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Am. J. Respir. Crit. Care Med., Volume 161, Number 6, June 2000, 1877-1880

Serum Vascular Endothelial Growth Factor Is Elevated in Cystic Fibrosis and Decreases with Treatment of Acute Pulmonary Exacerbation

SUSANNA A. MCCOLLEY, VERONICA STELLMACH, STEVEN R. BOAS, MANU JAIN, and SUSAN E. CRAWFORD

Departments of Pediatrics, Pathology, and Internal Medicine, Northwestern University Medical School, Chicago, Illinois

Chronic bacterial infection and neutrophilic inflammation characterize cystic fibrosis (CF) pulmonary disease. In many disorders, inflammation and angiogenesis are codependent phenomena. We previously noted excessive angiogenesis in CF tissues and elevated vascular endothelial growth factor (VEGF) in random serum samples from subjects with CF. To further explore this finding, we measured serum VEGF in 38 subjects with stable CF and in 25 subjects with other pulmonary diseases. Mean VEGF was elevated in both groups compared with reference values, but it was higher in CF: 403 ± 280 versus 255 ± 169 pg/ml, p = 0.02. VEGF was negatively correlated with FEV1 in CF, r = -0.51, p = 0.007. To assess the effect of airway infection on VEGF, 10 subjects with CF were studied before and after intravenous antibiotic therapy for pulmonary exacerbation. VEGF levels decreased with antibiotic therapy, from 537 ± 220 to 259 ± 176 pg/ml, p = 0.001. We conclude that circulating VEGF is increased in subjects with CF and other inflammatory pulmonary disorders. In CF, VEGF elevation is related to airway infection. We speculate that increased circulating VEGF is related to chronic inflammation, which is robust in CF. Elevated circulating VEGF may result in tissue angiogenesis, furthering the progression of pulmonary disease.




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