Title: Serum Vascular Endothelial Growth Factor in Children with Beta Thalassemia Major
Authors: Reem A. Abdel Aziz, Gamal B. Mohamed, Emad A. Abd El-Naeem, Eman M. Sedek
DOI: https://dx.doi.org/10.18535/jmscr/v4i12.107
Abstract
Introduction: Beta-thalassemia major is an autosomal recessive hereditary anemia; patients frequently end up with iron overload because of hemolysis and repeated blood transfusion. Treatment with iron chelating therapy in patients with beta-thalassemia is considered the standard care, leading to improvement of morbidity and increased rate of survival. Vascular endothelial growth factor (VEGF),is a signal protein produced by cells that stimulates vasculogenesis and angiogenesis.
Aim of the work: is to assess serum Vascular Endothelial Growth Factor level in children with beta-thalassemia major as a marker of angiogenesis.
Methods: this study was conducted upon 100 children; 50 with B thalassemia major, 50 children as a control group. Complete blood count, serum ferritin and serum VEGF level were assessed in all children.
Results: Patients had significantly lower serum levels of hemoglobin and hematocrit than controls (p< 0.001), and also had significantly higher serum levels of WBCs, platelets, ferritin and VEGF than controls (p< 0.001).Serum level of VEGF was significantly higher in splenectomized patients than in non-splenectomized patients (p< 0.001).
Conclusion: Patients with beta thalassemia major had high levels of VEGF. The VEGF level was higher in splenectomised thalassemic patients than non splenectomized ones. Chelation starting age was positively correlated with VEGF level. VEGF is a reliable marker for prediction of thalassemic patients for chelation therapy.
Keywords: thalassemia, VEGF, chelation therapy, angiogenesis.
References
1. Pirinccioglu AG, Deniz T, Gokalp D, Beyazit N, Haspolat K, Soker M. Assessment of thyroid function in children aged 1-13 years with Beta-thalassemia major. Iran J Pediatr. 2011;21(1):77-82.
2. Garadah TS, Mahdi NA, Jaradat AM, Hasan ZA, Nagalla DS. Thyroid function status and echocardiographic abnormalities in patients with Beta thalassemia major in Bahrain. Clin Med Insights Cardiol. 2013;7:21-27.
3. Shitrit D, Tamary H, Koren A, Levin C, Bargil-Shitrit A, Sulkes J, Kramer MR. Correlation of vascular endothelial growth factor with the severity of thalassemia intermedia. Blood Coagul Fibrinolysis. 2008;19(7):611-614.
4. Johnson, K.E., and Wilgus, T.A. Vascular Endothelial Growth Factor and Angiogenesis in the Regulation of Cutaneous Wound Repair. Advances in Wound Care. 2014;3(10):647-661.
5. Palmer, Biff F.; Clegg, Deborah J. Oxygen sensing and metabolic homeostasis. Molecular and Cellular Endocrinology. 2014;397(1-2):51–58.
6. Dunst J, Becker A, Lautenschläger C, Markau S, Becker H, Fischer K, Haensgen G. Anemia and elevated systemic levels of vascular endothelial growth factor (VEGF). Strahlenther Onkol. 2002;178 (8):436-441.
7. Kanavaki I, Makrythanasis P, Lazaropoulou C, Tsironi M, Kattamis A, Rombos I, Papassotiriou I. Soluble endothelial adhesion molecules and inflammation markers in patients with beta-thalassemia intermedia. Blood Cells Mol Dis. 2009;43(3):230-234.
8. Aggeli C, Antoniades C, Cosma C, Chrysohoou C, Tousoulis D, Ladis V, Karageorga M, Pitsavos C, Stefanadis C. Endothelial dysfunction and inflammatory process in transfusion-dependent patients with beta-thalassemia major. Int J Cardiol. 2005;105(1):80-84.
9. Birk DM, Barbato J, Mureebe L, Chaer RA. Current insights on the biology and clinical aspects of VEGF regulation. Vasc Endovascular Surg. 2009;42(6):517-530.
10. Karamysheva A.F. Mechanisms of Angiogenesis. Biochemistry (Moscow). 2008;73(7):751-762.
11. De Sanctis V, Soliman AT, Elsedfy H, Skordis N, Kattamis C, Angastiniotis M, Karimi M, Yassin MM, El Awwa A, Stoeva I, Raiola G, Galati MC, Bedair EM, Fiscina B, El Kholy M. Growth and endocrine disorders in thalassemia: The international network on endocrine complications in thalassemia (I-CET) position statement and guidelines. Indian J EndocrinolMetab. 2013;17(1):8–18.
12. Elsayh KI, Mohammed WS, Zahran AM, Saad K. Leukocytes apoptosis and adipocytokines in children with beta thalassemia major. ClinExp Med. 2016;16(3):345-350.
13. Chaudhary HT, Ahmad N. Frequency of platelet aggregation defects in children suffering fromg β-thalassemia. Saudi J Health Sci. 2012;1(2):92-98.
14. Shahramian I, Razzaghian M, Ramazani AA, Ahmadi GA, Noori NM, Rezae AR. The Correlation between Troponin and Ferritin Serum Levels in the Patients with Major Beta-Thalassemia. IntCardiovasc Res J. 2013;7(2):51–55.
15. Farokhi F, Razaviyan J, kosaryan M, Roudbari M, Reykande SE, Aliasghariyan A, Dehghani M . The relationship between serum vascular endothelial growth factor (SVEGF) and beta thalassemia major. Int J Med Invest. 2015;4(3):289-292.
16. Fahmey SS, Naguib HF, Abdelshafy SS, Alashry RE. Vascular endothelial growth factor in children with thalassemia major. Mediterr J Hematol Infect Dis. 2013;5(1):p.2013044.
17. Olgar S, Kara A, Hicyilmaz H, Balta N, Canatan D. Evaluation of angiogenesis with vascular endothelial growth factor in patients. Pediatr Int. 2010;52(2):247-251.
18. Blann A.D., Mohan J.S., Bareford D. and Lip G. Soluble P- selectin and vascular endothelial growth factor in steady state sickle cell disease: relationship to genotype. J. Thromb Thrombolysis. 2008;25(2):185–189.
19. Silha J.V., Krsek M., Sucharda P. and Murphy L.J. Angiogenic factors are elevated in overweight and obese individuals. Int. J. Obes. (Lond). 2005;29(11):1308-1314.