ELEVATED SERUM VASCULAR ENDOTHELIAL GROWTH FACTOR IN CHILDREN WITH CROHN'S DISEASE

Abstract

INTRODUCTION: Vascular endothelial growth factor (VEGF) is a cytokine produced by macrophages which targets endothelial cells, resulting in increased vascular permeability and angiogenesis. We hypothesized that VEGF would be released in increased amounts by gut tissues of patients with inflammatory bowel disease (IBD). Therefore, we suspected children with active Crohn's disease (CD) or ulcerative colitis (UC) would have elevated levels of VEGF in serum. METHODS: Sera were obtained from 80 children with CD, 50 children with UC, and 36 children without IBD. For children with IBD, clinical and laboratory data were gathered prospectively at the time of blood sampling. Disease activity for children with CD was assessed by the Pediatric Crohn's Disease Activity Index, and for children with UC by the clinical score of Kozarek. Serum VEGF levels were measured by ELISA. Statistical analysis was performed by analysis of variance followed by post-hoc Student's t tests. RESULTS: Mean VEGF was significantly elevated (p<0.005) in patients with CD (449±34.7 pg/ml) compared to UC patients (299±38.9 pg/ml) and controls (247±45.1 pg/ml). Children with moderate/severe CD (PCDAI > 30) had higher serum levels of VEGF than either children with inactive CD or controls. Table CONCLUSION: Serum VEGF is increased in children with Crohn's disease, especially those with active disease. This suggests that activated macrophages of CD patients manufacture this cytokine, and that VEFG might mediate new blood vessel formation and wound healing seen in Crohn's disease.