Increase in both angiogenic and angiostatic mediators in patients with idiopathic pulmonary fibrosis

Background

Idiopathic pulmonary fibrosis (IPF) is associated with a marked pulmonary vascular remodeling. The aim of this study was to investigate a potential imbalance between angiogenic and angiostatic factors in this disease.

Methods and results

Sixty-four subjects with IPF and 10 healthy control subjects (60–70 years old) were prospectively included in this multicenter study. Plasma levels of vascular endothelial growth factor A (VEGF-A), thrombospondin-1 (TSP-1) and stem cell factor (SCF) were determined by Elisa. Comparisons between IPF and controls were made using the Mann-Whitney U test. We also analyzed these soluble mediators in relation with IPF severity (DL_CO < 40% or > 40%) predicted or total lung capacity (TLC) and forced vital capacity (FVC) (both < 55% or > 55% predicted) using the same test. VEGF-A plasma levels were increased in IPF vs. controls (P = 0.0008) as well as those of TSP-1 (P = 0.008), irrespective of the severity of the disease as reflected by DL_CO, TLC or FVC values. In contrast, SCF levels were similar in IPF and controls.

Conclusions

Factors modulating angiogenic responses are dysregulated in patients with IPF with increases in VEGF-A and TSP-1. The serial assessment of VEGF-A and TSP-1 during the follow-up and the search for potential relationships with the outcome of the disease might give us hints to the clinical implication of these results.