Circulating vascular endothelial growth factor and systemic inflammatory markers in patients with stable and exacerbated chronic obstructive pulmonary disease
Résumé
Background: To assess circulating levels of vascular endothelial growth factor (VEGF), a biomarker with prognostic significance in cardiovascular disease, and markers of systemic inflammation in patients with stable and exacerbated chronic obstructive pulmonary disease (COPD). Materials and methods: Lung function parameters, arterial blood gas analysis and circulating levels of VEGF, interleukin-6, tumor necrosis factor-alpha, C-reactive protein, fibrinogen, and peripheral blood neutrophil cell count were assessed in 30 patients on admission to the hospital for acute exacerbation of COPD, in 30 age, sex and body mass index matched patients with stable COPD, and 30 matched controls with normal lung function. Results: Patients with acute exacerbated COPD had higher circulating concentrations of VEGF (p<0.001), interleukin-6 (p<0.05), C-reactive protein (p<0.01), and an increased blood neutrophil cell count (p<0.05) than did patients with stable COPD and healthy controls. VEGF levels in exacerbated COPD correlated with systemic inflammatory markers, such as C-reactive protein (r = 0.61, p <0.005), interleukin-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 FEV1% predicted (r = 0.47, p<0.01). Recovery from the exacerbation resulted in a significant reduction in both circulating VEGF levels and markers of systemic inflammation. Conclusions: 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.
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