Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.7)
Index Copernicus  – 161.11; MNiSW – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 2, March-April, p. 249–253

doi: 10.17219/acem/32484

Publication type: original article

Language: English

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The Protective Effects of Bevacizumab in Bleomycin-Induced Experimental Scleroderma

Suleyman S. Koca1,A,D,F, Metin Ozgen2,B, Adile F. Dagli3,C, Nevzat Gozel4,B, Ibrahim H. Ozercan3,C, Ahmet Isik1,A,E,F

1 Department of Rheumatology, Faculty of Medicine, Firat University, Turkey

2 Department of Rheumatology, Faculty of Medicine, Ondokuz Mayis University, Turkey

3 Department of Pathology, Faculty of Medicine, Firat University, Turkey

4 Department of Internal Medicine, Faculty of Medicine, Firat University, Turkey

Abstract

Background. The capillary networks are less dense and have irregular structures in scleroderma. These abnormalities result in lower capillary blood flow causing severe tissue hypoxia, which is a major stimulus for angiogenesis. However, current knowledge about compensatory angiogenesis is ambiguous in scleroderma. Bevacizumab is an inhibitor of vascular endothelial growth factor (VEGF).
Objectives. The aim of the present study is to evaluate the protective effects of bevacizumab in bleomycin (BLM)- -induced dermal fibrosis.
Material and Methods. This study involved 4 groups of Balb/c mice (n = 10 per group). Mice in the control group received 100 μL/day of phosphate-buffered saline (PBS) subcutaneously, while the other 3 groups were given 100 μg/day of BLM (dissolved in 100 μL PBS) subcutaneously, for 4 weeks. Mice in BLM-treated 3rd and 4th groups also received bevacizumab (1 or 5 mg/kg twice a week, intraperitoneally). At the end of the fourth week, all mice were sacrificed and blood and tissue samples were obtained.
Results. The BLM applications increased the dermal thicknesses, tissue hydroxyproline contents, and α-smooth muscle actin-positive (α-SMA+) cell counts, and led to histopathologically prominent dermal fibrosis. The bevacizumab treatments decreased the tissue hydroxyproline contents and dermal thicknesses, and these improvements were more prominent at doses by which α-SMA+ cell counts were markedly decreased, in the BLM-injected mice.
Conclusion. In our study, inhibition of VEGF with bevacizumab treatments prevented the BLM-induced dermal fibrosis suggesting that VEGF expression contributes to the pathogenesis of scleroderma.

Key words

bevacizumab, scleroderma, dermal fibrosis, VEGF

References (21)

  1. Denton CP, Black CM: Scleroderma-clinical and pathological advances. Best Pract Res Clin Rheumatol 2004, 18, 271–290.
  2. Gu YS, Kong J, Cheema GS, Keen CL, Wick G, Gershwin ME: The immunobiology of systemic sclerosis. Semin Arthritis Rheum 2008, 38, 132–160.
  3. Bhattacharyya S, Wei J, Varga J: Understanding fibrosis in systemic sclerosis: shifting paradigms, emerging opportunities. Nat Rev Rheumatol 2011, 8, 42–54.
  4. LeRoy EC: Systemic sclerosis. A vascular perspective. Rheum Dis Clin North Am 1996, 22, 675–694.
  5. Chung L, Fiorentino D: Digital ulcers in patients with systemic sclerosis. Autoimmun Rev 2006, 5, 125–128.
  6. Distler O, Del Rosso A, Giacomelli R, Cipriani P, Conforti ML, Guiducci S: Angiogenic and angiostatic factors in systemic sclerosis: Increased levels of vascular endothelial growth factor are a feature of the earliest disease stages and are associated with the absence of fingertip ulcers. Arthritis Res 2002, 4, R1 1.
  7. Distler O, Distler JH, Scheid A, Acker T, Hirth A, Rethage J: Uncontrolled expression of vascular endothelial growth factor and its receptors leads to insufficient skin angiogenesis in patients with systemic sclerosis. Circ Res 2004, 95, 109–116.
  8. Cipriani P, Guiducci S, Miniati I, Cinelli M, Urbani S, Marrelli A: Impairment of endothelial cell differentiation from bone marrow-derived mesenchymal stem cells: New insight into the pathogenesis of systemic sclerosis. Arthritis Rheum 2007, 56, 1994–2004.
  9. Cipriani P, Marrelli A, Liakouli V, Di Benedetto P, Giacomelli R: Cellular players in angiogenesis during the course of systemic sclerosis. Autoimmun Rev 2011, 10, 641–646.
  10. Ishisaki A, Tsunobuchi H, Nakajima K, Imamura T: Possible involvement of protein kinase C activation in differentiation of human umbilical vein endothelium-derived cell into smooth muscle-like cell. Biol Cell 2004, 96, 499–508.
  11. Chaudhuri V, Zhou L, Karasek M: Inflammatory cytokines induce the transformation of human dermal microvascular endothelial cells into myofibroblasts: A potential role in skin fibrogenesis. J Cutan Pathol 2007, 34, 146–153.
  12. Sen U, Moshal KS, Tyagi N, Kartha GK, Tyagi SC: Homocysteine-induced myofibroblast differentiation in mouse aortic endothelial cells. J Cell Physiol 2006, 209, 767–774.
  13. Segerström L, Fuchs D, Bäckman U, Holmquist K, Christofferson R, Azarbayjani F: The anti-VEGF antibody bevacizumab potently reduces the growth rate of high-risk neuroblastoma xenografts. Pediatr Res 2006, 60, 576–581.
  14. Woessner JF: The determination of hydroxyproline in tissue and protein samples containing small proportions of this imino acid. Arch Biochem Biophys 1961, 93, 440–447.
  15. Beyer C, Schett G, Gay S, Distler O, Distler JH: Hypoxia. Hypoxia in the pathogenesis of systemic sclerosis. Arthritis Res Ther 2009, 11, 220.
  16. Wipff J, Avouac J, Borderie D, Zerkak D, Lemarechal H, Kahan A: Disturbed angiogenesis in systemic sclerosis: high levels of soluble endoglin. Rheumatology (Oxford) 2008, 47, 972–975.
  17. Distler O, Distler JH, Scheid A, Acker T, Hirth A, Rethage J: Uncontrolled expression of vascular endothelial growth factor and its receptors leads to insufficient skin angiogenesis in patients with systemic sclerosis. Circ Res 2004, 95, 109–116.
  18. Koch AE, Distler O: Vasculopathy and disordered angiogenesis in selected rheumatic diseases: rheumatoid arthritis and systemic sclerosis. Arthritis Res Ther 2007, 9, Suppl 2, S3.
  19. Del Papa N, Colombo G, Fracchiolla N, Moronetti LM, Ingegnoli F, Maglione W: Circulating endothelial cells as a marker of ongoing vascular disease in systemic sclerosis. Arthritis Rheum 2004, 50, 1296–1304.
  20. Pandya NM, Dhalla NS, Santani DD: Angiogenesis – a new target for future therapy. Vascul Pharmacol 2006, 44, 265–274.
  21. D’Alessio S, Fibbi G, Cinelli M, Guiducci S, Del Rosso A, Margheri F: Matrix metalloproteinase 12-dependent cleavage of urokinase receptor in systemic sclerosis microvascular endothelial cells results in impaired angiogenesis. Arthritis Rheum 2004, 50, 3275–3285.