Circulating vascular endothelial growth factor and systemic inflammatory markers in patients with stable and exacerbated chronic obstructive pulmonary disease

Abstract

The aim of the present study was to assess circulating levels of VEGF (vascular endothelial growth factor), a biomarker with prognostic significance in cardiovascular disease, and markers of systemic inflammation in patients with stable and exacerbated COPD (chronic obstructive pulmonary disease). Lung function parameters, arterial blood gas analysis and circulating levels of VEGF, IL-6 (interleukin-6), TNF-alpha (tumour necrosis factor-alpha), CRP (C-reactive protein), fibrinogen and the peripheral blood neutrophil cell count were assessed in 30 patients on admission to the hospital for acute exacerbation of COPD, in 30 age-, gender- and BMI (body mass index)-matched patients with stable COPD, and 30 matched controls with normal lung function. Patients with acute exacerbated COPD had higher circulating concentrations of VEGF (P<0.001), IL-6 (P<0.05) and CRP (P<0.01) and an increased blood neutrophil cell count (P<0.05) compared with patients with stable COPD and healthy controls. VEGF levels in exacerbated COPD correlated with systemic inflammatory markers, such as CRP (r=0.61, P<0.005), IL-6 (r=0.46; P<0.01) and fibrinogen (r=0.39, P<0.05). In patients with stable COPD, there was a significant relationship between circulating VEGF levels and the percentage of the predicted FEV(1) (forced expiratory volume in 1 s) (r=0.47, P<0.01). Recovery from the exacerbation resulted in a significant decrease in both circulating VEGF levels and markers of systemic inflammation. In conclusion, circulating levels of VEGF and markers of systemic inflammation are up-regulated in patients with acute exacerbated COPD and decrease after recovery from the exacerbation.

Blood Specimen Biomarkers of Inflammation, Matrix Degradation, Angiogenesis, and Cardiac Involvement: a Future Useful Tool in Assessing Clinical Outcomes of COPD Patients in Clinical Practice?

“…In previous studies only the up-regulation of blood levels of VEGF has been reported during the acute exacerbation of COPD (Valipour et al 2008). Our research group has confirmed elevated concentrations of VEGF in the airways of patients with COPD, but we have not found any additional elevation of angiogenic factors at the time of exacerbation of COPD (Kristan et al 2012).…”

Pulmonary vascular changes in asthma and COPD

“…VEGF synthesis is increased by prostacyclin in human lung fibroblasts in vitro [51] and this cross talk may be important during inflammation and hypoxic conditions in the distal lung promoting angiogenesis in areas with poor circulation and ventilation. It has been shown that patients with acute exacerbations present high levels of VEGF in the circulation compared to stable COPD patients and healthy individuals [128]. In a small study with bronchial biopsies, patients without glucocorticosteroid treatment showed more bronchial vascularisation, larger vessels and more VEGF receptors expressed in the tissue compared to COPD patients that were treated with inhaled glucocorticosteroids [119].…”

The role of bone marrow-derived endothelial progenitor cells and angiogenic responses in chronic obstructive pulmonary disease

“…Studies have shown that VEGF is increased in pulmonary arteries and plasma of COPD patients, in parallel with prominent vascular remodelling and decreased PB EPCs (52,65 (67).…”