title: Increased angiogenesis and VEGF expression correlates with disease severity in prurigo patients.
abstract: BACKGROUND
  Vascular endothelial growth factor-A (VEGF-A) is known as the major skin angiogenesis factor and can be produced by various resident skin cells including keratinocytes.
  
  
  OBJECTIVE
  To identify and characterize the role of VEGF-A in the pathogenesis of prurigo.
  
  
  METHODS
  Expression of VEGF, VEGFR2, CD-31, and D2-40 was analyzed in the skin of eleven prurigo patients and seven healthy controls by immunohistochemistry.
  
  
  RESULTS
  VEGF immunoreactivity (IR) was markedly increased in the epidermis, dermis and subcutis of prurigo patients, whereas expression of the main receptor for VEGF-A in the skin, VEGFR2, was comparable to that of healthy controls. The increased VEGF expression in the skin was associated with a marked increase in the number (12.8 ± 2.1 vs 5.6 ± 0.5, P < 0.05) but not in the size of blood vessels, as assessed by staining of the endothelial cell marker CD31. This increase in small blood vessels correlated closely with increases in the epidermal thickness in prurigo lesions. The number of lymphatic vessels as assessed by D2-40 staining was found to be similar in prurigo patients and healthy controls.
  
  
  CONCLUSIONS
  Based on these findings, we speculate that the observed profound vascular remodelling in prurigo might contribute to the pathogenesis of prurigo and the corresponding clinical symptoms and that targeting of VEGF may present a novel therapeutic strategy in the treatment of prurigo patients.
authors.affiliation: Department of Dermatology and Allergy, Charité -Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Krull
authors.affiliation: Department of Dermatology and Allergy, Charité -Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Schoepke
authors.affiliation: Department of Dermatology and Allergy, Charité -Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Ohanyan
authors.affiliation: Department of Dermatology and Allergy, Charité -Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Brachaczek
authors.affiliation: Department of Dermatology and Allergy, Charité -Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Maurer
authors.affiliation: Department of Dermatology and Allergy, Charité -Universitätsmedizin Berlin, Berlin, Germany.|Department of Dermatology and Allergy, Klinikum Klagenfurt am Wörthersee, Klagenfurt am Wörthersee, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Lange-Asschenfeldt
authors.affiliation: Department of Dermatology and Allergy, Charité -Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Metz
mesh_terms: D006801:Humans; D018919:Neovascularization, Physiologic; D011536:Prurigo / Q000503:physiopathology*; D012720:Severity of Illness Index; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: D042461:Vascular Endothelial Growth Factor A