Increased plasma vascular endothelial growth factor among patients with chronic venous disease

Abstract

Skin damage in the presence of chronic venous disease is partially mediated through leukocytes. The endothelium is activated and exhibits proliferation in the skin. Up-regulation of vascular endothelial growth factor (VEGF) expression in the skin of patients with chronic venous disease has been demonstrated with immunohistologic techniques. Abnormal VEGF expression can have local deleterious effects. The aim of this study was to determine whether patients with chronic venous disease have elevated plasma levels of VEGF. We conducted a prospective study with 30 patients with varicose veins of clinical, etiologic, anatomic, and pathologic class C3 (normal skin, n = 15) and C4 (trophic skin changes, n = 15) and 25 control subjects with no clinical evidence of venous or arterial disease of the lower limb. Blood samples were collected from a foot vein of each subject before and after a period of experimental venous hypertension produced by means of standing. Assay of VEGF protein was performed with a sandwich enzyme-linked immunosorbent assay. Plasma VEGF level was elevated in both groups of patients with venous disease compared with the control group. The median VEGF levels among patients were 81 pg/mL (interquartile range [IQR] 56 to 122) supine and 98 pg/mL (IQR 63 to 153) after standing for 30 minutes. Median VEGF levels among control subjects were 52 pg/mL (IQR 35 to 71) lying supine and 60 pg/mL (IQR 39 to 105) after standing for 30 minutes. Experimental venous hypertension caused a small rise in VEGF levels among the patients but not the control subjects. Further studies are required to determine whether increased VEGF expression contributes to tissue injury in chronic venous disease.

Congenital disorder of oxygen sensing: association of the homozygous Chuvash polycythemia VHL mutation with thrombosis and vascular abnormalities but not tumors

“…Although it is possible that increased expression of VEGF contributes to lower blood pressure, in patients with Chuvash polycythemia, a number of other genes up-regulated by HIF-1␣ whose products we did not measure, such as ␣1 B -adrenergic receptor, adrenomedullin, endothelin-1, and heme oxygenase-1, could also plausibly contribute to blood pressure changes. Plasma VEGF levels have been reported to be increased in patients with varicose veins, 33 and we observed an association between serum levels of VEGF and varicose veins among the VHL 598CϾT homozygotes but not the unaffected subjects in the present study. Although increased expression of VEGF or mutations of its receptor have been associated with hemangiomas in mice 34,35 and humans, 36,37 we did not observe higher serum VEGF levels among the patients with Chuvash polycythemia with vertebral hemangiomas compared with those without vertebral hemangiomas in this study.…”

The Role of Vascular Endothelial Growth Factor in Wound Healing

“…143,144 However, the functional level or presence of VEGF and its receptors at the wound site is unknown, and it is uncertain whether chronic venous wounds display a defect in angiogenesis. It might be expected that exogenously administered VEGF would improve perfusion and hence, oxygenation, via angiogenesis.…”

Minimally invasive colon resection is associated with a transient increase in plasma sVEGFR1 levels and a decrease in sVEGFR2 levels during the early postoperative period

“…Numerous growth factors, inflammatory cytokines, and oncogenic mutations have been shown to mediate this upregulation [9][10][11][12][13][14][15]. The postsurgical VEGF increase may be related to wound healing; keratinocytes have been shown to increase VEGF production after an operation [16,17].…”