Changes of serum growth factors profiles in patients with venous thromboembolism

Background and rationale: Venous thromboembolism (VTE) is a multifactorial disorder. Multiple hits to the tightly regulated blood hemostasis systems are required to trigger VTE. Growth factors, such as angiopoietins 1 and 2 (Ang-1 and Ang-2), and the epidermal growth factor (EGF) are critically involved in the maintenance of endothelial activity and vascular stability. The aim of this study was to evaluate the changes of these serum growth factors in patients with VTE. Methods: This is a multi-institutional retrospective case-control study. The first arm included 50 patients diagnosed with deep vein thrombosis (DVT), pulmonary embolism (PE) or both. The control arm included 25 healthy subjects with no current or previous VTE. Both arms were investigated for changes in their serum levels of Ang-1, Ang-2 and EGF. Results: Compared to healthy controls, Ang-2 was significantly higher (p =.001) while Ang-1 and EGF were significantly lower (p =.001 and p =.004; respectively) in VTE patients compared to healthy subjects. The type of VTE (DVT vs. PE) did not affect the observed changes in serum growth factors profiles. These changes were not time- or frequency-dependent, as there were no significant differences between acute versus chronic, or between the first-time versus recurrent cases of VTE. Conclusions: Serum profiles of Ang-1, Ang-2 and EGF change dramatically during VTE. This hints the significant role that these growth factors played in the pathogenesis of VTE. Thus, serum levels of growth factors may help in the first-time diagnosis of VTE, but not in diagnosing a recurrent episode of VTE. Larger studies are required to determine ‘threshold levels’ or ‘likelihood ranges’ of each biomarker for accurate diagnosis.