P050. Relationship between levels of angiogenic and lymphangiogenic factors (ALF) and the extension, endoscopic activity, and acute phase reactants (APR) in patients with ulcerative colitis (UC)
P.M. Linares1, A. Algaba2, M.E. Fernández-Contreras1, I. Guerra2, M. Chaparro1, J.L. Rodríguez-Agulló2, F. Bermejo2, J.P. Gisbert1
1Hospital Universitario de la Princesa-IP, Gastroenterology and CIBEREHD, Madrid, Spain; 2Hospital Universitario de Fuenlabrada, Gastroenterology, Fuenlabrada, Spain
Background: The present study is aimed to correlate VEGFA, C, D, VEGFR1, R2, R3, PlGF, Ang1, Ang2 and Tie2 ALF levels in serum and colonic mucosa culture supernatant (MCS) with the extension, endoscopic activity, and APR in patients with UC.
Methods: A prospective study was performed in patients with UC and non-IBD controls.UC extension and endoscopic activity were assessed respectively by the Montreal's classification and the Mayo subscore. The assessed APR were leukocyte and platelet count, haemoglobin, C‑reactive protein (CRP) and erythrocyte sedimentation rate (ESR). ALF levels in serum and MCS were determined by ELISA.
Results: 28 controls and 37 patients with UC were included. Mean age was 42±11 years, and 57% were women. The mean disease duration was 9±8 years. 85% of patients were under treatment. Endoscopic activity was mild in 14% of cases, moderate in 38%, severe in 5% and 43% had no activity. Ang1, Tie2 and VEGFR3 serum levels were significantly higher in patients with endoscopic activity than in controls; those of VEGF sere elevated in active patients, compared with non-active (p < 0.05). No other ALF in serum correlated with the endoscopic activity. However, all ALF in MCS correlated with the endoscopic lesions. The area under receiver operating characteristic (ROC) curve for the diagnosis of the endoscopic activity was lower than 0.6 for all ALF in serum excepting for VEGF (0.71). The cutoff point with the best sensitivity (70%) and specitivity (68%) for the identification of endoscopic activity was 340 pg/mL for serum VEGF. For ALF in MCS, the areas under the ROC curve were higher than those for the corresponding ALF in serum, the highest being for VEGFR1 in MCS (0.83). No differences were found between ALF (both in serum and in MCS) and disease extension. VEGFC (r = 0.35) and VEGFR3 (r = 0.42) serum levels correlated with their corresponding concentrations in MCS (p < 0.05). No other serum ALF correlated with their MCS concentrations. Regarding the APR, Ang1 and VEGF serum levels significantly correlated with CRP, leukocyte and platelet count and ESR, while MCS levels of VEGF, PlGF, Ang1, Ang2 and Tie2 correlated with CRP, platelet count and ESR.
- No or low correlation was found between ALF in serum and in MCS in UC patients.
- The correlation between ALF and endoscopic activity of UC was higher for MCS levels than for serum levels.
- Nevertheless, VEGF serum concentrations may be a useful non-invasive marker of endoscopic disease activity in UC patients.