The Relationship of Serum levels of Vascular Endothelial Growth Factor with Disease Severity and the Number of Exacerbations in COPD Patients

Document Type: Original Article


1 Assistant Professor of Internal Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran

2 Associate Professor of Pulmonology, Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran

3 General Practitioner, Afzalipour Hospital Research Center, Kerman University of Medical Sciences, Kerman, Iran

4 Master of Nursing, Vice-Chancellor for Curative Affairs, Kerman University of Medical Sciences, Kerman, Iran

5 Department of Pharmacology & Toxicology, School of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran


Background: Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease characterized by progressive and irreversible obstruction of the airways of the lungs. Different studies have emphasized on the role of Vascular Endothelial Growth Factor (VEGF) in COPD patients. The aim of this study was to investigate the relationship of this factor with disease severity and the number of exacerbations in COPD patients.
Methods: This study is a Cross-sectional study on patients with chronic obstructive pulmonary disease referred to Besat clinic in Kerman in 2013-2014. After performing spirometery and confirming COPD diagnosis by a pulmonologist and obtaining consent form patients, blood samples were taken and level of VEGF was measured by ELISA method.
Results: Mean serum level of VEGF in patients was 160±156.6 µg/ml. More disease severity was associated with higher level of VEGF, but this association was not significant. No relationship was found between the number of exacerbations and VEGF level.
Conclusion:The results of our study showed that serum levels of VEGF increases in COPD patients, but there is not a significant correlation between serum levels of VEGF and the severity of the disease and the number of exacerbations.


  1. Kaner RJ, Crystal RG. Compartmentalization of vascular endothelial growth factor to the epithelial surface of the human lung.Molecular Medicine 2001; 7(4):240-6.
  2. Thickett DR, Armstrong L, Christie SJ, Millar AB.Vascular endothelial growth factor may contribute to increased vascular permeability in acute respiratory distress syndrome. American journal of respiratory and critical care medicine. 2001; 164(9):1601-5.
  3. Kasahara Y, Tuder RM, Cool CD, Lynch DA, Flores SC, Voelkel NF. Endothelial cell death and decreased expression of vascular endothelial growth factor and vascular endothelial growth factor receptor 2 in emphysema.American journal of respiratory and critical care medicine. 2001; 163(3):737-44.
  4. Pinto-Plata V, Casanova C, Müllerova H, de Torres JP, Corado H, Varo N, et al. Inflammatory and repair serum biomarker pattern. Association to clinical outcomes in COPD. Respiratory research 2012; 13(1):71.
  5. Cross MJ, Claesson-Welsh L. FGF and VEGF function in angiogenesis: signalling pathways, biological responses and therapeutic inhibition. Trends in pharmacological sciences 2001; 22(4):201-7.
  6. Wright JL, Lawson L, Paré PD, Hooper RO, Peretz DI, Nelems JB, et al. The Structure and Function of the Pulmonary Vasculature in Mild Chronic Obstructive Pulmonary Disease: The Effect of Oxygen and Exercise 1–3. American Review of Respiratory Disease 1983; 128(4):702-7.
  7. Santos S, Peinado V, Ramirez J, Melgosa T, Roca J, Rodriguez-Roisin R, et al. Characterization of pulmonary vascular remodelling in smokers and patients with mild COPD.European respiratory journal 2002; 19(4):632-8.
  8. Voelkel NF, Cool C, Taraceviene-Stewart L, Geraci MW, Yeager M, Bull T, et al. Janus face of vascular endothelial growth factor: the obligatory survival factor for lung vascular endothelium controls precapillary artery remodeling in severe pulmonary hypertension. Critical care medicine 2002; 30(5):S251-S6.
  9. Tuder RM, Flook BE, Voelkel NF. Increased gene expression for VEGF and the VEGF receptors KDR/Flk and Flt in lungs exposed to acute or to chronic hypoxia. Modulation of gene expression by nitric oxide. Journal of Clinical Investigation 1995; 95(4):1798.
  10. Kranenburg A, De Boer W, Alagappan VKT, Sterk P, Sharma H. Enhanced bronchial expression of vascular endothelial growth factor and receptors (Flk-1 and Flt-1) in patients with chronic obstructive pulmonary disease. Thorax 2005; 60(2):106-13.
  11. Pavlisa G, Pavlisa G, Kusec V, Kolonic SO, Markovic AS, Jaksic B. Serum levels of VEGF and bFGF in hypoxic patients with exacerbated COPD. European cytokine network 2010; 21(2):8-92.
  12. Valipour A, Schreder M, Wolzt M, Saliba S, Kapiotis S, Eickhoff P, et al. Circulating vascular endothelial growth factor and systemic inflammatory markers in patients with stable and exacerbated chronic obstructive pulmonary disease. Clinical Science 2008; 115:225-32.
  13. Wright JL, Petty T, Thurlbeck WM. Analysis of the structure of the muscular pulmonary arteries in patients with pulmonary hypertension and COPD: National Institutes of Health nocturnal oxygen therapy trial. Lung. 1992; 70:109-24.
  14. Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J. HARRISON'S Principles of Internal Medicine. Mc Graw Hill.19th edition. 2015; 1704-5.