Some Biochemical Changes in Serum and Synovial Fluid of Patients with Rheumatoid Arthritis

Sixty cases were included in this study, divided into 2 groups; Group I (Control) (n = 20) and Group II (RA) (n = 40). Estimation of VEGF levels in serum (VEGFBL) and in synovial fluid aspirates of Knee joint in 11 RA patients (VEGFSF) using ELISA, in addition to different acute phase reactants and indices of disease activity. Plain x-ray of both hands to detect juxta-articular osteopenia and erosions. Serum VEGF showed a highly significant difference between Group I (Control) (165.4 46 pg mL-1) and Group II (RA) (886.3 267.8 pg mL-1) (p = 0.000). Serum CRP showed a highly significant difference between Group I (Control) and Group II (RA) (p = 0.000). Serum VEGF showed significant correlation with VEGF in Synovial Fluid (p = 0.012), Articular Index (AI) (p = 0.04), ESR (p = 0.01), Alkaline Phosphatase (ALKPASE) (p = 0.04) and CRP (p = 0.00, highly significant correlation). VEGF levels in synovial fluids (88.7 17.3 pg mL-1) showed a significant correlation with VEGF in serum (VEGFBL) (p = 0.012) of the same RA patients, WBCs (p = 0.02) and CRP (p = 0.00, highly significant correlation). Serum VEGF is higher in RA patients than in controls. VEGF appears to play an active part in joint inflammation in early RA, however, in long-standing RA elevated VEGF serum levels may be an independent mark.