Angiogenic factors and angiogenesis inhibitors in exudative pleural effusions.
The angiogenesis system has been implicated in inflammatory and neoplastic processes; nevertheless, it has been little studied in relation to the pleural space. Our aim is to analyze pleural and plasma levels of the activators--vascular endothelial growth factor, basic fibroblastic growth factor, and inhibitors--endostatin and thrombospondin-1 and to estimate the association between these factors and related biochemical markers. We analyzed pleural fluid from 105 patients with one of the following types of pleural effusion: empyema or complicated parapneumonic, non-complicated parapneumonic, tuberculous, neoplastic and transudative. Angiogenesis activators were higher in exudates than in transudates (p < 0.001) and in empyema than in non-complicated parapneumonic patients (p < 0.001). Endostatin showed no significant differences. Trombospondin-1 showed higher levels in exudates than in transudates and in empyema than in non-complicated parapneumonic effusions (p < 0.001). In pleural exudates there was a positive correlation of angiogenesis activators and trombospondin-1 with low glucose and pH and high LDH. There was no correlation between pleural and plasma levels of the angiogenesis factors. We conclude that exudative pleural effusions showed higher vascular endothelial growth factor, basic-fibroblastic growth factor and trombospondin-1 values than transudative effusions that associated to low glucose and pH, and high LDH. There was no correlation between pleural and plasma concentrations, suggesting a compartmentalized response.
Ruiz
Eva
E
Department of Internal Medicine, General Universitari Vall d'Hebron, Barcelona, Spain. 30807err@comb.es
Alemán
Carmen
C
Alegre
José
J
Monasterio
Jasone
J
Segura
Rosa Ma
RM
Armadans
Lluis
L
Vázquez
Ana
A
Soriano
Teresa
T
Fernández de Sevilla
Tomás
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D043925:Angiogenesis Inducing Agents / Q000032:analysis*; D020533:Angiogenesis Inhibitors / Q000032:analysis*; D043169:Endostatins / Q000032:analysis; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic / Q000502:physiology*; D010996:Pleural Effusion / Q000737:chemistry*; D011446:Prospective Studies; D012372:ROC Curve; D019700:Thrombospondin 1 / Q000032:analysis; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
D043925:Angiogenesis Inducing Agents; D020533:Angiogenesis Inhibitors; D043169:Endostatins; D019700:Thrombospondin 1; D042461:Vascular Endothelial Growth Factor A; D016222:Fibroblast Growth Factor 2