Am. J. Respir. Crit. Care Med., Volume 162, Number 3, September 2000, 1120-1122

Increased Serum Level of Vascular Endothelial Growth Factor in Pulmonary Tuberculosis

WATARU MATSUYAMA, TERUTO HASHIGUCHI, KENJI MATSUMURO, FUMIYUKI IWAMI, YASUNOBU HIROTSU, MASAHARU KAWABATA, KIMIYOSHI ARIMURA, and MITSUHIRO OSAME

The Third Department of Internal Medicine, Kagoshima University School of Medicine, Kagoshima City, Japan; The Department of Respiratory Medicine, and The Department of Thoracic Surgery, National Minami-kyushu Hospital, Aira-gun, Kagoshima Prefecture, Japan

Pulmonary tuberculosis, one of the granulomatous diseases, has few serological markers for its activity. Recently, an increased serum level of vascular endothelial growth factor (VEGF) was detected in patients with Crohn's disease, also a granulomatous disease. We hypothesized that VEGF might be associated with the pathogenesis of pulmonary tuberculosis. We investigated the serum level of VEGF in 43 patients with active pulmonary tuberculosis, 29 patients with old tuberculosis, and 25 patients with acute bronchitis. We were able to examine the serum VEGF levels every 3 mo for a period of 6 mo in seven patients with active pulmonary tuberculosis. We examined the presence of VEGF in the resected lungs of three patients with active pulmonary tuberculosis by immunohistochemistry. The serum levels of VEGF were significantly higher in patients with active pulmonary tuberculosis than in patients with old tuberculosis and acute bronchitis. The decrease in titer of serum VEGF paralleled the clinical improvement of patients with pulmonary tuberculosis. Immunohistochemical staining of the resected lungs demonstrated the presence of VEGF in alveolar macrophages surrounding the lesion. Therefore, VEGF may be associated with the pathogenesis of pulmonary tuberculosis.

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