Vascular endothelial growth factor in epithelial lining fluid of patients with acute respiratory distress syndrome.
OBJECTIVE
Vascular endothelial growth factor (VEGF) is known to contribute to the development of pulmonary oedema, and has been suggested to have a protective role against lung injury. To determine the role of VEGF in acute lung injury (ALI) and ARDS, VEGF levels were measured in lung epithelial lining fluid (ELF) collected from patients with ALI/ARDS.


METHODS
Forty patients with ALI/ARDS underwent bronchoscopic microsampling to collect ELF on days 0 (onset of ALI/ARDS), 1, 3, 5, 7 and 10, unless the patient was extubated or had died. Twelve patients, who underwent bronchoscopy for examination of small, peripheral pulmonary nodules, served as controls.


RESULTS
The initial (day 0) levels of VEGF in ELF of the ALI/ARDS patients who survived and those who did not were 5.5 ng/mL (IQR: 2.3-19.7) and 1.7 ng/mL (IQR: 0.0-6.4), respectively. On days 0, 5, 7 and 10, the VEGF levels in ELF were significantly greater in survivors than in non-survivors (P < 0.05). VEGF levels on days 1 and 3 did not differ between survivors and non-survivors. There was no significant difference in ELF VEGF levels between control subjects and patients with ALI/ARDS at any time point. Lung injury score was inversely correlated with VEGF concentration in ELF (P < 0.001).


CONCLUSIONS
In patients with ALI/ARDS, elevated VEGF levels in ELF may predict a better outcome. Increased production of VEGF in the injured lung may contribute to resolution of inflammation in the lung.
Koh
Hidefumi
H
Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan.
Tasaka
Sadatomo
S
Hasegawa
Naoki
N
Asano
Koichiro
K
Kotani
Toru
T
Morisaki
Hiroshi
H
Takeda
Junzo
J
Fujishima
Seitaro
S
Matsuda
Tomoyuki
T
Hashimoto
Satoru
S
Ishizaka
Akitoshi
A
D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D001999:Bronchoscopy; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D020545:Respiratory Mucosa / Q000378:metabolism*; D012720:Severity of Illness Index; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
D042461:Vascular Endothelial Growth Factor A