title: PlGF and sVEGFR-1 in chronic subdural hematoma: implications for hematoma development.
abstract: OBJECTIVE
  A considerable body of evidence indicates that inflammation and angiogenesis play a significant role in the development and progression of chronic subdural hematoma (CSDH). While various experimental and clinical studies have implicated placental growth factor (PlGF) in the processes that underpin pathological angiogenesis, no study has thus far investigated its expression in CSDH. The actions of PlGF and its related proangiogenic vascular endothelial growth factor (VEGF) are antagonized by a high-affinity soluble receptor, namely soluble VEGF receptor-1 (sVEGFR-1), and thus the ratio between sVEGFR-1 and angiogenic factors provides an index of angiogenic capacity.
  
  
  METHODS
  In the present study, using an automated electrochemiluminescence assay, levels of PlGF and sVEGFR-1 were quantified in serum and hematoma fluid obtained in 16 patients with CSDH.
  
  
  RESULTS
  Levels of PlGF and sVEGFR-1 were significantly higher in hematoma fluid than in serum (p < 0.0001). In serum, levels of sVEGFR-1 were higher than those of PlGF (p < 0.0001), whereas in hematoma fluid this difference was not apparent. Furthermore, the ratio of sVEGFR-1 to PlGF was significantly lower in hematoma fluid than in serum (p < 0.0001).
  
  
  CONCLUSIONS
  Given previous evidence indicating a role for PlGF in promoting angiogenesis, inflammatory cell chemotaxis, and stimulation, as well as its ability to amplify VEGF-driven signaling under conditions favoring pathological angiogenesis, enhanced expression of PlGF in hematoma fluid suggests the involvement of this factor in the mechanisms of inflammation and angiogenesis in CSDH. Furthermore, a reduced ratio of sVEGFR-1 to PlGF in hematoma fluid is consistent with the proangiogenic capacity of CSDH. Future studies are warranted to clarify the precise role of PlGF and sVEGFR-1 in CSDH.
authors.affiliation: Hellenic Centre of Neurosurgical Research "Professor Petros S. Kokkalis", University of Athens, Athens, Greece. theodosis.kalamatianos@kcl.ac.uk
authors.forename: Theodosis
authors.initials: T
authors.lastname: Kalamatianos
authors.forename: Lampis C
authors.initials: LC
authors.lastname: Stavrinou
authors.forename: Christos
authors.initials: C
authors.lastname: Koutsarnakis
authors.forename: Christina
authors.initials: C
authors.lastname: Psachoulia
authors.forename: Damianos E
authors.initials: DE
authors.lastname: Sakas
authors.forename: George
authors.initials: G
authors.lastname: Stranjalis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001826:Body Fluids / Q000378:metabolism; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008163:Luminescent Measurements; D008297:Male; D009389:Neovascularization, Pathologic / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D000072483:Placenta Growth Factor; D011257:Pregnancy Proteins / Q000097:blood* / Q000378:metabolism; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood* / Q000378:metabolism
chemical_list: C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; D040281:Vascular Endothelial Growth Factor Receptor-1