title: Serum levels of vascular endothelial growth factor (VEGF) are markedly elevated in patients with Wegener's granulomatosis.
abstract: OBJECTIVE
  Necrotizing vasculitis and granuloma formation are the predominant features of Wegener's granulomatosis (WG). We have investigated the importance of vascular endothelial growth factor (VEGF) in monitoring disease activity in WG.
  
  
  METHODS
  Serum VEGF levels were determined in 23 patients with active WG, 21 healthy controls and 25 patients with urinary infection, by ELISA using commercially available antibodies to VEGF.
  
  
  RESULTS
  VEGF levels were enormously elevated in patients with WG compared to both controls and patients with urinary infection (P < 0.0001). Of the 23 patients, 21 (91.3%) had VEGF levels above the cut-off value (3.3 ng/ml, calculated as the mean of the controls + 2 S.D.). Further analysis of the data showed that VEGF levels did not correlate with age, sex, incidence of classic antineutrophil cytoplasmic antibodies (c-ANCA) or duration of the disease (P > 0.05), but there was correlation with disease activity (r = 0.51, P < 0.01). VEGF levels were higher in patients with major compared to those with minor disease activity (P < 0.01). However, there was no significant correlation between VEGF levels and the Birmingham scores for vascular activity and damage.
  
  
  CONCLUSIONS
  VEGF levels are raised in WG patients compared to normal controls and may be a marker of disease activity. Further studies on serial blood samples from a large cohort of patients with WG and other systemic vasculitides are needed to evaluate the specificity and usefulness of VEGF levels in monitoring disease activity.
authors.affiliation: Musculoskeletal Research Group, University of Manchester.
authors.forename: C G
authors.initials: CG
authors.lastname: Li
authors.forename: I
authors.initials: I
authors.lastname: Reynolds
authors.forename: J M
authors.initials: JM
authors.lastname: Ponting
authors.forename: P J
authors.initials: PJ
authors.lastname: Holt
authors.forename: M C
authors.initials: MC
authors.lastname: Hillarby
authors.forename: S
authors.initials: S
authors.lastname: Kumar
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis; D015415:Biomarkers; D016228:Endothelial Growth Factors / Q000097:blood*; D005260:Female; D005455:Fluorescent Antibody Technique; D014890:Granulomatosis with Polyangiitis / Q000097:blood* / Q000276:immunology; D006801:Humans; D007249:Inflammation / Q000097:blood; D008222:Lymphokines / Q000097:blood*; D008297:Male; D009504:Neutrophils / Q000737:chemistry; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors