Soluble vascular cell adhesion molecular-1 is a potential biological indicator of hemophilic arthropathy

Abstract

Hemophilic arthropathy is the most common chronic complication in patients with hemophilia. The pathogenesis of hemophilic arthropathy involves the inflammatory processes associated with rheumatoid arthritis (RA). Determining the severity and/or progression of joint damage is crucial when evaluating the effect of treatment modalities. Identifying reliable biomarkers in the peripheral blood of patients with hemophilic arthropathy may be beneficial in clinical practice. Circulating soluble vascular cell adhesion molecule-1 (sVCAM-1), E-selectin, and P-selectin levels are elevated in patients with RA. Our study investigated whether these soluble adhesion molecules can be used as biological indicators in the course of joint damage in patients with hemophilia A.Patients with hemophilia A (mild, moderate, and severe) were enrolled. The plasma levels of sVCAM-1, E-selectin, and P-selectin in patients with hemophilia A and control were measured using specific enzyme-linked immunosorbent assay kits. Joint damages were evaluated using Pettersson scores.No statistically significant differences were observed in E-selectin and P-selectin levels between patients and controls. The sVCAM-1 level was significantly higher in patients with hemophilia A than in controls. The differences remained significant in patients with severe hemophilia A but not in patients with mild or moderate hemophilia A. The degree of hemophilic arthropathy was evaluated using Pettersson scores, and a score higher than 5 indicated marked arthropathy. Patients with more than 1 joint with marked arthropathy showed significantly higher sVCAM-1 levels.sVCAM-1 levels in patients with hemophilia A are associated with the severity of hemophilic arthropathy.

The Progression of Hemophilic Arthropathy: The Role of Biomarkers

“…A biomarker to evaluate the severity of hemophilia is plasma soluble vascular cell adhesion protein 1 (VCAM-1), which was significantly higher in patients with more severe arthropathy on X-ray [ 46 ].…”

“…Among the synovitis biomarkers were also studied: plasma MMP-9, SDF-1a, soluble VCAM-1, serum calprotectin, (high sensitive) CRP, plasminogen, FDP, D-dimer, ferritin and MIF that were significantly increased in hemophilia patients compared to controls, whereas results for plasma leukocyte and serum lactic acid were unclear or contradictory. Plasma hemoglobin (Hb), monocyte, platelet, soluble E-selectin and P-selectin and serum α2-antiplasmin (α2-AP), endostatin, TM and intercellular adhesion molecule-1 (ICAM-1) did not differ between subjects [ 33 , 46 , 47 ].…”

Plasma levels of IL-1β and IL-37 in patients with severe haemophilia

“…Haemophilia is an X-linked bleeding disorder in which the blood clotting process is slowed. 1 , 2 Haemophilia A and B are caused by deficiency of clotting factors VIII and IX, respectively. 1 , 3 , 4 Based on the plasma levels of clotting factors, haemophilia can be classified as severe (factor levels <1%), moderate (factor levels 1% to 5%), or mild (factor levels >5% to 30%).…”

“… 1 , 2 Haemophilia A and B are caused by deficiency of clotting factors VIII and IX, respectively. 1 , 3 , 4 Based on the plasma levels of clotting factors, haemophilia can be classified as severe (factor levels <1%), moderate (factor levels 1% to 5%), or mild (factor levels >5% to 30%). 5 Haemophilic arthropathy (HA) is the most typical manifestation caused by repeated bleeds in patients with haemophilia.…”

“… 1 , 3 In RA and OA, many cellular constituents and plasma constituents, including cytokines, have been detected and considered potentially responsible for HA. 1 However, the expression level of IL-37 in HA has been not investigated. In this study, we grouped patients with severe haemophilia according to severity of HA.…”