Plasma Vascular Endothelial Growth Factor Concentration and Alveolar Nitric Oxide as Potential Predictors of Disease Progression and Mortality in Idiopathic Pulmonary Fibrosis.
BACKGROUND
Declining lung function signifies disease progression in idiopathic pulmonary fibrosis (IPF). Vascular endothelial growth factor (VEGF) concentration is associated with declining lung function in 6 and 12-month studies. Alveolar nitric oxide concentration (CANO) is increased in patients with IPF, however its significance is unclear. This study investigated whether baseline plasma VEGF concentration and CANO are associated with disease progression or mortality in IPF.


METHODS
27 IPF patients were studied (maximum follow-up 65 months). Baseline plasma VEGF concentration, CANO and pulmonary function tests (PFTs) were measured. PFTs were performed the preceding year and subsequent PFTs and data regarding mortality were collected. Disease progression was defined as one of: death, relative decrease of ≥10% in baseline forced vital capacity (FVC) % predicted, or relative decrease of ≥15% in baseline single breath diffusion capacity of carbon monoxide (TLCO-SB) % predicted.


RESULTS
Plasma VEGF concentration was not associated with progression-free survival or mortality. There was a trend towards shorter time to disease progression and death with higher CANO. CANO was significantly higher in patients with previous declining versus stable lung function.


CONCLUSIONS
The role of VEGF in IPF remains uncertain. It may be of value to further investigate CANO in IPF.
Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, Norfolk, UK. jalpa.kotecha@cantab.net.
Jalpa
J
Kotecha
Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, Norfolk, UK. ludmila.shulgina@nhs.net.
Ludmila
L
Shulgina
Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, Norfolk, UK. D.W.Sexton@ljmu.ac.uk.
Darren W
DW
Sexton
Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, Norfolk, UK. c.atkins@uea.ac.uk.
Christopher P
CP
Atkins
Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, Norfolk, UK. a.m.wilson@uea.ac.uk.
Andrew M
AM
Wilson
alveolar nitric oxide; idiopathic pulmonary fibrosis; vascular endothelial growth factor