Evaluation of Vascular Endothelial Growth Factor as a Marker of Severity in Childhood Interstitial Lung Disease

Abstract

BACKGROUND: Vascular endothelial growth factor (VEGF) is thought to play a significant role in interstitial lung disease (ILD) pathogenesis. It has been found to be upregulated in the serum of adult ILD patients. However, its role in childhood interstitial lung disease (chILD) is still undetermined. OBJECTIVES: To assess the levels of VEGF in serum and induced sputum of children with chILD and determine their relationship with disease severity. METHODS: In this controlled cross-sectional study, serum VEGF levels were measured in 45 pediatric patients and 40 healthy controls of comparable age and gender. Serum VEGF concentrations and induced sputum samples were analyzed simultaneously in the studied patients. Arterial blood gas analysis and pulmonary function test parameters were collected. The chest high-resolution computed tomography (HRCT) score was used to evaluate lung involvement progression. Spearman's correlation coefficient was used to assess the relationship between VEGF cytokine levels, lung function, radiological parameters, and disease severity. RESULTS: Children with chILD had significantly higher serum VEGF levels than controls (p < 0.001). Within the chILD group, serum and sputum VEGF levels showed a significant positive correlation with exacerbation frequency, HRCT score, and Fan score. Furthermore, there was an inverse correlation between VEGF levels and oxygen saturation (p = 0.002, 0.005). CONCLUSIONS: Children with chILD had significantly higher VEGF levels, which correlated with lung function and disease severity scores. Therefore, increased VEGF levels in the serum and sputum of ILD patients may reflect the severity of chronic pulmonary involvement in childhood ILD, providing clinical benefits in predicting disease progression.