Immunohistochemical study in dural arteriovenous fistula and possible role of ephrin-B2 for development of dural arteriovenous fistula.
BACKGROUND
Although there were several clinical and experimental studies discussing the pathogenesis of dural arteriovenous fistula (DAVF), the pathological process leading to intracranial DAVF so far remains unknown. In this study, we investigated the expression of vascular growth factors in order to elucidate the possible role of these factors for the development of DAVF and to study the biological activity of this uncommon lesion.


METHODS
We examined the histological features, proliferative and angiogenic capacities of the tissue specimens obtained from 6 patients who underwent surgery at our institution. Immunohistochemical staining for vascular endothelial growth factor (VEGF), its receptors Flk-1 and Flt-1, ephrin-B2, MIB-1 and proliferating cell nuclear antigen (PCNA) was performed using standard immunohistochemical techniques.


RESULTS
A positive immunostaining was found for all antibodies studied except MIB-1, whereas nuclear endothelial expression of PCNA was observed in only 3/6 cases. VEGF stained positive in all of the available specimens (6/6). Flk-1 showed a positive immunoreaction in only 2/6 cases and Flt-1 in 4/6 cases. Ephrin-B2 was expressed in the majority (5/6) of the cases.


CONCLUSIONS
These results support the hypothesis that DAVFs might be acquired dynamic vascular malformations with low biological activity. Vascular growth factors like VEGF and ephrin-B2 might play a pivotal role in the formation of DAVF.
Tirakotai
Wuttipong
W
Department of Neurosurgery, Philipps University, Marburg 35033, Germany.
Bian
Liu-guan
LG
Bertalanffy
Helmut
H
Siegfried
Bien
B
Sure
Ulrich
U
D000368:Aged; D002455:Cell Division; D020785:Central Nervous System Vascular Malformations / Q000209:etiology / Q000378:metabolism* / Q000473:pathology; D042783:Endothelial Cells / Q000166:cytology; D036388:Ephrin-B2 / Q000032:analysis / Q000502:physiology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
D036388:Ephrin-B2; D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen; D042461:Vascular Endothelial Growth Factor A