Purpose : Vascular endothelial growth factor (VEGF) is an important mediator of airway inflammation and remodeling in asthma. We aimed to explore whether VEGF is expressed at elevated levels in asthmatic airways or eosinophilic bronchitis (EB) and associated with eosinophilic inflammation, pulmonary function, and airway hyperresponsiveness (AHR) in children. Methods : One hundred seventeen asthmatic children, 77 children with EB, and 84 healthy children were enrolled. Sputum supernatants were collected and VEGF and eosinophil cationic protein (ECP) levels were measured. Results : Asthmatic children had significantly higher levels of VEGF in induced sputum [89.04 (29.95-178.09) pg/mL] compared to children with EB [25.30 (11.02-80.23) pg/mL] and healthy children [37.37 (16.56-71.30) pg/mL; P=0.0003]. VEGF in sputum positively correlated with sputum ECP (r=0.524; P<0.0001). Negative significant correlations were found between sputum VEGF and FEV1, (r=-0.252; P=0.001) or post-bronchodilator FEV1 (r=-0.181; P= 0.038) whereas nonsignificant correlations were found between sputum VEGF and sputum eosinophils. Conclusion : Our findings suggest that VEGF is associated with activated eosinophils in the asthmatic airway, but not EB. Sputum VEGF could be a supportive marker that represents activation of airway eosinophils and persistent airflow limitation in asthmatic children.

Purpose : Vascular endothelial growth factor (VEGF) is an important mediator of airway inflammation and remodeling in asthma. We aimed to explore whether VEGF is expressed at elevated levels in asthmatic airways or eosinophilic bronchitis (EB) and associated with eosinophilic inflammation, pulmonary function, and airway hyperresponsiveness (AHR) in children. Methods : One hundred seventeen asthmatic children, 77 children with EB, and 84 healthy children were enrolled. Sputum supernatants were collected and VEGF and eosinophil cationic protein (ECP) levels were measured. Results : Asthmatic children had significantly higher levels of VEGF in induced sputum [89.04 (29.95-178.09) pg/mL] compared to children with EB [25.30 (11.02-80.23) pg/mL] and healthy children [37.37 (16.56-71.30) pg/mL; P=0.0003]. VEGF in sputum positively correlated with sputum ECP (r=0.524; P<0.0001). Negative significant correlations were found between sputum VEGF and FEV1, (r=-0.252; P=0.001) or post-bronchodilator FEV1 (r=-0.181; P= 0.038) whereas nonsignificant correlations were found between sputum VEGF and sputum eosinophils. Conclusion : Our findings suggest that VEGF is associated with activated eosinophils in the asthmatic airway, but not EB. Sputum VEGF could be a supportive marker that represents activation of airway eosinophils and persistent airflow limitation in asthmatic children.

목 적 :혈관 내피세포 성장인자(Vascular endothelial growth factor, VEGF)는 기도개형에 중심적인 역할을 하며, 혈관의 투과성을 증가시켜 천식에서 기도 벽의 부종에 기여할 뿐 아니라 기관지과민성에 관여하는 것으로 알려져 기관지 천식의 중요한 매개물질로 주목받고 있다. 본 연구에서는 천식 및 호산구성 기관지염 환아에서 이러한 VEGF의 임상적인 의의와 기관지과민성 및 폐기능에 미치는 영향에 대해 알아보고자 하였다. 방 법 : 만 6세에서 14세 사이의 278명을 대상으로 하였다. 천식 환아는 117명, 호산구성 기관지염 환아는 77명, 대조군은 84명이었다. 전체 대상자에서 폐기능 검사, 메타콜린 흡입 유발시험, 피부 단자 시험을 시행하였고, 혈액 내 호산구수, 혈청 총 IgE, ECP, 유도 객담 내 호산구수 및 유도 객담 상층액의 ECP, VEGF 농도를 측정하였다. 결 과 : 천식군의 유도 객담 VEGF 농도는 89.04 (29.95-178.09) pg/mL, 호산구성 기관지염군은 25.30 (11.02-80.23) pg/mL, 대조군은 37.37 (16.56-71.30) pg/mL로 천식군에서 호산구성 기관지염군과 대조군에 비해 의미있는 증가를 보였다 (P=0.0003). 또한 유도 객담 VEGF 농도는 유도 객담 내 ECP 농도와 유의한 양의 상관관계를 나타내었으나 (r= 0.524; P<0.0001), 유도 객담 내 호산구수와는 관련이 없었다. 또한 유도 객담 내 VEGF는 FEV1, (r=-0.252; P=0.001) 및 post -bronchodilator FEV1 (r=-0.181; P=0.038)와 의미있는 음의 상관관계를 나타내었다. 결 론 : VEGF는 소아 천식에서 기도 내 호산구 활성화와 연관이 있는 것으로 생각되며, 특히 유도 객담 VEGF는 호산구성 기도 염증의 정도 및 기류제한을 반영하는 보조적인 지표가 될 수 있을 것으로 생각된다.