title: Important of Angiopoietic System in Evaluation of Endothelial Damage in Children with Crimean-Congo Hemorrhagic Fever.
abstract: BACKGROUND
  Crimean-Congo hemorrhagic fever (CCHF) causes endothelial activation and dysfunction by affecting the endothelium directly or indirectly. In maintaining the vascular integrity, vascular endothelial growth factor (VEGF-A) and its receptor (VEGFR1) and angiopoietin-2 (Ang-2) and its receptor (Tie-2) are very important mediators. For this reason, we aimed at studying the association of Ang-2 and VEGF and their receptors Tie-2 and VEGFR1 with CCHF infection.
  
  
  METHODS
  Thirty one CCHF patients and 31 healthy controls (HC) were included in the study. CCHF patients were classified into 2 groups in terms of disease severity (severe and nonsevere). VEGF-A, VEGFR1, Ang-2 and Tie-2 levels were measured in all groups.
  
  
  RESULTS
  Serum levels of Tie-2, Ang-2, VEGF-A and VEGFR1 were significantly increased in CCHF patients compared with the HC. Furthermore, serum Tie-2, Ang-2, VEGF and VEGFR1 levels were found to be significantly higher in the severe group than in the nonsevere and HC groups (P < 0.05 and P < 0.001, respectively). Also, Tie-2, Ang-2, VEGF-A and VEGFR1 levels were significantly higher in the nonsevere group than in the HC group (P < 0.05).
  
  
  CONCLUSIONS
  Having statistically significant higher Ang-2, Tie-2, VEGF-A and VEGFR1 levels in the severe group when compared with the other groups suggested that VEGF-related Ang-2/Tie-2 system played a critical role in the pathogenesis of the disease, and these markers could be used as the severity criteria.
authors.affiliation: From the *Department of Biochemistry, †Department of Pediatrics, ‡Department of Microbiology, and §Department of Biostatistics, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
authors.forename: Enver
authors.initials: E
authors.lastname: Sancakdar
authors.forename: Ahmet S
authors.initials: AS
authors.lastname: Guven
authors.forename: Elif B
authors.initials: EB
authors.lastname: Uysal
authors.forename: Köksal
authors.initials: K
authors.lastname: Deveci
authors.forename: Esra
authors.initials: E
authors.lastname: Gültürk
mesh_terms: D000293:Adolescent; D042702:Angiopoietin-2 / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006479:Hemorrhagic Fever, Crimean / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D012372:ROC Curve; D042787:Receptor, TIE-2 / Q000097:blood*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D042702:Angiopoietin-2; D042461:Vascular Endothelial Growth Factor A; D042787:Receptor, TIE-2