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(Chest. 2006;129:407-411.)
© 2006 American College of Chest Physicians

Increased Serum Vascular Endothelial Growth Factor Level in Churg-Strauss Syndrome*

Hideo Mitsuyama, MD; Wataru Matsuyama, MD, PhD; Jun Iwakawa, MD; Ikkou Higashimoto, MD, PhD; Masaki Watanabe, MD, PhD; Mitsuhiro Osame, MD, PhD and Kimiyoshi Arimura, MD

* From the Division of Respiratory Medicine, Respiratory and Stress Care Center, Kagoshima University Hospital, Kagoshima, Japan.

Correspondence to: Wataru Matsuyama, MD, PhD, Division of Respiratory Medicine, Respiratory and Stress Care Center, Kagoshima University Hospital, Sakuragaoka 8–35-1, Kagoshima 890-8520, Japan; e-mail: vega{at}xa2.so-net.ne.jp

Abstract

Background: Churg-Strauss syndrome (CSS) is a rare form of systemic vasculitis occurring in patients with asthma and hypereosinophilia. For optimal treatment, prompt distinction of CSS from asthma is necessary; however, there are few serologic screening markers for this purpose. Vascular endothelial growth factor (VEGF), a vascular permeability factor, has been associated with other systemic vasculitis such as Wegener granulomatosis and giant-cell arteritis.

Objective: The aim of this study was to clarify the clinical value of the measurement of serum VEGF for the distinction of CSS from asthma.

Methods: We investigated serum VEGF levels in 18 CSS patients, 19 asthma patients, and 12 acute bronchitis patients. We also performed immunohistochemical analysis for VEGF.

Results: The serum VEGF levels of CSS patients were significantly higher than those of asthma patients and acute bronchitis patients. The sensitivity and specificity to distinguish CSS from asthma were 93.3% and 81.8%, respectively (cutoff, 600 pg/mL). Infiltrating eosinophils stained intensely positive for VEGF, and serum VEGF levels showed a significant correlation with peripheral eosinophil counts. Serum VEGF levels decreased significantly after therapy (p < 0.001). The infiltrating eosinophils in the CSS lesion stained positive for VEGF in the immunohistochemical analysis.

Conclusion: VEGF is one of the useful screening markers for the distinction of CSS from asthma. We suggest that VEGF might be associated with the pathogenesis of CSS.

Key Words: allergy • asthma • eosinophils • vasculitis






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