ORIGINAL ARTICLES   

International Angiology 2002 June;21(2):165-8

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Vascular endothelial growth factor in patients with critical limb ischemia before and after amputation

McLaren M., Newton D. J., Khan F., Belch J. J. F.

Department of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee United Kingdom

Background. It is known that lev­els of vas­cu­lar endo­the­lial ­growth fac­tor (VEGF) in bio­log­i­cal ­fluids ­increase with inflam­ma­tion and vas­cu­lar pro­life­ra­tion. Theraputic angio­gen­e­sis by injec­tion of VEGF or genes encod­ing for it may be a prom­is­ing strat­e­gy for treat­ment of crit­i­cal limb ische­mia. However ­growth fac­tors are also impli­cat­ed in the devel­op­ment of vas­cu­lar dis­ease by ­smooth mus­cle cell pro­life­ra­tion.
Methods. We have pre­vi­ous­ly shown VEGF lev­els to be ­increased in juve­nile dia­bet­ic sub­jects with no clin­i­cal evi­dence of vas­cu­lar dis­ease. We have meas­ured serum VEGF using an ­enzyme ­linked immu­no­sor­bent assay and cel­lu­lar VEGF expres­sion using flow cytom­e­try in ­patients with crit­i­cal limb ische­mia prior to and 6 ­months postampu­ta­tion to deter­mine wheth­er remov­al of the ischem­ic limb leads to chang­es in system­ic endo­the­lial cell func­tion.
Results. Baseline VEGF lev­els were sig­nif­i­cant­ly ­increased in the ­patient group com­pared to con­trols with lev­els return­ing to con­trol lev­els at 6 ­months postsur­gery. Monocyte and neu­troph­il VEGF expres­sion was sig­nif­i­cant­ly ­reduced in the ­patient group. Platelet expres­sion of VEGF was also ­reduced but this ­failed to reach sta­tis­ti­cal sig­nif­i­cance.
Conclusions. The ­results sug­gest that it may be use­ful to deter­mine the bal­ance ­between VEGF pro­duc­tion and cel­lu­lar recep­tor expres­sion prior to treat­ment.