An experimental study in the chick embryo chorioallantoic membrane of the anti-angiogenic activity of cyclosporine in rheumatoid arthritis versus osteoarthritis

Objective and Design. Angiogenesis plays an important role in the pathogenesis of rheumatoid arthritis (RA) and correlates with clinical score, synovial hyperplasia and infiltration of inflammatory cells. Many of the available treatments for RA have been shown to possess some degree of anti-angiogenic activity. Here, we studied the effect of cyclosporine, which exerts anti-angiogenic activity in vitro and in vivo [1] on angiogenesis induced in vivo in the chick embryo chorioallantoic membrane (CAM) by synovial RA and osteoarthritis (OA) tissues. Material and Methods. Wet synovial biopsies from 10 RA and 6 OA patients were treated with vehicle alone or with cyclosporine and implanted on the CAM at day 8 of incubation. On day 12, CAM tissues were assessed for the extent of angiogenesis and mononuclear cell infiltration. Results. Cyclosporine inhibited angiogenesis and reduced the number of mononuclear cells in the CAM extracellular matrix only in RA implants. Conclusions. These data provide further evidence for a central role of new-formed blood vessels in RA. Moreover, cyclosporine on account of both its immunosuppressive and its anti-angiogenic activity can be proposed for the treatment of RA.