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P047. Relation between endoscopic and histological activity of the intestinal inflammatory bowel disease (IBD) and angiogenic and lymphangiogenic factors

A. Algaba1, P.M. Linares2, M.E. Fernández-Contreras2, A. Ordoñez1, J. Trápaga1, I. Guerra1, M. Chaparro2, J.L. Rodríguez-Agulló1, J.P. Gisbert2, F. Bermejo1

1Fuenlabrada University Hospital, Fuenlabrada, Spain; 2La Princesa University Hospital, Madrid, Spain

Aim: To correlate the levels of the main angio and lymphangiogenic factors (ALF) in serum and colonic mucosa biopsies cultures supernatant with the endoscopic and histological activity in patients with IBD.

Methods: A transversal study in 60 patients with IBD that underwent a colonoscopy because of medical criteria. From each patient, three different types of samples were obtained: a blood sample for ALF determination in serum, several samples of colonic tissue for their 24 h culture and supernatant determination of the same ALF and other biopsies for histological analyses. In those patients in which activity was observed during the colonoscopy and, in which the disease extension allowed it, samples from affected and non-affected mucosa were also taken. The patients were classified into four groups based on the endoscopic activity (endoscopic Mayo subscore for ulcerative collitis and SES-CD for Crohn's disease): non-activity of the disease, mild, moderate and severe activity. Considering histological findings, patients were also classified into four groups: Quiescent IBD, mild, moderate and severe lesion. VEGFA, VEGFC, VEGFD, VEGFR1, VEGFR2, VEGFR3, PlGF, Ang-1, Ang-2 and Tie2 concentrations both in serum and tissue culture supernatant were determined by ELISA assay.

Results: 49% of the patients did not have endoscopic activity, 23% moderate activity, 20% mild and 8% severe activity. There were significant differences between the concentrations of VEGFA (p < 0.001), VEGFC (p < 0.05), VEGFD (p < 0.001), PlGF (p < 0.001), VEGFR1 (p < 0.01), Ang-1 (p < 0.001), Ang-2 (p < 0.001) and Tie-2 (p < 0.001) in cultures supernatant based on endoscopic activity. These concentrations increase parallel to the endoscopic activity. According to histology, 45% of the patients had quiescent IBD, 25% had a moderate lesion, 22% mild and 8% severe lesions. Levels of all the studied proteins (except VEGFR3) were also significantly higher in those patients with severe histological lesions: VEGFA (p < 0.001), VEGFC (p ≤ 0.01), VEGFD (p < 0.001), PlGF (p < 0.001), VEGFR1 (p < 0.01), VEGFR2 (P < 0.05), Ang-1 (p < 0.001), Ang-2 (p < 0.001) and de Tie-2 (p < 0.001). The concordance between endoscopic and histological activity was of 88.14%. In 67% of the patients with activity, biopsies of affected and non-affected mucosa were taken for comparison. Significant differences in Ang1 (p < 0.05), Ang2 (p < 0.001) and VEGFR3 (p < 0.05) levels were observed. These levels were higher in the affected than in the non-affected mucosa. Significant differences were demonstrated in the VEGFA (p < 0.05) and Ang-1 (p < 0.001) serum levels depending on the endoscopic activity observed.

Conclusions: The levels of angio and lymphangiogenic factors and their receptors in tissue culture supernatant and VEGFA and Ang-1 in serum correlate with the endoscopic and histologic activity of IBD. Therefore serum determination of VEGFA and Ang-1 could be useful to avoid unnecessary colonoscopies.