Original Articles
Copyright ©The Author(s) 1999. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 15, 1999; 5(4): 296-300
Published online Aug 15, 1999. doi: 10.3748/wjg.v5.i4.296
Clinical implication of VEGF serum levels in cirrhotic patients with or without portal hypertension
Assy Nimer, Paizi M, Gaitini D, Baruch Y, Spira G
Assy Nimer, Baruch Y, Departments of Medicine B, Liver Unit, Technion, Haifa, Israel
Gaitini D, Ultrasound, Rambam Medical Center, Haifa, Technion, Haifa, Israel
Paizi M, Spira G, Department of Anatomy and Cell Biology, Technion, Haifa, Israel
Assy Nimer, Paizi M, Baruch Y and Spira G, Bruce Rappaport Faculty of Medicine, Technion, Haifa, Technion, Haifa, Israel
Spira G, Rappaport Institute for Research of the Medical Sciences, Technion, Haifa, Israel
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Assy Nimer, Fassouta 25170, Box 428, Upper Galilee, Israel. drnimer@netvision.net.il
Telephone: 972-4-9870-080 Fax: 972-4-9870-080
Received: May 19, 1999
Revised: July 3, 1999
Accepted: July 19, 1999
Published online: August 15, 1999
Abstract

AIM: To determine whether serum vascular endothelial growth factor (VEGF) levels correlates with the severity of liver cirrhosis and whether portal hypertension impacts on the expression of serum VEGF protein.

METHODS: Fifty-three patients (mean age 56 ± 2 years) with HCV (n = 26), HBV (n = 13), and cryptogenic liver cirrhosis (n = 14) (Child-Pugh-s class A: 24, B: 19 and C: 12) and normal renal function constitute the patient population, who were all diagnosed by clinical, histological and radiological findings. Six healthy people and six patients with acute hepatitis served as controls. Severity of liver disease was evaluated by the CP score. Serum levels of IGF-1 and VEGF were measured by radioimmunoassay and ELISA, respectively. Portal hypertension was assessed using pulsed Doppler ultrasound.

RESULTS: The mean serum VEGF levels in all cirrhotic patients (73 ± 58) were significantly lower than those of healthy controls (360 ± 217, P < 0.01) and acute hepatitis (1123 ± 1261, P < 0.01) respectively. No significant difference in median serum VEGF levels were noted among the different Child-Pugh-s classes (class A: median, 49.4 ng/L, range, 21-260 ng/L, Class B: median 59.9 ng/L; range 21-92, and Class C: median 69; range 20-247 ng/L). A significant correlation was noted between serum VEGF and two accurate parameters of portal hypertension: portal blood flow velocity (r = 06) and spleen size (r = 0.55). No correlation was found between VEGF serum levels and serum albumin, IGF-1, platelets count and aminotrasnferases (r = 0.2, r = 0.1, r = 0.2 and r = 0.2, respectively).

CONCLUSION: Circulating VEGF level in patients with liver cirrhosis could not serve as an indicator of the progression of chronic liver disease but rather, they may reflect increased portal hypertension or decreased hepatic regenerative activity or the combination of both.

Keywords: VEGF; growth factors; liver cirrhosis; liver regeneration; hypertension portal; duplex sonography; angiogenesis