ACCP). Instrumental methods for early diagnosis of RA include the ultrasound of joints. Vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF) can stimulate the processes of angiogenesis and proliferation, which in turn can increase the infiltration and hyperplasia of synovia, the growth of pannus mass and contribute to the development of bone and cartilage erosions. Objectives: to establish the correlation of growth factor indicators with markers of the destructive course of rheumatoid arthritis. <h3>Methods</h3> 194 patients with a diagnosis of RA were examined, among the examined patients women prevailed - 86.6%, the age was 47.7 ± 10.22 years. Positive by the presence of ACCP (&gt; 20 U/ml) was 76.8%, and negative - 23.2%. The ELISA in the serum was determined by the concentration of CRP and TNF-α (Vector-Best, Russia), antibodies to cyclic citrulinated peptide (ACCP) (Euroimmun, Germany), VEGF and FGF (BCM Diagnostic, Canada). Ultrasound of the joints was performed by the device "ESAOTE MyLAB40" (Netherlands, 2011) with a linear sensor of 7.5 L 70 (frequency 7.5 MHz), semi-quantitative evaluation of indicators was used: effusion into the joint space (JS), synovial thickness, vascularization of the synovial membrane (SM), the presence of pannus and bone-cartilage erosion. <h3>Results</h3> Direct correlations with CRP and ACCP levels (p = 0.02; p = 0.01, respectively), TNFα and DAS28 (p &lt;0.001) were established during analysis of the correlation links between VEGF and RA clinical course indicators. Analysis of the correlation of VEGF and ultrasound indices of the joints in the examined patients RA established strong direct links with the JS effusion parameters and the SM vascularization assessment (p &lt;0.001, in all cases), and a direct interaction of weak force with the indicator of pannus (p = 0.04) was found. Regression analysis of the dependence of the variability of the SM vascularization assessment on the level of VEGF in the blood showed a sufficient value of the coefficient of determination (0.57), and the data of the normalized index DW = 2.09 reliably indicate the absence of autocorrelation (0.06). Direct correlations with Rö stage (p &lt;0.001) and the rate of CRP (p = 0.02) were established during analysis of correlation links of FGF with the RA clinical course. Analysis of the correlation of FGF and ultrasound indices of the joints in the examined RA patients established strong direct correlations with the indicators of the thickness of SM, pannus, and bone-cartilage erosion (p &lt;0.001, in all cases), the direct correlation of weak force (p = 0.04) was with the SM vascularization assessment index. Regression analysis of the dependence of the variability of the SM thickness indicator on the FGF blood level showed a sufficient value of the multiple correlation R<sup>2</sup> = 0.47. Also showed a regression analysis of the dependence of the variability of pannus and bone and cartilage erosion indices on the FGF blood level (R2 = 0.51; R2 = 0.46, respectively), which evidences the regression line approximation to the observed data. <h3>Conclusion</h3> According to the correlations of VEGF, FGF levels with CRP, ACCP, assessment of synovial vascularization and bone-cartilage erosions - the high levels of VEGF, FGF in the blood can be used as markers of severe destructive course of RA and of the high rate of disease progression, which requires the early aggressive basic therapy of RA with the use of genetically engineered biologic drugs prescription. <h3>Disclosure of Interests</h3> None declared