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. 2024 Dec 7;25(23):13166.
doi: 10.3390/ijms252313166.

The VEGFB Gene Variants and the Effectiveness of Platelet-Rich Plasma Treatment of Lateral Elbow Tendinopathy: A Prospective Cohort Study with a Two-Year Follow-Up

Alicja Jarosz  1 , Tomasz Nowak  1 , Karol Szyluk  2   3 , Anna Balcerzyk-Matić  1 , Tomasz Iwanicki  1 , Joanna Iwanicka  1 , Marcin Kalita  2 , Katarzyna Gawron  4 , Wojciech Kania  5 , Paweł Niemiec  1
Affiliations

The VEGFB Gene Variants and the Effectiveness of Platelet-Rich Plasma Treatment of Lateral Elbow Tendinopathy: A Prospective Cohort Study with a Two-Year Follow-Up

Alicja Jarosz et al. Int J Mol Sci. .

Abstract

Platelet-rich plasma (PRP) is an autologous preparation used to accelerate regeneration; however, this form of therapy is not always effective. Vascular endothelial growth factor B (VEGFB), which affects vessel survival, pathological angiogenesis, and muscle development may differentiate the risk and treatment of lateral elbow tendinopathy (LET). In this study, we analyzed the influence of VEGFB gene polymorphisms on the effectiveness of LET treatment with PRP. Therapeutic effectiveness was analyzed in 107 patients (132 elbows) using patient-reported outcome measures (PROMs), specifically the visual analog scale (VAS); quick version of disabilities of the arm, shoulder, and hand score (QDASH); and patient-rated tennis elbow evaluation (PRTEE), for two years (weeks 2, 4, 8, 12, 24, 52, and 104). The polymorphisms selected for the study were rs72922019, rs12366035, rs4930152, rs594942, and rs595880, being in strong linkage disequilibrium. Patients with TT (rs72922019), TT (rs12366035), AA (rs4930152), CC (rs594942), and GG (rs595880) genotypes showed better treatment effectiveness. Statistically important differences were shown for rs72922019 VAS (week 2), QDASH (weeks 0-4), and PRTEE (week 2); rs12366035 and rs4930152 VAS (week 2), QDASH (week 2), and PRTEE (weeks 2 and 4); and rs594942 and rs595880 VAS (weeks 2 and 4), QDASH (week 2), and PRTEE (weeks 2, 52, and 104). The studied polymorphisms also showed an association with blood morphological parameters, including mean platelet volume, platelet distribution width, and eosinophil levels, as well as some comorbidities (heart failure). Genotyping due to patient selection for therapy may be considered for any of the rs72922019, rs12366035, or rs4930152 polymorphisms.

Keywords: LET; PRP; SNP; VEGFB; lateral elbow tendinopathy; platelet-rich plasma; single-nucleotide polymorphism; vascular endothelial growth factor B.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Growth factors from the VEGF family and their receptors. Selected growth factors bind to specific receptors and coreceptors. Binding to a particular receptor leads to a different biological effect [1,2,3,4,5,6]. A description is in the text. Legend: IG domain, immunoglobulin domain; TK domain, tyrosine kinase domain; VEGF, vascular endothelial growth factor; PlGF, placenta growth factor; VEGFR, vascular endothelial growth factor receptor; NRP, neuropilin.
Figure 2
Figure 2
Locations of the studied VEGFB polymorphisms. The figure was created using data from the LDmatrix tool [24].
Figure 3
Figure 3
Linkage analyses between studied polymorphisms. (A) Haplotype block with D’ value. (B) Haplotype block with R2 value. (C) Haplotypes and their frequency. Colors highlight the degree of linkage disequilibrium. The darker the color, the greater the D’ or R2 values.
Figure 4
Figure 4
Medians (±QD) of PROM values for carriers of different rs12366035 and rs4930152 genotypes. Results for (A) VAS, (B) QDASH, and (C) PRTEE. Legend: QD, quartile deviation; PROM, patient-reported outcome measure; VAS, visual analog scale; QDASH, quick version of disabilities of the arm, shoulder, and hand score; PRTEE, patient-rated tennis elbow evaluation; *, significant difference (p < 0.050).
Figure 5
Figure 5
In silico analysis of rs72922019 VEGFB gene polymorphism influence on expression level. Results for (A) skeletal muscle tissue and (B) whole blood. Based on GTEx Portal [24].
Figure 6
Figure 6
Flow chart presenting selection of studied group.
See this image and copyright information in PMC

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