Multiple angiogenetic factors are upregulated in POEMS syndrome.
Polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome is a multisystem disorder associated with plasma cell dyscrasia. Elevated serum levels of vascular endothelial growth factor (VEGF), which strongly promotes neovascularization and vasopermeability, are considered to be responsible for the characteristic symptoms such as angiomata, pleural effusion/ascites, edema, and organomegaly in the disorder. To study whether other angiogenetic factors are upregulated in POEMS syndrome, we measured serum levels of basic fibroblast growth factor and hepatocyte growth factor (HGF), as well as VEGF, in 17 patients with POEMS syndrome. All these factors were significantly upregulated in the POEMS syndrome patients. After the treatment with anti-VEGF antibody, the levels of HGF did not change, suggesting that elevation of HGF levels is not secondary to VEGF overproduction. These results suggest that different angiogenetic factors might contribute to the pathogenesis of POEMS syndrome, and this fact might contribute to the insufficient clinical effects obtained by suppression of VEGF alone.
Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yuta
Y
Yamada
Setsu
S
Sawai
Sonoko
S
Misawa
Kazuaki
K
Kanai
Kazumoto
K
Shibuya
Masahiro
M
Mori
Junji
J
Moriya
Kazuyuki
K
Sogawa
Haruna
H
Yamamoto
Minako
M
Beppu
Junko
J
Taniguchi
Chiaki
C
Nakaseko
Fumio
F
Nomura
Satoshi
S
Kuwabara
D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology / Q000627:therapeutic use; D000068258:Bevacizumab; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000096:biosynthesis* / Q000235:genetics; D005786:Gene Expression Regulation / Q000187:drug effects; D017228:Hepatocyte Growth Factor / Q000096:biosynthesis* / Q000235:genetics; D006801:Humans; D008297:Male; D008558:Melphalan / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D016878:POEMS Syndrome / Q000097:blood / Q000188:drug therapy / Q000235:genetics*; D013792:Thalidomide / Q000494:pharmacology / Q000627:therapeutic use; D015854:Up-Regulation / Q000187:drug effects; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors / Q000096:biosynthesis* / Q000235:genetics
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C066855:HGF protein, human; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D016222:Fibroblast Growth Factor 2; D000068258:Bevacizumab; D013792:Thalidomide; D017228:Hepatocyte Growth Factor; D008558:Melphalan