Cg. Li et al., Serum levels of vascular endothelial growth factor (VEGF) are markedly elevated in patients with Wegener's granulomatosis, BR J RHEUM, 37(12), 1998, pp. 1303-1306
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.