Vascular endotherial growth factor )VEGF) in paranasal sinusitis and allergic rhinitis

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The level of Vascular Endothelial Growth Factor (VEGF) in nasal secretions and blood plasma obtained from rhinosinusitis cases was quantified by enzyme-linked immunosorbent assay (ELISA) and compared among patients with nasal allergy and those with paranasal sinusitis with/without nasal allergy. In addition, the distribution of VEGF-positive cells in paranasal sinus mucosa obtained during surgical procedures was investigated immunohistochemincally. The ratio of VEGF to albumin (V/A) in nasal secretion was significantly higher than that of VEGF in plasma (p,0.01) in all the rhinosinusitis cases. Among rhinosinusitis cases, the ratio of V/A in nasal secretion was higher in cases of nasal allergy (p<0.01) or sinusitis with nasal allergy (p<0.02) than in cases with sinusitis only. According to the immunohistochemical study, VEGF-positive findings were observed in inflammatory infiltrating cells including eosinophils, serous glandular acini and vascular endothelium. While glandular acini clearly differentiating to the serous or mucous type were observed to be hyperplastic in allergic cases, hyperplastic glandular acini were not clearly differentiating to the serous or mucous type in non-allergic cases. These results suggest that VEGF production increases at the site of rhinosinusitis mucosa especially in cases with allergic diseases. According to the study by cultured fibloblasts from human nasal polyp, VEGF production was activated by hypoxia and it was suppressed by clarithromycin (CAM), roxithromycin (RXM) and Dexametazone (DXM) but not by Ampicillin (ABPC) and Dimethyl Sulfoxide (DMSO). PD098059 suppressed more effectively the VEGF production from the culture under hypoxia than Gliotoxin, which suggests the pathway of tyrosine phosphorylation of Mitogen-Activated Protein (MAP) kinase is more important than that of Nuclear Factor κ B (NFκB) under the hypoxic stress on nasal fibloblasts.