Decreased VEGF Level Is Associated with Elevated Ferritin Concentration in Bronchoalveolar Lavage Fluid of Children with Interstitial Lung Diseases

• Published in: Respiration Vol. 90; no. 6; pp. 443 - 450
• Main Authors: Papp, Ágnes, Bene, Zsolt, Gáspár, Imre, Nagy Jr, Béla, Kádár, László, Márialigeti, Tivadar, Bánfi, Andrea, Baktai, György, Balla, György, Nagy, Béla
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.12.2015
• Subjects: Adolescent; Albumins - analysis; Apoptosis; Bronchoalveolar lavage; Bronchoalveolar Lavage Fluid - chemistry; C-Reactive Protein - analysis; Care and treatment; Case-Control Studies; Cell Count; Child; Child, Preschool; Children & youth; Clinical Investigations; Development and progression; Female; Ferritins - analysis; Genetic aspects; Health aspects; Hemosiderosis - metabolism; Humans; Iron; Lung diseases; Lung Diseases - metabolism; Lung diseases, Interstitial; Lung Diseases, Interstitial - metabolism; Lymphocyte Count; Macrophages, Alveolar - metabolism; Male; Neutrophils - metabolism; Testing; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - analysis; Hungary; Children; Bronchoalveolar lavage; Interstitial lung diseases; Vascular endothelial growth factor; Ferritin
• ISSN: 0025-7931; 1423-0356
• DOI: 10.1159/000440888

Background: A decreased level of vascular endothelial growth factor (VEGF) was previously described in bronchoalveolar lavage fluid (BALF) of adults with interstitial lung diseases (ILD) due to bronchial epithelial cell apoptosis and its proteolytic degradation. Elevated intrapulmonary ferritin was produced by alveolar cells that promoted oxidative injury in such patients. Objectives: In this study, we analyzed the concentrations of VEGF and ferritin in BALF samples of ILD children and studied the relationship between their levels and the degree of inflammation. Methods: BALF and serum concentration of VEGF as well as ferritin and albumin in BALF samples were measured using enzyme-linked immunosorbent assay in children with idiopathic interstitial pneumonia (n = 16), hypersensitivity pneumonitis (n = 11) and idiopathic pulmonary hemosiderosis (n = 3). Twenty-four age- and gender-matched subjects with suspicious foreign body aspiration served as a control group. Results: VEGF per albumin levels in BALF were significantly decreased in ILD children compared to controls (1,075 [784-1,415] pg/mg albumin vs. 2,741 [1,131-4,660] pg/mg albumin, p = 0.0008). These values showed a significant negative correlation with inflammatory markers of total immune cell count in BALF (r = -0.411, p = 0.002) and serum C-reactive protein (r = -0.367, p = 0.006). Although serum VEGF was augmented in ILD children versus controls, no difference was observed among the ILD groups. In addition, BALF ferritin/albumin level (688 [188-1,571] ng/mg albumin vs. 256 [178-350] ng/mg albumin, p = 0.022) was significantly higher than normal in ILD individuals, especially in idiopathic pulmonary hemosiderosis. Conclusion: Depressed VEGF and increased ferritin in BALF may reflect the severity of chronic pulmonary inflammation in altered respiratory epithelium of childhood ILD.