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dc.contributor.authorKelly, Sen_US
dc.contributor.authorBombardieri, Men_US
dc.contributor.authorHumby, Fen_US
dc.contributor.authorNg, Nen_US
dc.contributor.authorMarrelli, Aen_US
dc.contributor.authorRiahi, Sen_US
dc.contributor.authorDiCicco, Men_US
dc.contributor.authorMahto, Aen_US
dc.contributor.authorZou, Len_US
dc.contributor.authorPyne, Den_US
dc.contributor.authorHands, REen_US
dc.contributor.authorPitzalis, Cen_US
dc.date.accessioned2015-12-16T16:28:59Z
dc.date.available2015-02-19en_US
dc.date.issued2015-03-13en_US
dc.identifier.urihttp://qmro.qmul.ac.uk/xmlui/handle/123456789/9883
dc.description.abstractINTRODUCTION: Neovascularization contributes to the development of sustained synovial inflammation in the early stages of Rheumatoid Arthritis. Ultrasound (US) provides an indirect method of assessing synovial blood flow and has been shown to correlate with clinical disease activity in patients with Rheumatoid Arthritis. This study examines the relationship of US determined synovitis with synovial vascularity, angiogenic/lymphangiogenic factors and cellular mediators of inflammation in a cohort of patients with early Rheumatoid Arthritis (RA) patients prior to therapeutic intervention with disease modifying therapy or corticosteroids. METHODS: An ultrasound guided synovial biopsy of the supra-patella pouch was performed in 12 patients with early RA prior to treatment. Clinical, US and biochemical assessments were undertaken prior to the procedure. Ultrasound images and histological samples were obtained from the supra-patella pouch. Histological samples were stained for Factor VIII and a-SMA (a-smooth muscle actin). Using digital imaging analysis a vascular area score was recorded. QT-PCR (quantitative-PCR) of samples provided quantification of angiogenic and lymphangiogenic gene expression and immunohistochemistry stained tissue was scored for macrophage, T cell and B cell infiltration using an existing semi-quantitative score. RESULTS: Power Doppler showed a good correlation with histological vascular area (Spearman r--0.73) and angiogenic factors such as vascular endothelial growth factor-A (VEGF-A), Angiopoietin 2 and Tie-2. In addition, lymphangiogenic factors such as VEGF-C and VEGF-R3 correlated well with US assessment of synovitis. A significant correlation was also found between power Doppler and synovial thickness, pro-inflammatory cytokines and sub-lining macrophage infiltrate. Within the supra-patella pouch there was no significant difference in US findings, gene expression or inflammatory cell infiltrate between any regions of synovium biopsied. CONCLUSION: Ultrasound assessment of synovial tissue faithfully reflects synovial vascularity. Both grey scale and power Doppler synovitis in early RA patients correlate with a pro-angiogenic and lymphangiogenic gene expression profile. In early RA both grey scale and power Doppler synovitis are associated with a pro-inflammatory cellular and cytokine profile providing considerable validity in its use as an objective assessment of synovial inflammation in clinical practice.en_US
dc.format.extent58 - ?en_US
dc.languageengen_US
dc.language.isoenen_US
dc.relation.ispartofArthritis Res Theren_US
dc.rightshttp://www.arthritis-research.com/content/17/1/58/abstract
dc.subjectAdulten_US
dc.subjectArthritis, Rheumatoiden_US
dc.subjectFemaleen_US
dc.subjectHumansen_US
dc.subjectImage Interpretation, Computer-Assisteden_US
dc.subjectImmunohistochemistryen_US
dc.subjectMaleen_US
dc.subjectMiddle Ageden_US
dc.subjectNeovascularization, Pathologicen_US
dc.subjectSynovial Membraneen_US
dc.subjectSynovitisen_US
dc.subjectUltrasonographyen_US
dc.titleAngiogenic gene expression and vascular density are reflected in ultrasonographic features of synovitis in early Rheumatoid Arthritis: an observational study.en_US
dc.typeArticle
dc.identifier.doi10.1186/s13075-015-0567-8en_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/25889955en_US
pubs.notesNot knownen_US
pubs.publication-statusPublished onlineen_US
pubs.volume17en_US
dcterms.dateAccepted2015-02-19en_US


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