Lower-extremity edema associated with gene transfer of naked DNA encoding vascular endothelial growth factor

I Baumgartner, G Rauh, A Pieczek… - Annals of internal …, 2000 - acpjournals.org
I Baumgartner, G Rauh, A Pieczek, D Wuensch, M Magner, M Kearney, R Schainfeld…
Annals of internal medicine, 2000acpjournals.org
Background: Vascular endothelial growth factor (VEGF) promotes angiogenesis and
vascular permeability. The extent to which VEGF may cause tissue edema in humans has
not been established. Objective: To evaluate patients undergoing VEGF gene transfer for
evidence of lower-extremity edema. Design: Prospective consecutive case series. Setting:
Hospital outpatient clinic. Patients: 62 patients with critical limb ischemia and 28 patients
with claudication. Intervention: Gene transfer of VEGF DNA. Measurements …
Background
Vascular endothelial growth factor (VEGF) promotes angiogenesis and vascular permeability. The extent to which VEGF may cause tissue edema in humans has not been established.
Objective
To evaluate patients undergoing VEGF gene transfer for evidence of lower-extremity edema.
Design
Prospective consecutive case series.
Setting
Hospital outpatient clinic.
Patients
62 patients with critical limb ischemia and 28 patients with claudication.
Intervention
Gene transfer of VEGF DNA.
Measurements
Semiquantitative analysis of lower-extremity edema.
Results
Lower-extremity edema was observed in 31 of 90 (34%) patients. Edema was less common in patients with claudication than in those with pain at rest (P = 0.016) or ischemic ulcers (P < 0.001), and it was less common in patients with pain at rest than in those with ischemic ulcers (P = 0.017). Treatment was typically limited to a brief course of oral diuretics.
Conclusions
Vascular endothelial growth factor may enhance vascular permeability in humans. At the doses of plasmid DNA used in this study, lower-extremity edema responded to oral diuretic therapy and did not seem to be associated with serious sequelae.
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