title: [The potential pathogenesis of gastrointestinal vascular malformation and the potential mechanism of thalidomide in the treatment of gastrointestinal vascular malformation].
abstract: OBJECTIVE
  To study the pathogenesis of gastrointestinal vascular malformation (GIVM) and the potential mechanism of thalidomide in the treatment of gastrointestinal bleeding due to GIVM.
  
  
  METHODS
  We collected the surgical intestinal specimens from 10 patients who suffered from massive hemorrhage of gastrointestinal tract owning to GIVM and the normal intestinal mucosa around the lesions, as well as normal intestinal mucosa from healthy subjects. Immunohistochemical (IHC) staining was carried out to investigate the differences of angiopoietin 2 (Ang2), Notch1 and delta like ligand 4 (Dll4) in the above three intestinal mucosa to find the relationship with the pathogenesis of GIVM. Human umbilical vein endothelial cells (HUVECs) were cultured with 0, 25, 50, 100 and 200 mg/L thalidomide for 24 or 48 hours to observe their mRNA and protein expressions of Ang2, Notch1, Dll4 by real-time PCR and Western blot.
  
  
  RESULTS
  By IHC staining, more expressions of Ang2, Notch1 and Dll4 in the lesions were detected than those in the normal intestinal mucosa around the lesions and the normal intestinal mucosa in healthy people. The expressions of Ang2, Notch1 and Dll4 were significantly correlated (P = 0.016, r = 0.732), and the expressions of Notch1 and Dll4 were absolutely correlated (P = 0.000, r = 1.000). Real-time PCR and Western blot showed that thalidomide could down-regulate the expressions of them, which were in a concentration-dependent manner.
  
  
  CONCLUSIONS
  Ang2, Notch1 and Dll4 may correlate with the pathogenesis of GIVM, while thalidomide can concentration-dependently down-regulate the expression of Ang2, Notch1 and Dll4, which may be one of the mechanism that thalidomide play a therapeutic role in GIVM.
authors.affiliation: Department of Gastroenterology and Hepatology, Shanghai Jiao-Tong University School of Medicine Renji Hospital, Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, (Shanghai Jiao-Tong University), Shanghai 200001, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Feng
authors.forename: Hong-Hong
authors.initials: HH
authors.lastname: Tan
authors.forename: Zhi-Zheng
authors.initials: ZZ
authors.lastname: Ge
authors.forename: Yun-Jie
authors.initials: YJ
authors.lastname: Gao
authors.forename: Hui-Min
authors.initials: HM
authors.lastname: Chen
authors.forename: Jing-Yuan
authors.initials: JY
authors.lastname: Fang
authors.forename: Shu-Dong
authors.initials: SD
authors.lastname: Xiao
mesh_terms: D000328:Adult; D000368:Aged; D042702:Angiopoietin-2 / Q000378:metabolism; D005260:Female; D041981:Gastrointestinal Tract / Q000098:blood supply / Q000473:pathology; D005786:Gene Expression Regulation; D061307:Human Umbilical Vein Endothelial Cells; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins / Q000378:metabolism; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism; D008875:Middle Aged; D051881:Receptor, Notch1 / Q000378:metabolism; D015398:Signal Transduction; D013792:Thalidomide / Q000627:therapeutic use*; D054079:Vascular Malformations / Q000188:drug therapy* / Q000378:metabolism*; D055815:Young Adult
chemical_list: D042702:Angiopoietin-2; D047908:Intracellular Signaling Peptides and Proteins; D008565:Membrane Proteins; C497761:NOTCH1 protein, human; D051881:Receptor, Notch1; C064045:delta protein; D013792:Thalidomide