Effects of one-year anti-TNF-α therapy on biomarkers of angiogenesis and functional vascular parameters in arthritides

Background: Increased cardiovascular (CV) morbidity and mortality and abundant angiogenesis have been associated with rheumatoid arthritis (RA) and ankylosing spondylitis (AS).Biologics may influence both vascular function and angiogenesis.Here, vascular function, markers of atherosclerosis angiogenesis and the effects of anti-TNF therapy on these biomarkers were assessed arthritides.Patients and methods: Altogether 53 arthritis patients including 36 RA patients treated with etanercept (ETN) or certolizumab pegol (CZP) and 17 AS patients treated with ETN were included in a 12-month follow-up study.Angiogenesis markers including vascular endothelial (VEGF) and platelet-derived growth factor (PDGF-BB), angiopoetin 1 and 2 (Ang1, Ang2) and thrombospondin 1 (TSP-1) were assessed by ELISA.Anti-CCP and anti-citrullinated enolase peptide (CEP) antibodies were also determined by ELISA.Flow-mediated vasodilation (FMD), common carotid intima-media thickness (ccIMT) and pulse-wave velocity (PWV) were assessed by ultrasound.All assessments were performed at baseline, as well as 6 and 12 months after treatment initiation.Results: One-year anti-TNF therapy significantly decreased VEGF, PDGF-BB and Ang2 serum levels.In uni-and multivariate analyses, PDGF-BB levels correlated with smoking, disease duration and ccIMT.Moreover, Ang1 correlated with CRP, Ang2 with disease duration, CRP and positive CV history.Finally, TSP-1 levels correlated with disease duration, anti-CCP, anti-CEP and ccIMT.Conclusions: In our arthritis cohort, the levels of angiogenic markers correlated with disease duration, CRP, ACPA and ccIMT.Anti-TNF therapy attenuated the production of angiogenic markers in these arthritides.Some angiogenic mediators may be used as surrogate biomarkers that link angiogenesis, inflammation and atherosclerosis in arthritides.