Increased serum level of vascular endothelial growth factor in Mycobacterium avium complex infection.
OBJECTIVE
Pulmonary infection caused by Mycobacterium avium complex (MAC) is one of the granulomatous diseases which are associated with the expression of vascular endothelial growth factor (VEGF). The aim of the present study was to clarify the association of VEGF with the pathogenesis of MAC infection.


METHODS
The serum VEGF levels in 46 patients with pulmonary MAC infection were compared with those in 16 normal control subjects. Pulmonary lesions were evaluated using chest CT. In 20 patients, after treatment, serum VEGF levels were measured and chest CT performed again to evaluate pulmonary response to treatment.


RESULTS
Infected patients had higher serum VEGF levels than controls (435.2 +/- 29.1 vs. 167.0 +/- 10.6 pg/mL, P < 0.0001), and serum VEGF level correlated with the extent of disease. The serum VEGF levels in 14 patients who underwent treatment and exhibited an improvement in their pulmonary lesions decreased significantly compared with the results pretreatment (509.0 +/- 60.7 vs. 303.6 +/- 65.3 pg/mL, P = 0.0092). In infected patients, alveolar macrophages, epithelioid cells and multinucleated giant cells exhibited VEGF overexpression on immunohistochemical staining.


CONCLUSIONS
This study suggests that VEGF may be associated with the pathogenesis of pulmonary MAC infection. Additionally, serum VEGF levels may be a useful surrogate marker for evaluating the extent of disease and of the response to treatment.
Nishigaki
Yutaka
Y
Department of Respiratory Medicine, National Dohoku Hospital, Asahikawa, Japan. yutakan@asahikawa.hosp.go.jp
Fujiuchi
Satoru
S
Fujita
Yuka
Y
Yamazaki
Yasuhiro
Y
Sato
Maki
M
Yamamoto
Yasushi
Y
Takeda
Akinori
A
Fujikane
Toshiaki
T
Shimizu
Tetsuo
T
Kikuchi
Kenjiro
K
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D018942:Macrolides / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000097:blood* / Q000378:metabolism
D000995:Antitubercular Agents; D018942:Macrolides; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A