inflammatory and malignant pleural eVusions. D R Thickett, L ... pleural fluid accumulation is poorly un- derstood. ... malignant and inflammatory cells. A.
Thorax 1999;54:707–710
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Vascular endothelial growth factor (VEGF) in inflammatory and malignant pleural eVusions D R Thickett, L Armstrong, A B Millar
Lung Research Group, Medical School Unit, Southmead Hospital, Bristol BS10 5NB, UK D R Thickett L Armstrong A B Millar Correspondence to: Dr D R Thickett. Manuscript received 24 June 1998 Returned to authors 23 September 1998 Revised manuscript received 16 April 1999 Accepted for publication 19 April 1999
Abstract Background—Investigation and management of pleural eVusions is an important clinical problem yet the pathogenesis of pleural fluid accumulation is poorly understood. Vascular endothelial growth factor (VEGF) is a potent inducer of capillary permeability that is produced by both malignant and inflammatory cells. A study was undertaken to determine whether VEGF has a potential pathogenic role in the development of pleural eVusions and whether VEGF receptors are present on human pleural mesothelial cells. Methods—Normal and inflamed pleura were examined immunohistochemically for the presence of FLT-1 (the fms-like tyrosine kinase receptor of VEGF). VEGF levels were measured by ELISA in 78 consecutive patients presenting with undiagnosed unilateral pleural eVusions and the levels were correlated with the aetiology of the eVusions. Results—Immunohistochemical staining of normal and diseased pleura demonstrated the presence of the FLT-1 VEGF receptor on human mesothelial cells. Median VEGF levels were 2500 pg/ml in the malignant group and 305 pg/ml in the non-malignant group (median diVerence 1397.5 pg/ml (95% CI 851 to 2693), p
