title: Vascular endothelial growth factor-A (VEGF-A) and chemokine ligand-2 (CCL2) in amyotrophic lateral sclerosis (ALS) patients.
abstract: BACKGROUND
  Vascular endothelial growth factor-A (VEGF-A) and chemokne ligand-2 (CCL2) levels have been examined in Amyotrophic Lateral Sclerosis (ALS) patients in Western countries. We measured these values in North Indian ALS patients, since these patients display considerably enhanced survival duration.
  
  
  METHODS
  Sporadic ALS patients were included on the basis of El Escorial criteria. VEGF-A and CCL2 levels were analyzed in serum and cerebrospinal fluid (CSF) of 50 ALS patients using enzyme linked immunosorbent assay (ELISA) and compared with normal controls. Their levels were adjusted for possible confounders like cigarette smoking, alcohol and meat consumption.
  
  
  RESULTS
  Contrary to previous studies, VEGF-A was found to be elevated significantly in serum and CSF in ALS patient population studied. We also found an increase in CCL2 levels in CSF of these ALS patients. Serum and CSF from definite ALS revealed higher VEGF-A as compared to probable and possible ALS. CCL2 was unaltered between definite, probable and possible ALS. Univariate and multivariate analysis revealed a lack of association of smoking, alcohol and meat consumption with VEGF-A and CCL2 levels.
  
  
  CONCLUSIONS
  VEGF-A upregulation may indicate an activation of compensatory responses in ALS which may reflect or in fact account for increased survival of North Indian ALS patients after disease onset. The intrathecal synthesis of CCL2 suggests the involvement of adult neural stem cells and microglial activation in ALS pathogenesis which needs further investigation.
authors.affiliation: Department of Neurology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh-160012, India.
authors.forename: Pawan K
authors.initials: PK
authors.lastname: Gupta
authors.forename: Sudesh
authors.initials: S
authors.lastname: Prabhakar
authors.forename: Suresh
authors.initials: S
authors.lastname: Sharma
authors.forename: Akshay
authors.initials: A
authors.lastname: Anand
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000097:blood* / Q000134:cerebrospinal fluid*; D018932:Chemokine CCL2 / Q000097:blood* / Q000134:cerebrospinal fluid*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D042461:Vascular Endothelial Growth Factor A / Q000097:blood* / Q000134:cerebrospinal fluid*
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D042461:Vascular Endothelial Growth Factor A