Selected angiogenic factors in plasma of patients with lower limb symptomatic peripheral arterial disease: preliminary report.

AIM: The number of people suffering from atherosclerosis-related complications such as peripheral arterial disease (PAD) ‑ including lower limbs PAD increases. Hypoxia and ischemia stimulate angiogenesis ‑ a postnatal multistage process in which new blood vessels form and the Vascular Endothelial Growth Factor (VEGF-A) is the key proangiogenic factor whereas its soluble receptors type 1 and type 2 (sVEGFR-1, sVEGFR-2) are regarded as inhibitory factors. The aim of this study was to assess the concentrations of VEGF-A, sVEGFR-1 and sVEGFR-2 in plasma of patients with symptomatic lower extremity PAD compared with selected clinical parameters (Ankle-Brachial Index, distance in walking test) and severity of PAD (according to the Fontaine classification).

METHODS: The study group included 46 patients suffering from symptomatic PAD with Fontaine class IIa-IV without any history of neoplastic disease. The control group consisted of 30 healthy non-smoking volunteers. The following parameters were determined: plasma concentrations of VEGF-A, its soluble receptors (sVEGFR-1, sVEGFR-2) using the ELISA method also VEGF-A and sVEGFR-1 quotient was calculated on the basis of mean concentrations in homogenous units (pg/mL).

RESULTS: The study group revealed a statistically significant higher level of VEGF-A concentration when compared with the control group and statistically significant lower concentration of sVEGFR-2 in the study group. In the study group a statistically significant negative correlation between VEGF-A concentrations and the length of irrelative distance in walking test was observed. In the group of PAD a significantly higher VEGF-A/sVEGFR-1 ratio in comparison with the control group was obtained. Within the group of patient suffering from PAD there was noticed an increasing VEGF-A/sVEGFR-1 ratio in subsequent subgroups according to the Fontaine classification.

CONCLUSION: The plasma concentrations of VEGF-A correlated with increased clinical symptoms of PAD in the walking test. The plasma VEGF-A/sVEGFR-1 ratio may be used as a useful ischemic marker in patients with PAD which should be tested and finally verified in large group of patients.