title: Relationship between serum levels of vascular endothelial growth factor, hepatocyte growth factor and matrix metalloproteinase-9 with biochemical markers of bone disease in multiple myeloma.
abstract: BACKGROUND
  Multiple myeloma is characterized by accumulation of plasma cells in the bone marrow, with osteolysis and increased marrow angiogenesis. We studied molecules involved in angiogenesis (MMP-9, HGF, VEGF) in relation to disease stage, extent of bone destruction, and markers of bone turnover (Ntx and PICP).
  
  
  METHODS
  MMP-9, HGF, VEGF were measured in the serum of 42 newly diagnosed myeloma patients and 24 controls with commercial ELISA kits. Urinary levels of Ntx were measured by ELISA, and serum PICP with RIA. Extent of radiological bone disease was graded into low and high score. Stage was estimated according to the Durie-Salmon criteria.
  
  
  RESULTS
  HGF, VEGF and Ntx were higher in patients than controls (p<0.001). MMP-9 and PICP did not differ between patients and controls. HGF, VEGF, MMP-9 and Ntx increased significantly with disease stage (I to III, p<0.001) and PICP decreased significantly with advancing stage (p<0.05). There was a positive correlation between HGF and MMP-9 (r: 0.36, p<0.01), VEGF and MMP-9 (r: 0.38, p<0.01), Ntx and MMP-9 (r: 0.39, p<0.01) and an inverse correlation between PICP and MMP-9 (r: -0.66, p<0.0001).
  
  
  CONCLUSIONS
  Angiogenesis and bone destruction are closely interrelated in myeloma, and cytokine levels (MMP-9, VEGF and HGF) may be useful in monitoring progression.
authors.affiliation: Department of Haematology, University Hospital of Heraklion, Heraklion, Crete, Greece. freda@med.uoc.gr
authors.forename: Michael G
authors.initials: MG
authors.lastname: Alexandrakis
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Sfiridaki
authors.forename: Spiros
authors.initials: S
authors.lastname: Miyakis
authors.forename: Constantina
authors.initials: C
authors.lastname: Pappa
authors.forename: Ermioni
authors.initials: E
authors.lastname: Kandidaki
authors.forename: Athanassios
authors.initials: A
authors.lastname: Alegakis
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Margioris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001847:Bone Diseases / Q000175:diagnosis* / Q000209:etiology; D024042:Collagen Type I / Q000097:blood; D005260:Female; D017228:Hepatocyte Growth Factor / Q000097:blood*; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000209:etiology; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D011347:Procollagen / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; D042461:Vascular Endothelial Growth Factor A; C052929:collagen type I trimeric cross-linked peptide; C042813:procollagen type I carboxy terminal peptide; D017228:Hepatocyte Growth Factor; D020780:Matrix Metalloproteinase 9