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VEGF-RELATED ANTIBODIOME CHARACTERIZES PATIENTS WITH CROHN’S DISEASE AND DIFFERENTIATES THE LOCATION OF INFLAMMATION

Piotr Eder 1, Rusan Catar 2, Harald Heidecke 3, Guido Moll 2, Pinchao Wang 2, Michael Adu-Gyamfi 2, Katarzyna Korybalska 1, Janusz Witowski 1

Affiliations

1 Poznan University of Medical Sciences, Poznan, Poland

2 Charite University Medicine Berlin, Berlin, Germany

3 CellTrend, Luckenwalde, Germany

Summary

AI Generated

A study of 66 patients with active Crohn's disease found that serum levels of autoantibodies against VEGF-A and its receptors distinguish patients with isolated colonic disease from those with ileal involvement.

Compared to 197 healthy controls, Crohn's disease patients had significantly lower levels of autoantibodies against VEGF-A, VEGFR1, and VEGFR2, and significantly higher levels of autoantibodies against AT1R, with no difference in anti-ETAR levels.
All VEGF-related autoantibodies were significantly lower in patients with isolated colonic disease compared to those with ileal involvement, discriminating between these locations with AUC values ranging from 0.72 to 0.77.
In isolated colonic disease, correlations between autoantibodies were strongly positive (r=0.5-0.9) and CRP correlated positively with VEGF-A (r=0.6) but negatively with VEGF-related autoantibodies; these correlations were absent or less pronounced in patients with ileal involvement.
The authors suggest this antibodiome profile may represent a laboratory signature for disease location in Crohn's disease, though these differences were independent of steroid and azathioprine treatment requirements.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Dysregulated immune-mediated angiogenesis is believed to be a crucial step in the initiation and propagation of excessive inflammatory response. It is largely mediated by Vascular Endothelial Growth Factor (VEGF-A), but there is a growing body of evidence for the role of newly discovered autoantibodies related to VEGF signaling.

Aims & Methods

The aim of the study was to determine if clinical aspects of Crohn’s disease (CD) could be defined by the antibodiome related to VEGF signaling. To this end, serum samples from 66 deeply characterized patients with clinically active CD were analyzed for the levels of VEGF-A and autoantibodies against VEGF-A, VEGF receptors VEGFR1 and VEGFR2, angiotensin II receptor type 1 (AT1R) and endothelin A receptor (ETAR).

Results

When compared to reference levels from 197 healthy controls, the levels of autoantibodies against VEGF-A, VEGFR1, VEGFR2 were significantly lower, and against AT1R were significantly higher in CD patients, separating these two cohorts with high specificity and sensitivity (AUC: 0.78, 0.91, 0.99, 0.79, respectively; p<0.0001 for all). There was no difference in anti-ETAR levels between controls and CD patients. Interestingly, for all VEGF-related autoantibodies, their levels were significantly lower in CD patients with isolated colonic disease compared to those with ileal involvement. In this respect, the levels of autoantibodies against VEGF-A, VEGFR1, VEGFR2, AT1R, and ETAR discriminated with high sensitivity and specificity colonic from non-colonic CD with AUC and p-values: 0.77, 0.72, 0.74, 0.77, 0.77 and 0.001, 0.009, 0.004, 0.001, 0.001, respectively. Also when CD patients were categorized into quartiles according to the concentration of autoantibodies, their high levels were more frequently observed in patients with ileal lesions (see table). These differences were not related to whether patients required treatment with steroids and azathioprine or not. Heatmaps representing correlations between autoantibodies revealed that in patients with the isolated colonic disease, these correlations were strongly positive (r values ranging from 0.5 to 0.9), while they were less pronounced in patients with ileal involvement (r values ranging from 0.3 to 0.9). Moreover, in patients with isolated colonic disease, C-reactive protein (CRP) levels correlated positively with the levels of VEGF-A (r=0.6) but negatively with the levels of VEGF-related autoantibodies (r values ranging from - 0.3 to - 0.4). In contrast, in patients with ileal involvement, CRP did not show any significant correlations in these respects.

The percentages of colonic (L2) and ileo(colonic) (L1+L3) Crohn's disease among patients categorized into quartiles according to the level of VEGF-related autoantibodies
Autoantibody	Crohn's disease location	Q1	Q2	Q3	Q4	Chi-square p-value
Anti-VEGF-A	Colonic	59	19	12	6	0.001
Anti-VEGF-A	Ileo(colonic)	41	81	88	94	0.001
Anti-VEGFR1	Colonic	53	12	25	6	0.007
Anti-VEGFR1	Ileo(colonic)	47	88	75	94	0.007
Anti-VEGFR2	Colonic	41	35	13	6	0.05
Anti-VEGFR2	Ileo(colonic)	59	65	87	94	0.05

Conclusion

To the best of our knowledge, this is the first demonstration that antibodiome related to VEGF signaling may represent a laboratory signature that differentiates CD patients and healthy individuals and that discriminates CD patients with colonic disease from those with ileal involvement.
These data support the concept that the patient’s immune background as represented by a set of angiogenesis-related autoantibodies may determine the extent and location of gastrointestinal inflammation.