Serum vascular endothelial growth factor is elevated in cystic fibrosis and decreases with treatment of acute pulmonary exacerbation

Chronic bacterial infection and neutrophilic inflammation characterize cyst ic fibrosis (CF) pulmonary disease. In many disorders, inflammation and ang iogenesis are codependent phenomena. We previously noted excessive angiogen esis in CF tissues and elevated vascular endothelial growth factor (VEGF) i n random serum samples from subjects with CF. To further explore this findi ng, we measured serum VEGF in 38 subjects with stable CF and in 25 subjects with other pulmonary diseases. Mean VEGF was elevated in both groups compa red with reference values, but it was higher in CF: 403 +/- 280 versus 255 +/- 169 pg/ml, p = 0.02. VEGF was negatively correlated with FEV, in CF, r = -0.51, p = 0.007. To assess the effect of airway infection on VEGF, 10 su bjects with CF were studied before and after intravenous antibiotic therapy for pulmonary exacerbation. VEGF levels decreased with antibiotic: therapy , from 537 +/- 220 to 259 +/- 176 pg/ml, p = 0.001. We conclude that circul ating VEGF is increased in subjects with CF and other inflammatory pulmonar y disorders. In CF, VEGF elevation is related to airway infection. We specu late that increased circulating VEGF is related to chronic inflammation, wh ich is robust in CF. Elevated circulating VEGF may result in tissue angioge nesis, furthering the progression of pulmonary disease.