Vascular endothelial growth factor (VEGF) is one of the cytokines causative and predictive of hepatic veno-occlusive disease (VOD) in stem cell transplantation.
Hepatic veno-occlusive disease (VOD) is one of the most serious complications in patients receiving stem cell transplantation (SCT). However, the cause of VOD remained to be elucidated. Vascular endothelial growth factor (VEGF) has been reported to have various physiological effects including neovascularization and acceleration of vasopermeability. Because we postulated that VEGF could be one of the causative factors in VOD after SCT, serum VEGF levels were measured by ELISA in 50 patients receiving SCT. Six of the patients showed typical manifestations of VOD and four of them died due to VOD. The mean maximum serum VEGF level in the six patients with VOD was markedly increased compared to that in the patients without VOD (P < 0.001) and in normal controls (P < 0.001). Moreover, the mean maximum serum VEGF level in patients with VOD before conditioning chemoradiotherapy for SCT was also high compared to patients without VOD (P = 0.0012) in the same period. Similarly, serum VEGF levels were significantly higher in patients whose plasma protein C activities decreased below 40% (P < 0.001). During the clinical course of VOD after SCT, the increase of serum VEGF synchronized fairly well with the development of VOD. Since VEGF causes the expression of tissue factor on circulating monocyte/macrophages and results in hypercoagulability, our observation suggests that in the patients with VOD who showed high serum VEGF it might account for the development of VOD. Furthermore, this observation may indicate a novel therapeutic strategy for prevention of VOD.
Iguchi
A
A
Department of Pediatrics, Hokkaido University School of Medicine, Sapporo City, Japan.
Kobayashi
R
R
Yoshida
M
M
Kobayashi
K
K
Matsuo
K
K
Kitajima
I
I
Maruyama
I
I
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016207:Cytokines / Q000009:adverse effects / Q000097:blood; D016228:Endothelial Growth Factors / Q000009:adverse effects / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006402:Hematologic Diseases / Q000150:complications / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006504:Hepatic Veno-Occlusive Disease / Q000097:blood* / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007223:Infant; D008222:Lymphokines / Q000009:adverse effects / Q000097:blood*; D008297:Male; D011379:Prognosis; D011486:Protein C / Q000378:metabolism; D013997:Time Factors; D019172:Transplantation Conditioning; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D015415:Biomarkers; D016207:Cytokines; D016228:Endothelial Growth Factors; D008222:Lymphokines; D011486:Protein C; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors