VEGF Correlates with Inflammation and Fibrosis in Tuberculous Pleural Effusion

Abstract

Objective. To investigate the relationship among angiogenic cytokines, inflammatory markers, and fibrinolytic activity in tuberculous pleural effusion (TBPE) and their clinical importance. Methods. Forty-two patients diagnosed with TBPE were studied. Based on chest ultrasonography, there were 26 loculated and 16 nonloculated TBPE patients. The effusion size radiological scores and effusion vascular endothelial growth factor (VEGF), interleukin- (IL-) 8, plasminogen activator inhibitor type-1 (PAI-1), and tissue type plasminogen activator (tPA) were measured. Treatment outcome and pleural fibrosis, defined as radiological residual pleural thickening (RPT), were assessed at 6-month follow-up. Results. The effusion size and effusion lactate dehydrogenase (LDH), VEGF, IL-8, PAI-1, and PAI-1/tPA ratio were significantly higher, while effusion glucose, pH value, and tPA were significantly lower, in loculated than in nonloculated TBPE. VEGF and IL-8 correlated positively with LDH and PAI-1/tPA ratio and negatively with tPA in both loculated and nonloculated TBPE. Patients with higher VEGF or greater effusion size were prone to develop RPT (n = 14; VEGF, odds ratio 1.28, P = 0.01; effusion size, odds ratio 1.01, P = 0.02), and VEGF was an independent predictor of RPT in TBPE (receiver operating characteristic curve AUC = 0.985, P < 0.001). Conclusions. Effusion VEGF correlates with pleural inflammation and fibrosis and may be targeted for adjunct therapy for TBPE.

Vascular endothelial growth factor levels in tuberculosis: A systematic review and meta-analysis

“…Among patients with pulmonary TB, the increase of systemic VEGF is more prominent in patients with cavitation [ 61 , 62 ] and in those who have bilateral involvement [ 62 ]. For patients with TPE, pleural VEGF levels in patients with loculated pleural effusion are higher than those in patients with non-loculated pleural effusion, and that patients with higher pleural levels of VEGF at baseline appear to be more likely to develop residual pleural thickening (RPE) [ 63 ]. In addition, patients with drug-resistant TB with higher systemic levels of VEGF at baseline might be more prone to delays in sputum culture conversion [ 61 ].…”

MnTBAP Inhibits Bleomycin-Induced Pulmonary Fibrosis by Regulating VEGF and Wnt Signaling

“…Recent reports indicate that VEGF, a central regulator of angiogenesis, is dysregulated in patients with fibrotic diseases (Smadja et al, ; Bien et al, ; Roels et al, ). Furthermore, VEGF inhibitors have been shown to attenuate bleomycin‐induced pulmonary fibrosis in mice (Ou et al, ; Iyer et al, ).…”

Pre-clinical Research of Human Amnion-derived Mesenchymal Stem Cells and its First Clinical Treatment for a Severe Uremic Calciphylaxis Patient

“…VEGF affects most downstream activities of angiogenesis including endothelial cells proliferation, migration, invasion, survival and promotes vascular permeability (Waldner et al, 2010;Hu et al, 2019). VEGF also induces extravascular leakage of plasma proteins, modulates extracellular matrix proteolysis (Bien et al, 2015), regulates the local immune response and helps recovery from inflammation (Cañedo-Dorantes and Cañedo-Ayala, 2019). FGF-7 can contribute to synthesize various proangiogenic molecules, including VEGF, to promote angiogenesis (Qu et al, 2018).…”

“…preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in The copyright holder for this this version posted September 24, 2021. ; https://doi.org/10.1101/2021.09.23.21261751 doi: medRxiv preprint (Waldner et al, 2010;Hu et al, 2019). VEGF also induces extravascular leakage of plasma proteins, modulates extracellular matrix proteolysis (Bien et al, 2015), regulates the local immune response and helps recovery from inflammation (Cañedo-Dorantes and Cañedo-Ayala, 2019). FGF-7 can contribute to synthesize various proangiogenic molecules, including VEGF, to promote angiogenesis (Qu et al, 2018).…”