Serum levels of vascular endothelial growth factor (VEGF) are markedly elevated in patients with Wegener's granulomatosis

Objectives. Necrotizing vasculitis and granuloma formation are the predomin ant features of Wegener's granulomatosis (WG). We have investigated the imp ortance of vascular endothelial growth factor (VEGF) in monitoring disease activity in WG. Methods. Serum VEGF levels were determined in 23 patients with active WG, 2 1 healthy controls and 25 patients with urinary infection, by ELISA using c ommercially available antibodies to VEGF. Results. VEGF levels were enormously elevated in patients with WG compared to both controls and patients with urinary infection (P < 0.0001). Of the 2 3 patients, 21 (91.3%) had VEGF levels above the cut-off value (3.3 ng/ml, calculated as the mean of the controls +2 S.D.). Further analysis of the da ta showed that VEGF levels did not correlate with age, sex, incidence of cl assic antineutrophil cytoplasmic antibodies (c-ANCA) or duration of the dis ease (P > 0.05), but there was correlation with disease activity (r = 0.51, P < 0.01). VEGF levels were higher in patients with major compared to thos e with minor disease activity (P < 0.01). However, there was no significant correlation between VEGF levels and the Birmingham scores for vascular act ivity and damage. Conclusion. VEGF levels are raised in WG patients compared to normal contro ls and may be a marker of disease activity. Further studies on serial blood samples from a large cohort of patients with WG and other systemic vasculi tides are needed to evaluate the specificity and usefulness of VEGF levels in monitoring disease activity.