title: Expression and proteolysis of vascular endothelial growth factor is increased in chronic wounds.
abstract: Degradation of angiogenic mediators might be an underlying cause of chronic wounds. To test this hypothesis, we evaluated the expression and integrity of vascular endothelial growth factor, a potent angiogenic mediator, and its receptors, Flt-1 and KDR, in chronic venous leg ulcerations. Immunohisto- chemical, in situ hybridization, and semiquantitative reverse transcriptase polymerase chain reaction analyses all indicate that expression of vascular endothelial growth factor is elevated in ulcerative tissue, with vascular endothelial growth factor mRNA being especially pronounced in the hyperplastic epithelium of the wound margin. Flt-1 and KDR protein and mRNA were detected in the papillary vessels in close vicinity to the lesional epithelium of chronic wounds. Although increased expression of vascular endothelial growth factor protein was detected in the epidermis, the intensity of this staining was weak compared with the epidermal staining in psoriatic lesions and compared with the strong vascular endothelial growth factor mRNA signal in chronic wounds and psoriasis. To analyze whether this apparent decrease in immunoreactivity could be the result of degradation of vascular endothelial growth factor by proteolytic activities from the wound environment, we examined the stability of recombinant vascular endothelial growth factor in wound fluid from chronic leg ulcers. As demonstrated by sodium dodecyl sulfate polyacrylamide gel electrophoresis, incubation of rVEGF165 with chronic, but not acute, wound fluid resulted in rapid proteolytic degradation of rVEGF165. Protease inhibitor studies indicate that serine proteases, such as plasmin, are involved in this degradation. Together, our data show that, although vascular endothelial growth factor expression is elevated in chronic wounds, increased proteolytic activity in this environment results in its degradation, which may contribute to an impaired wound healing response.
authors.affiliation: Department of Dermatology, University of Cologne, Cologne, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Lauer
authors.forename: S
authors.initials: S
authors.lastname: Sollberg
authors.forename: M
authors.initials: M
authors.lastname: Cole
authors.forename: I
authors.initials: I
authors.lastname: Flamme
authors.forename: J
authors.initials: J
authors.lastname: Stürzebecher
authors.forename: K
authors.initials: K
authors.lastname: Mann
authors.forename: T
authors.initials: T
authors.lastname: Krieg
authors.forename: S A
authors.initials: SA
authors.lastname: Eming
mesh_terms: D002908:Chronic Disease; D004355:Drug Stability; D016228:Endothelial Growth Factors / Q000096:biosynthesis / Q000378:metabolism*; D005122:Exudates and Transudates / Q000378:metabolism; D005341:Fibrinolysin / Q000502:physiology; D015870:Gene Expression; D006801:Humans; D007871:Leg Ulcer / Q000378:metabolism; D008222:Lymphokines / Q000096:biosynthesis / Q000378:metabolism*; D011480:Protease Inhibitors / Q000494:pharmacology; D020033:Protein Isoforms / Q000378:metabolism; D011518:Proto-Oncogene Proteins / Q000235:genetics; D012333:RNA, Messenger / Q000378:metabolism; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics; D017978:Receptors, Growth Factor / Q000235:genetics; D040262:Receptors, Vascular Endothelial Growth Factor; D011994:Recombinant Proteins / Q000378:metabolism; D015854:Up-Regulation; D042461:Vascular Endothelial Growth Factor A; D040281:Vascular Endothelial Growth Factor Receptor-1; D042442:Vascular Endothelial Growth Factors; D014947:Wounds and Injuries / Q000378:metabolism*
chemical_list: D016228:Endothelial Growth Factors; D008222:Lymphokines; D011480:Protease Inhibitors; D020033:Protein Isoforms; D011518:Proto-Oncogene Proteins; D012333:RNA, Messenger; D017978:Receptors, Growth Factor; D011994:Recombinant Proteins; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D020794:Receptor Protein-Tyrosine Kinases; D040262:Receptors, Vascular Endothelial Growth Factor; D040281:Vascular Endothelial Growth Factor Receptor-1; D005341:Fibrinolysin