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Effects of inhaled fluticasone on angiogenesis and vascular endothelial growth factor in asthma


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Feltis, BN, Wignarajah, D, Reid, DW, Ward, C, Harding, R and Walters, EH 2007 , 'Effects of inhaled fluticasone on angiogenesis and vascular endothelial growth factor in asthma' , Thorax, vol. 62, no. 4 , pp. 314-319 , doi: 10.1136/thx.2006.069229.

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Background: Subepithelial hypervascularity and angiogenesis in the airways are part of structural
remodelling of the airway wall in asthma, but the effects of inhaled corticosteroids (ICS) on these have not
been explored. Increased vascularity in asthma may contribute to a number of functional abnormalities. A
study was undertaken to explore angiogenic modulation by ICS and its likely regulation via vascular
endothelial growth factor (VEGF), its receptors and the angiopoietins.
Methods: A placebo-controlled intervention study with ICS in asthma was performed, examining vascularity,
VEGF, its receptors (VEGFR1 and VEGFR2), and angiopoietin-1 (Ang1) to assess which of these factors were
changed in the asthmatic airways after ICS treatment. Airway wall biopsy specimens, lavage fluid and cells
were obtained from 35 patients with mild asthma randomised to receive ICS or placebo for 3 months, after
which bronchoscopic examination and sample collection were repeated. Immunohistochemistry and image
analysis were used to obtain quantitative measures of vessels, angiogenic sprouts, VEGF, VEGFR1, VEGFR2
and Ang1 staining in airway biopsy specimens. ELISA was used to assess VEGF concentrations in the lavage
Results: Vessel, VEGF and sprout staining were decreased after 3 months of ICS treatment. VEGF levels
remained unchanged. VEGF receptors and Ang1 staining were not reduced after treatment.
Conclusions: The findings of this study support an effect of ICS in downregulating angiogenic remodelling in
the airways in asthma, associated with decreasing VEGF activity within the airway wall. The environment of
the airways after treatment with ICS, with changes in the balance between

Item Type: Article
Authors/Creators:Feltis, BN and Wignarajah, D and Reid, DW and Ward, C and Harding, R and Walters, EH
Journal or Publication Title: Thorax
ISSN: 0040-6376
DOI / ID Number: 10.1136/thx.2006.069229
Additional Information:

Copyright © 2007 BMJ Publishing Group Ltd & British Thoracic Society

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