title: Targeting vascular endothelial growth factor pathway offers new possibilities to counteract microvascular disturbances during ischemia/reperfusion of the pancreas.
abstract: BACKGROUND
  It is of crucial importance to explore new therapeutic strategies capable of combating or even preventing pancreatic graft failure after transplantation caused by ischemia reperfusion damage. So far, the role of the hypoxia induced mediator vascular endothelial growth factor (VEGF) upon pancreatic microcirculation has not been described. Therefore the aim of this study was to investigate its influence, using the novel tyrosinekinase inhibitor PTK787/ZK222584 (PTK/ZK), upon functional capillary density (FCD), leukocyte-endothelium interaction (LEI), and macromolecular permeability (P) of normal and postischemic pancreas tissue.
  
  
  METHODS
  Sprague-Dawley rats were anesthetized and randomly assigned to five groups (n=7/group): (a) sham, (b) ischemia/reperfusion (I/R) control, (c) I/R and PTK/ZK treatment, (d) VEGF-superfusion, (e) VEGF-superfusion and PTK/ZK-treatment. A recently established method of digital dynamic intravital epifluorescence microscopy was used for evaluating the effective microvascular permeability together with FCD and LEI.
  
  
  RESULTS
  Comparison between sham vs. I/R shows a significant upregulation of VEGF-expression followed by deterioration of microcirculation with decreased FCD, increased P and LEI. Treatment with PTK/ZK resulted in a significant decrease of P under conditions of superfusion with VEGF as well as I/R compared to corresponding groups without treatment.
  
  
  CONCLUSIONS
  VEGF plays a crucial causative role involving an increase in permeability in normal as well as in postischemic pancreatitis via tyrosinkinase receptors. VEGF seems to be partly accountable for a deterioration of FCD and an upregulation of LEI via VEGF-tyrosinekinase receptor independent mechanisms. VEGF might be a promising potential therapeutic target in order to minimize edema formation caused by I/R and pancreatitis in pancreas transplantation.
authors.affiliation: Department of General and Visceral Surgery, University of Freiburg, Freiburg, Germany. ernst@von-dobschuetz.de
authors.forename: Ernst
authors.initials: E
authors.lastname: von Dobschuetz
authors.forename: Sebastian
authors.initials: S
authors.lastname: Meyer
authors.forename: David
authors.initials: D
authors.lastname: Thorn
authors.forename: Dieter
authors.initials: D
authors.lastname: Marme
authors.forename: Ulrich Theodor
authors.initials: UT
authors.lastname: Hopt
authors.forename: Oliver
authors.initials: O
authors.lastname: Thomusch
mesh_terms: D000818:Animals; D002199:Capillary Permeability; D004487:Edema / Q000209:etiology; D004797:Enzyme-Linked Immunosorbent Assay; D007962:Leukocytes / Q000502:physiology; D008297:Male; D010179:Pancreas / Q000098:blood supply*; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis / Q000037:antagonists & inhibitors / Q000502:physiology*
chemical_list: D042461:Vascular Endothelial Growth Factor A