title: Decreased VEGF Level Is Associated with Elevated Ferritin Concentration in Bronchoalveolar Lavage Fluid of Children with Interstitial Lung Diseases.
abstract: BACKGROUND
  A decreased level of vascular endothelial growth factor (VEGF) was previously described in bronchoalveolar lavage fluid (BALF) of adults with interstitial lung diseases (ILD) due to bronchial epithelial cell apoptosis and its proteolytic degradation. Elevated intrapulmonary ferritin was produced by alveolar cells that promoted oxidative injury in such patients.
  
  
  OBJECTIVE
  In this study, we analyzed the concentrations of VEGF and ferritin in BALF samples of ILD children and studied the relationship between their levels and the degree of inflammation.
  
  
  METHODS
  BALF and serum concentration of VEGF as well as ferritin and albumin in BALF samples were measured using enzyme-linked immunosorbent assay in children with idiopathic interstitial pneumonia (n = 16), hypersensitivity pneumonitis (n = 11) and idiopathic pulmonary hemosiderosis (n = 3). Twenty-four age- and gender-matched subjects with suspicious foreign body aspiration served as a control group.
  
  
  RESULTS
  VEGF per albumin levels in BALF were significantly decreased in ILD children compared to controls (1,075 [784-1,415] pg/mg albumin vs. 2,741 [1,131-4,660] pg/mg albumin, p = 0.0008). These values showed a significant negative correlation with inflammatory markers of total immune cell count in BALF (r = -0.411, p = 0.002) and serum C-reactive protein (r = -0.367, p = 0.006). Although serum VEGF was augmented in ILD children versus controls, no difference was observed among the ILD groups. In addition, BALF ferritin/albumin level (688 [188-1,571] ng/mg albumin vs. 256 [178-350] ng/mg albumin, p = 0.022) was significantly higher than normal in ILD individuals, especially in idiopathic pulmonary hemosiderosis.
  
  
  CONCLUSIONS
  Depressed VEGF and increased ferritin in BALF may reflect the severity of chronic pulmonary inflammation in altered respiratory epithelium of childhood ILD.
authors.affiliation: Department of Pediatrics, Clinical Center, University of Debrecen, Debrecen, Hungary.
authors.forename: Ágnes
authors.initials: Á
authors.lastname: Papp
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Bene
authors.forename: Imre
authors.initials: I
authors.lastname: Gáspár
authors.forename: Béla
authors.initials: B
authors.lastname: Nagy
authors.forename: László
authors.initials: L
authors.lastname: Kádár
authors.forename: Tivadar
authors.initials: T
authors.lastname: Márialigeti
authors.forename: Andrea
authors.initials: A
authors.lastname: Bánfi
authors.forename: György
authors.initials: G
authors.lastname: Baktai
authors.forename: György
authors.initials: G
authors.lastname: Balla
authors.forename: Béla
authors.initials: B
authors.lastname: Nagy
mesh_terms: D000293:Adolescent; D000418:Albumins / Q000032:analysis; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002452:Cell Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D005293:Ferritins / Q000032:analysis*; D006486:Hemosiderosis / Q000378:metabolism; D006801:Humans; D008171:Lung Diseases / Q000378:metabolism; D017563:Lung Diseases, Interstitial / Q000378:metabolism*; D018655:Lymphocyte Count; D016676:Macrophages, Alveolar / Q000378:metabolism; D008297:Male; D009504:Neutrophils / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*
chemical_list: D000418:Albumins; D042461:Vascular Endothelial Growth Factor A; D002097:C-Reactive Protein; D005293:Ferritins