Selected angiogenic factors in plasma of patients with lower limb symptomatic peripheral arterial disease: preliminary report.
OBJECTIVE
The number of people suffering from atherosclerosis-related complications such as peripheral arterial disease (PAD) ‑ including lower limbs PAD increases. Hypoxia and ischemia stimulate angiogenesis ‑ a postnatal multistage process in which new blood vessels form and the Vascular Endothelial Growth Factor (VEGF-A) is the key proangiogenic factor whereas its soluble receptors type 1 and type 2 (sVEGFR-1, sVEGFR-2) are regarded as inhibitory factors. The aim of this study was to assess the concentrations of VEGF-A, sVEGFR-1 and sVEGFR-2 in plasma of patients with symptomatic lower extremity PAD compared with selected clinical parameters (Ankle-Brachial Index, distance in walking test) and severity of PAD (according to the Fontaine classification).


METHODS
The study group included 46 patients suffering from symptomatic PAD with Fontaine class IIa-IV without any history of neoplastic disease. The control group consisted of 30 healthy non-smoking volunteers. The following parameters were determined: plasma concentrations of VEGF-A, its soluble receptors (sVEGFR-1, sVEGFR-2) using the ELISA method also VEGF-A and sVEGFR-1 quotient was calculated on the basis of mean concentrations in homogenous units (pg/mL).


RESULTS
The study group revealed a statistically significant higher level of VEGF-A concentration when compared with the control group and statistically significant lower concentration of sVEGFR-2 in the study group. In the study group a statistically significant negative correlation between VEGF-A concentrations and the length of irrelative distance in walking test was observed. In the group of PAD a significantly higher VEGF-A/sVEGFR-1 ratio in comparison with the control group was obtained. Within the group of patient suffering from PAD there was noticed an increasing VEGF-A/sVEGFR-1 ratio in subsequent subgroups according to the Fontaine classification.


CONCLUSIONS
The plasma concentrations of VEGF-A correlated with increased clinical symptoms of PAD in the walking test. The plasma VEGF-A/sVEGFR-1 ratio may be used as a useful ischemic marker in patients with PAD which should be tested and finally verified in large group of patients.
Department of Pathophysiology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland - wieczorcmumk@tlen.pl.
R
R
Wieczór
G
G
Gadomska
B
B
Góralczyk
K
K
Stankowska
J
J
Budzyński
J
J
Fabisiak
K
K
Suppan
G
G
Pulkowski
D
D
Rość
D000368:Aged; D055109:Ankle Brachial Index; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007511:Ischemia / Q000097:blood*; D035002:Lower Extremity / Q000098:blood supply / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000097:blood*; D058729:Peripheral Arterial Disease / Q000097:blood / Q000175:diagnosis*; D012720:Severity of Illness Index; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000097:blood*
D015415:Biomarkers; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D040281:Vascular Endothelial Growth Factor Receptor-1; D040301:Vascular Endothelial Growth Factor Receptor-2