Increased serum level of vascular endothelial growth factor in pulmonary tuberculosis

Pulmonary tuberculosis, one of the granulomatous diseases, has few serologi cal markers for its activity. Recently, an increased serum level of vascula r endothelial growth factor (VEGF) was detected in patients with Crohn's di sease, also a granulomatous disease. We hypothesized that VEGF might be ass ociated with the pathogenesis of pulmonary tuberculosis. We investigated th e serum level of VECF in 43 patients with active pulmonary tuberculosis, 29 patients with old tuberculosis, and 25 patients with acute bronchitis. We were able to examine the serum VEGF levels every 3 mo for a period of 6 mo in seven patients with active pulmonary tuberculosis. We examined the prese nce of VEGF in the resected lungs of three patients with active pulmonary t uberculosis by immunohistochemistry. The serum levels of VEGF were signific antly higher in patients with active pulmonary tuberculosis than in patient s with old tuberculosis and acute bronchitis. The decrease in titer of seru m VEGF paralleled the clinical improvement of patients with pulmonary tuber culosis. Immunohistochemical staining of the resected lungs demonstrated th e presence of VEGF in alveolar macrophages surrounding the lesion. Therefor e, VEGF may be associated with the pathogenesis of pulmonary tuberculosis.