Plasma levels of vascular endothelial growth factor after treatment for cerebral arteriovenous malformations
Plasma levels of vascular endothelial growth factor after treatment for cerebral arteriovenous malformations
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DOI：
10.1161/strokeaha.107.512442
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发表时间：
2008-08-01
期刊：
影响因子：
8.3
通讯作者：
Connolly, Sander, Jr.
中科院分区：
文献类型：
--
作者：
Kim, Grace H.;Hahn, David K.;Connolly, Sander, Jr.
背景和目的--异常血管生成在脑动静脉畸形(Avms)的形成和发展中的作用尚不清楚。以往的研究表明，血管内皮细胞生长因子在AVM组织中的局部表达增加，并且在AVM患者中循环中的VEGF水平增加。我们通过检测动静脉畸形患者治疗前后血浆中血管内皮生长因子水平的变化，进一步探讨血管内皮细胞生长因子在动静脉畸形病理生理学中的作用。方法：13例动静脉畸形患者在治疗前、术后24小时和术后30天分别采集3份连续血样。采用商品化的酶联免疫吸附试验(EL ISA)测定血浆中血管内皮生长因子的浓度。结果：脑动静脉畸形患者基础状态下平均血浆血管内皮生长因子水平为36.08±13.02pg/mL，显著低于对照组的80.52±14.02pg/mL(P=0.028)。术后24小时，血浆血管内皮生长因子水平降至20.09+/-4.54pg/mL，30天后回升至66.81+/-26.45pg/mL(P=0.048)。AVM患者术后30d血浆VEGF水平与对照组无显著差异(P=0.33)。结论：13例AVM患者血浆VEGF水平显著低于对照组，术后早期下降，30d后显著升高。这些结果支持异常血管生成在AVM病理生理学中的关键作用，并提示系统血管内皮生长因子表达的中断可能有助于这些病变的自然病程。
Background and Purpose - The role of abnormal angiogenesis in the formation and progression of cerebral arteriovenous malformations (AVMs) is unclear. Previous studies have demonstrated increased local expression of vascular endothelial growth factor (VEGF) in AVM tissue and increased circulating levels of VEGF in AVM patients. We sought to further investigate the role of VEGF in AVM pathophysiology by examining changes in plasma VEGF levels in patients undergoing treatment for AVMs.Methods - Three serial blood samples were obtained from 13 AVM patients undergoing treatment: (1) before any treatment, (2) 24 hours postresection, and (3) 30 days postresection. Plasma VEGF concentrations were measured via commercially available enzyme-linked immunosorbent assay (ELISA). For controls, blood samples were obtained from 29 lumbar laminectomy patients.Results - The mean plasma VEGF level in AVM patients at baseline was 36.08 +/- 13.02 pg/mL, significantly lower than that of the control group (80.52 +/- 14.02 pg/mL, P=0.028). Twenty-four hours postresection, plasma VEGF levels dropped to 20.09 +/- 4.54 pg/mL, then increased to 66.81 +/- 26.45 pg/mL 30 days later (P=0.048). The mean plasma VEGF concentration 30 days after resection was no longer significantly different from the control group (P=0.33).Conclusions - Plasma VEGF levels in 13 AVM patients were unexpectedly lower than controls, dropped early after AVM resection, then significantly increased 30 days later. These results support the key role of abnormal angiogenesis in AVM pathophysiology and suggest that a disruption in systemic VEGF expression may contribute to the natural history of these lesions.