High levels of endothelial progenitor cells and circulating endothelial cells in patients with Behçet's disease and their relationship to disease activity

Abstract

Background Behçet's disease is a multisystemic vasculitis, associated with vascular endothelial dysfunction. Currently, the prognosis is unpredictable, because there is still no valid laboratory marker indicating the disease activity in Behçet's disease. Endothelial progenitor cells and circulating endothelial cells are newly introduced hematological markers which are presumed to take part in the pathogenesis of vasculitis. Objectives To evaluate the levels of endothelial progenitor cells and subtypes and circulating endothelial cells in patients with Behçet's disease and to describe their relationship with the disease activity. Methods A total of 45 patients with Behçet's disease and 28 healthy controls were included in the study. Endothelial progenitor cells (CD34+CD133+KDR+ as early endothelial progenitor cells and CD34+KDR+ as late endothelial progenitor cells), and circulating endothelial cells (CD34+CD133+) were measured by flow cytometry. Results The mean plasma level of endothelial progenitor cells and circulating endothelial cells, vascular endothelial growth factor, matrix metalloproteinase-9, C-reactive protein, and erythrocyte sedimentation rate were significantly higher in patients with Behçet's disease. All of these parameters except circulating endothelial cells were also found to be higher in patients with active disease than in patients with inactive disease. Early endothelial progenitor cells showed significant correlations with C-reactive protein and circulating endothelial cells. Study Limitations The cross-sectional nature of the study and patient characteristics such as being under treatment, which can affect endothelial progenitor cells numbers. Conclusion The increase in endothelial progenitor cells may play an essential role in the repair of endothelial injury in Behçet's disease, especially in the active period of the disease. Thus, endothelial progenitor cells can indicate the disease activity. In addition, endothelial progenitor cells and circulating endothelial cells can be used as endothelial repair and injury markers for Behçet's disease, respectively.

Association of Circulating Vascular Endothelial Growth Factor Levels With Autoimmune Diseases: A Systematic Review and Meta-Analysis

“…Among 241 eligible studies meeting the inclusion criteria, 76 articles were excluded due to unextractable data, insufficient data on HCs, irrelevant VEGF sample type (urine/synovial fluid/tear fluid), or inappropriate disease control groups. Finally, 165 studies were included in the meta-analysis, with 28, 29, 40, 13, 8, 12, 16, 23, and six studies on SLE ( 20 , 21 , 26 – 51 ), RA ( 12 , 22 – 24 , 38 , 43 , 52 – 74 ), SSc ( 11 , 38 , 39 , 64 , 75 – 110 ), BD ( 111 – 123 ), KD ( 18 , 124 – 130 ), AS ( 55 , 73 , 131 – 140 ), IBD ( 141 – 156 ), PsA ( 12 , 14 , 135 , 136 , 157 – 175 ) and GD ( 10 , 176 – 180 ), respectively. The main study characteristics are summarized in Table 1 and Appendix 1 .…”

“…Among 241 eligible studies meeting the inclusion criteria, 76 articles were excluded due to unextractable data, insufficient data on HCs, irrelevant VEGF sample type (urine/synovial fluid/tear fluid), or inappropriate disease control groups. Finally, 165 studies were included in the meta-analysis, with 28,29,40,13,8,12,16,23, and six studies on SLE (20,21,, RA (12, 22-24, 38, 43, 52-74), SSc (11,38,39,64,, BD (111)(112)(113)(114)(115)(116)(117)(118)(119)(120)(121)(122)(123), KD (18,(124)(125)(126)(127)(128)(129)(130), AS (55,73,(131)(132)(133)(134)(135)(136)(137)(138)(139)(140)…”

“…VEGF was reported to be overexpressed in the skin and peripheral blood of patients with PsA (14). Serum VEGF levels were shown to be elevated and to correlate with disease activity and severity in PsA, SLE, BD, IBD, KD, and AS (14)(15)(16)(17)(18)(19). These findings suggest VEGF as a potential pathogenic factor with promising diagnostic value in ADs.…”

Neutralizing interferon‐α blocks inflammation‐mediated vascular injury via PI3K and AMPK in systemic lupus erythematosus

“…Elevated level of circulating ECs is a proxy for diverse inflammatory diseases with vascular injury [4,11,13]. The vascular inflammatory response involves interaction between vascular ECs and inflammatory cells (including monocytes, neutrophils and macrophages).…”

“…Patients with immune disorders or inflammatory diseases always show high level of circulating endothelial cells (ECs) and endothelial progenitor cells (EPCs), especially those with cardiovascular disease and vascular injury [4,[11][12][13][14]. EPCs favour angiogenesis and repair of endothelial injury.…”