Background/Purpose: Vascular endothelial growth factor (VEGF) may have important contribution in the pathogenesis of knee osteoarthritis. MMP-13 is expressed by chondrocytes and synovial cells, and is thought to play a critical role in cartilage destruction. It is not certain whether VEGF correlate with the radiographic severity of knee osteoarthritis(OA).  The aim of this study was to determine VEGF and MMP13 as new potential biomarkers in patients with knee OA, and their relevance for radiographic severity and ultrasonographic finding.

Methods: The study was conducted with 34 consecutive patients with clinical and radiographic evidence of  knee OA with joint effusion detected clinically. The questionnaire included the duration of knee pain, 100 mm visual analog scale (VAS), and Western Ontario McMaster Universities (WOMAC) Osteoarthritis Index. All patients were examined by plain radiography on the same day as ultrasonography and arthrocetesis of knee joint were performed simultaneously. Knee radiographs were analyzed by Kellgren-Lawrence (KL) grading system. Plasma and synovial fluid (SF) VEGF and MMP 13 levels were determined by ELISA.

Results: Thirty four patients with knee OA included two men and 26 women, with a mean age of 65.5 ± 7.9 years and mean disease duration of 38.2 ± 48.9 months. Mean pain VAS was 56.8 ± 23.9 mm and total WOMAC score was 89.9 ± 42.9. Fourteen patients were categorized as grade 2 (KL 2), 16 as grade 3 (KL 3), and 4 as grade 4 (KL 4). The median value of SF VEGF were higher in KL grade 4 than those of KL grade 2 (845.0±82.3 pg/ml vs 624.6±37 pg/ml, p=0.025). By Spearman analysis, SF VEGF levels positively correlated with KL scores (r=0.444, p=0.009). No significant difference in SF and plasma levels of MMP-13 as well as plasma levels of VEGF were found among OA subjects with radiographic severity. We further analyzed the correlations between laboratory and ultrasonographic finding adjusted by age and BMI. The SF VEGF correlated positively with the length of the medial osteophytes (r=0.502, P=0.012), lateral osteophytes (r=0.528, P=0.008) and joint capsule distension (r=0.423, p=0.048). The SF MMP-13 did not show any correlation with ultrasonographic finding.

Conclusion: SF VEGF levels significantly increased in advanced OA according to KL scores and correlated well with ultrasonographic findings such as length of medial and lateral osteophytes and joint capsule distension.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/synovial-fluid-vascular-endothelial-growth-factor-could-predict-progression-of-osteoarthritis-according-to-radiological-and-ultrasonographic-findings/