VEGF in idiopathic ILD
Authors: A R L Medford
Journal: Thorax (2005)

Simler et al raise an interesting possibility of the prognostic value of plasma VEGF in interstitial lung disease.1 Meyer et al 2 in a previous study did not find any difference in serum VEGF165 levels in patients with diffuse parenchymal lung disease. It would have been interesting to know the bronchoalveolar lavage (BAL) fluid levels of VEGF in these patients as Meyer et al 2 and Koyama et al 3 have shown reduced BAL fluid VEGF levels in interstitial lung disease. This might simply reflect damage to the alveolar epithelium (a known major source) in this disease or, indeed, VEGF may have an important role in the pathogenesis of interstitial disease. Interestingly, VEGF receptor blockade has been shown to lead to an induction of apoptosis and an emphysema-like histological appearance in rats but with no evidence of fibrosis or inflammatory cells.4 In addition, it is interesting to speculate on the cellular source of the increased plasma levels of VEGF in the more fibrotic patients. Could this represent alveolar-capillary membrane damage with leakage of intra-alveolar VEGF which is known to be compartmentalised and hence lower BAL fluid levels as described in the previous studies?5 Or does it represent an inflammatory cell source of systemic VEGF correlating with an inflammatory response that is here associated with a poorer outcome? Or is there some other mechanism? Finally, Koyama et al 3 have shown that smokers also have reduced BAL fluid levels of VEGF and this may be of relevance (if intrapulmonary VEGF is postulated as having a role in this disease), given that the patients with desquamative interstitial pneumonia had all smoked compared with 50% of those with non-specific interstitial pneumonia and only 20% of the controls. 1. ↵ Simler NR , Brenchley PE, Horrocks AW, et al. Angiogenic cytokines in patients with idiopathic interstitial pneumonia. Thorax2004;59:581–5. [OpenUrl][1][Abstract/FREE Full Text][2] 2. ↵ Meyer KC , Cardoni A, Xiang ZZ. Vascular endothelial growth factor in bronchoalveolar lavage from normal subjects and patients with diffuse parenchymal lung disease. J Lab Clin Med2000;135:332–8. [OpenUrl][3][CrossRef][4][PubMed][5][Web of Science][6] 3. ↵ Koyama S , Sato E, Haniuda M, et al. Decreased level of vascular endothelial growth factor in bronchoalveolar lavage fluid of normal smokers and patients with pulmonary fibrosis. Am J Respir Crit Care Med2002;166:382–5. [OpenUrl][7][CrossRef][8][PubMed][9][Web of Science][10] 4. ↵ Kasahara Y , Tuder RM, Taraseviciene-Stewart L, et al. Inhibition of VEGF receptors causes lung cell apoptosis and emphysema. J Clin Invest2000;106:1311–9. [OpenUrl][11][CrossRef][12][PubMed][13][Web of Science][14] 5. ↵ Kaner RJ , Crystal RG. Compartmentalization of vascular endothelial growth factor to the epithelial surface of the human lung. Mol Med2001;7:240–6. [OpenUrl][15][PubMed][16][Web of Science][17] # Authors’ reply {#article-title-2} Dr Medford laudably highlights the interesting findings of other authors regarding levels … [1]: {openurl}?query=rft.jtitle%253DThorax%26rft.stitle%253DThorax%26rft.issn%253D0040-6376%26rft.aulast%253DSimler%26rft.auinit1%253DN%2BR%26rft.volume%253D59%26rft.issue%253D7%26rft.spage%253D581%26rft.epage%253D585%26rft.atitle%253DAngiogenic%2Bcytokines%2Bin%2Bpatients%2Bwith%2Bidiopathic%2Binterstitial%2Bpneumonia%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fthx.2003.009860%26rft_id%253Dinfo%253Apmid%252F15223865%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=thoraxjnl&resid=59/7/581&atom=%2Fthoraxjnl%2F60%2F4%2F353.atom [3]: {openurl}?query=rft.jtitle%253DThe%2BJournal%2Bof%2Blaboratory%2Band%2Bclinical%2Bmedicine%26rft.stitle%253DJ%2BLab%2BClin%2BMed%26rft.aulast%253DMeyer%26rft.auinit1%253DK.%2BC.%26rft.volume%253D135%26rft.issue%253D4%26rft.spage%253D332%26rft.epage%253D338%26rft.atitle%253DVascular%2Bendothelial%2Bgrowth%2Bfactor%2Bin%2Bbronchoalveolar%2Blavage%2Bfrom%2Bnormal%2Bsubjects%2Band%2Bpatients%2Bwith%2Bdiffuse%2Bparenchymal%2Blung%2Bdisease.%26rft_id%253Dinfo%253Adoi%252F10.1067%252Fmlc.2000.105618%26rft_id%253Dinfo%253Apmid%252F10779049%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/external-ref?access_num=10.1067/mlc.2000.105618&link_type=DOI [5]: /lookup/external-ref?access_num=10779049&link_type=MED&atom=%2Fthoraxjnl%2F60%2F4%2F353.atom [6]: /lookup/external-ref?access_num=000086536700007&link_type=ISI [7]: {openurl}?query=rft.jtitle%253DAmerican%2BJournal%2Bof%2BRespiratory%2Band%2BCritical%2BCare%2BMedicine%26rft.stitle%253DAm.%2BJ.%2BRespir.%2BCrit.%2BCare%2BMed.%26rft.issn%253D1073-449X%26rft.aulast%253DKoyama%26rft.auinit1%253DS.%26rft.volume%253D166%26rft.issue%253D3%26rft.spage%253D382%26rft.epage%253D385%26rft.atitle%253DDecreased%2BLevel%2Bof%2BVascular%2BEndothelial%2BGrowth%2BFactor%2Bin%2BBronchoalveolar%2BLavage%2BFluid%2Bof%2BNormal%2BSmokers%2Band%2BPatients%2Bwith%2BPulmonary%2BFibrosis%26rft_id%253Dinfo%253Adoi%252F10.1164%252Frccm.2103112%26rft_id%253Dinfo%253Apmid%252F12153975%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [8]: /lookup/external-ref?access_num=10.1164/rccm.2103112&link_type=DOI [9]: /lookup/external-ref?access_num=12153975&link_type=MED&atom=%2Fthoraxjnl%2F60%2F4%2F353.atom [10]: /lookup/external-ref?access_num=000177246000025&link_type=ISI [11]: {openurl}?query=rft.jtitle%253DJournal%2Bof%2BClinical%2BInvestigation%26rft.stitle%253DJCI%26rft.issn%253D0021-9738%26rft.aulast%253DKasahara%26rft.auinit1%253DY.%26rft.volume%253D106%26rft.issue%253D11%26rft.spage%253D1311%26rft.epage%253D1319%26rft.atitle%253DInhibition%2Bof%2BVEGF%2Breceptors%2Bcauses%2Blung%2Bcell%2Bapoptosis%2Band%2Bemphysema%26rft_id%253Dinfo%253Adoi%252F10.1172%252FJCI10259%26rft_id%253Dinfo%253Apmid%252F11104784%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [12]: /lookup/external-ref?access_num=10.1172/JCI10259&link_type=DOI [13]: /lookup/external-ref?access_num=11104784&link_type=MED&atom=%2Fthoraxjnl%2F60%2F4%2F353.atom [14]: /lookup/external-ref?access_num=000165647800003&link_type=ISI [15]: {openurl}?query=rft.jtitle%253DMolecular%2Bmedicine%2B%2528Cambridge%252C%2BMass.%2529%26rft.stitle%253DMol%2BMed%26rft.aulast%253DKaner%26rft.auinit1%253DR.%2BJ.%26rft.volume%253D7%26rft.issue%253D4%26rft.spage%253D240%26rft.epage%253D246%26rft.atitle%253DCompartmentalization%2Bof%2Bvascular%2Bendothelial%2Bgrowth%2Bfactor%2Bto%2Bthe%2Bepithelial%2Bsurface%2Bof%2Bthe%2Bhuman%2Blung.%26rft_id%253Dinfo%253Apmid%252F11471568%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [16]: /lookup/external-ref?access_num=11471568&link_type=MED&atom=%2Fthoraxjnl%2F60%2F4%2F353.atom [17]: /lookup/external-ref?access_num=000168714100003&link_type=ISI