Increased vascular endothelial growth factor in acute eosinophilic pneumonia

Abstract

Acute eosinophilic pneumonia (AEP) is associated with the presence of diffuse pulmonary infiltrates on the chest radiograph and an increased number of eosinophils and an elevation of interleukin (IL)-5 levels in bronchoalveolar lavage (BAL) fluid. Vascular endothelial growth factor (VEGF) is a constitutively expressed protein encoded by messenger ribonucleic acid in human eosinophils and is released following stimulation with IL-5. However, the roles of IL-5 and VEGF in the pathogenesis or activity of this disease have not been clarified.The authors investigated the cells and the levels of these two factors in BAL fluid in five AEP patients and five normal controls before and after corticosteroid treatment.The absolute number of eosinophils?mL -1 , IL-5 and VEGF levels in patients before treatment were higher than in controls (53.8 versus 0.3610 4 ?mL -1 , 490.1 versus 5.2 pg?mL -1 and 643.0 versus 133.9 pg?mL -1 , respectively). IL-5 and VEGF rapidly decreased to the control level in parallel with clinical improvement. The relationship between eosinophilia and IL-5 and VEGF levels was strongly significant.Elevated interleukin-5 in the lung may initiate the recruitment of eosinophils and enhance the release of mediators, such as vascular endothelial growth factor from eosinophils, which, in turn, increases the permeability of blood vessels. Eur Respir J 2003; 21: 774-778.

Elevated Periostin Concentrations in the Bronchoalveolar Lavage Fluid of Patients with Eosinophilic Pneumonia

“…3c). Consistent with another study [34], our result suggested that blood leakage may play a role in the development of AEP. However, the periostin/albumin ratio remained higher in AEP and CEP than in sarcoidosis.…”

Calcitonin gene-related peptide– and vascular endothelial growth factor–positive inflammatory cells in late-phase allergic skin reactions in atopic subjects

“…22 The VEGF family is composed of several isotypes, including VEGF-A, VEGF-B, VEGF-C, and VEGF-D, which exist as numerous splice variant isoforms. 15 VEGF 1 eosinophils have been identified in a number of pathological states, including asthma, 13 eosinophilic pneumonia, 23 urticaria, 14 and angioedema. 24 However, to our knowledge, VEGF 1 eosinophils, T cells, and macrophages have not been previously reported in allergen-induced skin inflammation in human subjects.…”

Eosinophilic Pneumonias

“…Cationic granule proteins and inflammatory lipid mediators are detectable in the urine of subjects with AEP (136). Vascular endothelial growth factor (VEGF) is elevated in the lungs in AEP, consistent with increased vascular permeability contributing to the pathophysiology of the disease (125). BAL fluid eosinophils in AEP have been noted to have an activated phenotype, with upregulation of HLA-DR and CD69 (135).…”