ELEVATED LEVELS OF BASIC FIBROBLAST GROWTH-FACTOR IN PATIENTS WITH LIMB ISCHEMIA

Basic fibroblast growth factor (bFGF), a prototypic member of a family of heparin-binding growth factors, is angiogenic both in vitro and in vivo. Increased levels and activity of bFGF have been documented in a variety of diseases, including tumors. We sought to determine whether bFGF might be similarly elevated in patients with clinical evidence o f limb ischemia. Serum was obtained at the time of percutaneous revasc ularization from patients with symptomatic peripheral vascular disease (46 procedures were performed on 40 patients). An enzyme-linked immun oassay specific for bFGF was used (limit of detection, 1 pg/ml; range in normal subjects, 0 to 5 pg/ml). Among the 40 patients (28 men, 12 w omen, mean age 70 years) studied, elevated circulating bFGF (greater t han or equal to 10 pg/ml) was detected in 36 samples (78%); levels ran ged from 10 to 310 pg/ml (mean +/- SEM = 62 +/- 12). In 16 (89%) of 18 patients with both rest pain and nonhealing ischemic ulcers, serum bF GF levels were elevated up to 30 times normal values. In conclusion, c irculating levels of bFGF are elevated in patients with vascular insuf ficiency and may reflect a physiologic response to limb ischemia.