title: Vascular endothelial growth factor A protein level and gene expression in intracranial meningiomas with brain edema.
abstract: Meningiomas are the second most common primary intracranial tumors in adults. Although meningiomas are mostly benign, more than 50% of patients with meningioma develop peritumoral brain edema (PTBE), which may be fatal because of increased intracranial pressure. Vascular endothelial growth factor (VEGF) is an endothelial cell-specific mitogen and angiogen. VEGF-A protein, which is identical to vascular permeability factor, is a regulator of angiogenesis. In this study, 101 patients with meningiomas, and possible co-factors to PTBE, such as meningioma subtypes and tumor location, were examined. Forty-three patients had primary, solitary, supratentorial meningiomas with PTBE. In these, correlations in PTBE, edema index, VEGF-A protein, VEGF gene expression, capillary length, and tumor water content were investigated. DNA-branched hybridization was used for measuring VEGF gene expression in tissue homogenates prepared from frozen tissue samples. The method for VEGF-A analysis resembled an ELISA assay, but was based on chemiluminescence. The edema index was positively correlated to VEGF-A protein (p = 0.014) and VEGF gene expression (p < 0.05). The capillary length in the meningiomas was positively correlated to the PTBE (p = 0.038). If VEGF is responsible for the formation of PTBE, the edema may be treated with the anti-VEGF drug Bevacizumab (Avastin), which has been shown to reduce PTBE in patients with glioblastoma multiforme.
authors.affiliation: Department of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark. damoun.nassehi@gmail.com
authors.forename: Damoun
authors.initials: D
authors.lastname: Nassehi
authors.forename: Henrik
authors.initials: H
authors.lastname: Dyrbye
authors.forename: Morten
authors.initials: M
authors.lastname: Andresen
authors.forename: Carsten
authors.initials: C
authors.lastname: Thomsen
authors.forename: Marianne
authors.initials: M
authors.lastname: Juhler
authors.forename: Henning
authors.initials: H
authors.lastname: Laursen
authors.forename: Helle
authors.initials: H
authors.lastname: Broholm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000188:drug therapy / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D008579:Meningioma / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D060787:Neoplasm Grading; D012333:RNA, Messenger / Q000032:analysis; D012727:Sex Characteristics; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis* / Q000235:genetics
chemical_list: D012333:RNA, Messenger; D042461:Vascular Endothelial Growth Factor A