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Abstract Number: 2609

Anti-angiogenic VEGF-A165b Is Associated with Systemic Sclerosis Peripheral Vasculopathy

Victoria Flower1, Shaney Barratt 2, Darren Hart 3, Amanda Mackenzie 4, Jacqueline Shipley 3, Stephen Ward 4 and John Pauling 1, 1Department of Rheumatology, Royal National Hospital of Rheumatic Diseases, Royal United Hospitals NHS Foundation Trusts, Bath, England, United Kingdom, 2North Bristol NHS Trust, Bristol, England, United Kingdom, 3Department of Clinical Measurement, Royal National Hospital for Rheumatic Diseases, Royal United Hospitals NHS Trust, Bath, England, United Kingdom, 4Centre for Therapeutic Innovation & Department of Pharmacy and Pharmacology, University of Bath, Bath, England, United Kingdom

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Systemic sclerosis, ultrasound and plasma, VEGF

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Session Information

Date: Tuesday, November 12, 2019

Session Title: Systemic Sclerosis & Related Disorders – Clinical Poster III

Session Type: Poster Session (Tuesday)

Session Time: 9:00AM-11:00AM

Background/Purpose: The anti-angiogenic isoform of Vascular Endothelial Growth Factor-A (VEGF-A165b) has been implicated in Systemic sclerosis (SSc) vasculopathy. High frequency ultrasound (HFUS) is a novel approach to assessing digital perfusion. We report on the relationship between plasma VEGF-A165b and peripheral microvascular perfusion using HFUS in SSc.

Methods: Fifty-one patients fulfilling 2013 ACR/EULAR criteria for SSc and fifteen healthy controls (HC) underwent HFUS Doppler assessment of microvascular flow at the distal middle finger, from which a Vascularity Index was calculated. Plasma VEGF-A165b levels were assessed using ELISA. Ongoing administration of vasodilator and disease modifying therapies were permitted.

Results: Plasma VEGF-A165b was detectable in 16/51 (31%) of SSc with a peak level of >4000pg/mL (Figure 1). In contrast, only 3/15 (20%) healthy controls had plasma VEGF-A165b greater than the lower limit of detection by ELISA, with a maximum plasma level of 46pg/mL. Median levels were not significantly different between groups. When VEGF-A165b was detectable, it was associated with significantly reduced Vascularity Index in SSc (Figure 2). In contrast, HC showed no difference in the Vascularity Index irrespective of VEGF-A165b. Additionally, the Vascularity Index correlated with VEGF-A165b in SSc (Spearman’s ρ = -0.289, p=0.039) but not HC. The Vascularity Index was reduced in SSc even in those with undetectable VEGF-A165b compared to HC (both with detectable (p=0.047) and undetectable (non-significant) VEGF-A165b).

Conclusion: Increased levels of VEGF-A165b are associated with reduced digital vascularity in SSc. Low levels of VEGF-A165b are sometimes detected in HC but are not associated with reduced digital perfusion. Peripheral vascular compromise in SSc is evident even in the absence of detectable VEGF-A165b. Further longitudinal studies are needed to investigate the role of VEGF-A165b in determining microvascular flow and the impact of disease duration and intervention on VEGF-A165b and digital perfusion over time.


Disclosure: V. Flower, None; S. Barratt, None; D. Hart, None; A. Mackenzie, None; J. Shipley, None; S. Ward, None; J. Pauling, Boehringer Ingelheim, 5, Chugai Roche, 9.

To cite this abstract in AMA style:

Flower V, Barratt S, Hart D, Mackenzie A, Shipley J, Ward S, Pauling J. Anti-angiogenic VEGF-A165b Is Associated with Systemic Sclerosis Peripheral Vasculopathy [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/anti-angiogenic-vegf-a165b-is-associated-with-systemic-sclerosis-peripheral-vasculopathy/. Accessed January 16, 2021.
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