مستشفى جامعة تشوننامالوطنية

The Division of Rheumatology specializes in care of patients with common musculoskeletal complaints as well as complex autoimmune and rheumatic diseases including systemic lupus erythematosus, rheumatoid arthritis, systemic vasculitis, scleroderma, Sjogren's syndrome, gout and osteoarthritis. Our main research interest is an angiogenesis in rheumatoid arthritis. Rheumatoid arthritis (RA) is characterized by synovial cell hyperplasia and the overgrowth of a fibrovascular granulation tissue, known as pannus, which proliferates like tumor cells and destroys cartilage and bone within the joint. Since neovascularization is necessary for the continual proliferation of synovial tissue, it is believed to play an important role in the development and progression of RA. 

Angiogenesis in the inflamed joints represents the net balance between the effects of angiogenic and anti-angiogenic factors. A number of angiogenic factors have been described in RA, of which vascular endothelial growth factor (VEGF) and basic fibroblast growth factor are the most potent. In RA, high levels of VEGF are present in synovial fluid and synovial tissue, which is produced by cells near endothelial cells and acts on endothelial cells via interaction with its receptors. 

VEGF is induced by hypoxia, which may occur in the inflamed joint. We demonstrated that VEGF level is related to RA disease activity, suggesting that VEGF may play some role in the pathogenesis of RA. 

We also reported that not only do cytokines like interleukin (IL)-1β, IL-6, and TGF-β induce fibroblast expression of VEGF, but so does engagement of CD 40 ligand.