Clinical Implications for Vascular Endothelial Growth Factor Levels among Egyptians with Pulmonary Tuberculosis
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Vascular endothelial growth factor (VEGF) is a potent angiogenic factor. Intense angiogenesis has been found in active pulmonary tuberculosis. VEGF role in tuberculosis (TB) has not been fully elucidated. Aim: This study aimed to measure serum VEGF levels in active pulmonary tuberculosis and changes following chemotherapy. Subjects and Methods: Twenty five consecutive patients with active pulmonary tuberculosis and 15 healthy control subjects were enrolled in this prospective randomized controlled study. Complete medical history, full clinical examination, complete blood examination, erythrocyte sedimentation rate, liver function tests, kidney function tests, fasting blood sugar, radiological examination by plain X ray chest, tuberculin skin test by Mantoux method, sputum for acidfast bacilli by Zeil Neilsen stain and estimation of serum VEGF before treatment, 3 months and 6 months after treatment. Results: There was no statistical significant difference (p value >0.05) between patients and control group regarding age in years (with a mean of 36.75 ±8.95 for patients and 26.2±4.4 for control group) and smoking index in packs/year (with a mean of 239.65 ±215.40 for patients and 190.6 ±115.2 for control group). There was a highly statistical significant difference(p value<0.001) between patients pretreatment and control group as regarding serum VEGF (pg/m1)(with a mean of 596.02 ± 298.15 for patients and 336.61± 70.45 for control group), There was statistical significant difference(p value<0.05) between patients, 3 months after treatment and control group as regarding serum VEGF(pg/m1) (with a mean of 490.01 ±290.14 for patients and 336.60 ±70.45 for control group).There was a statistical significant difference(p value<0.05) between patients,6 months after treatment and control group as regarding serum VEGF( pg/m) (with a mean of 380.01 ±280.13 for patients and 336.6 ± 70.45 for control group). There was a statistical significant difference (p value<0.05) for serum VEGF levels(pg/m1) in patients pretreatment, 3 and 6 months after treatment( with a mean of 596.02 ± 218.15 pretreatment, 490.01±240.1I three months after treatment, 380.01±217.12 six months after treatment). In conclusion: our observations revealed that increased serum VEGF may be an indicator of active pulmonary tuberculosis, since levels were higher in patients with active pulmonary tuberculosis and were lower after successful treatment. The role of VEGF medicated angiogenesis in pathogenesis and progression of pulmonary tuberculosis lesions should be further elucidated.