Abstract
Increased angiogenetic activity in inflammatory bowel disease (IBD) has been shown in previous studies. The aim of this study was to evaluate the relationship of serum vascular endothelial growth factor (VEGF) and endostatin levels with clinical features and mucosal expression in patients with ulcerative colitis (UC). Cross-sectional analytical study conducted in a tertiary-level public hospital. Serum VEGF and endostatin levels were determined in 82 individuals: 39 with UC, 28 with irritable bowel syndrome (IBS) and 15 healthy controls (HCs), using enzyme-linked immunosorbent assays (ELISA). VEGF and endostatin expressions were studied using immunohistochemistry (IHC). Mean serum VEGF and endostatin levels were significantly higher in patients with UC than in patients with IBS and in HCs (511.9 ± 377.5 pg/ml, 305.0 ± 121.42 pg/ml and 36.1 ± 40.6 pg/ml; P = 0.001 for VEGF; and 155.50 ± 59.8 ng/ml, 116.9 ± 23.8 ng/ml and 102.2 ± 22.4 ng/ml; P < 0.001 for endostatin, respectively). There was a positive correlation between serum VEGF and endostatin levels (r = 0.422; P < 0.01). Mean H-scores for VEGF expression were higher in the active UC group than in the inactive UC and IBS groups, in the stroma, endothelium and epithelium. Mean H-scores for endostatin expression were higher in the active UC group than in the inactive UC and IBS groups, in the stroma and endothelium. There was no endostatin expression in the epithelium. Increased endostatin appears to be a defensive reaction to increased VEGF in patients with UC.
Highlights
Ulcerative colitis is characterized by chronic inflammation and ulceration of the colonic mucosa
We aimed to evaluate the relationship between serum vascular endothelial growth factor (VEGF) and endostatin levels and the clinical features of patients with ulcerative colitis, and to evaluate VEGF and endostatin expression in the colonic mucosa of these patients
Participants The participants of this study were recruited according to their consecutive admittance to a gastroenterology outpatient clinic: 39 ulcerative colitis (UC) patients, 28 patients with irritable bowel syndrome (IBS) and 15 healthy controls (HCs) who came for consultations between September 2007 and July 2008 were included in this study
Summary
Ulcerative colitis is characterized by chronic inflammation and ulceration of the colonic mucosa. Under the influence of inflammatory mediators such as cytokines, growth factors and proteases that come to the healing site, angiogenesis increases further and the microvascular bed enlarges. In this manner, this condition becomes a vicious circle that attracts more inflammatory mediators to the center. The aim of this study was to evaluate the relationship of serum vascular endothelial growth factor (VEGF) and endostatin levels with clinical features and mucosal expression in patients with ulcerative colitis (UC). Mean H-scores for VEGF expression were higher in the active UC group than in the inactive UC and IBS groups, in the stroma, endothelium and epithelium. CONCLUSION: Increased endostatin appears to be a defensive reaction to increased VEGF in patients with UC
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