Evaluation of serum Angiopoietin-1, Angiopoietin-2, Vascular Endothelial Growth Factor ve Tumor Necrosis Factor-α levels in asthmatic children

Asthma is a chronic inflammatory disorder of airways. Chronic inflammatory response within the airways of asthmatics is associated with structural changes termed airway remodeling. Angiogenesis and microvascular remodelling is responsible for important part of remodelling. The aim of our study is to evaluate serum Angiopoietin (Ang) -1, Ang-2, Vascular Endothelial Growth Factor (VEGF) and Tumor Necrosis Factor (TNF)-α values which have important roles in inflammation, angiogenesis and remodelling in asthmatic children. We also aimed to document correlations between demographic features, duration of asthma and pulmonary function test (PFT) parameters. Randomly selected 40 children (20 male and 20 female, age; 6-16 years) with mild or moderate asthma and 32 healthy children (15 male and 17 female, age 6-16 years) enrolled in the study. All asthmatics had been using inhaled steroids at least three months. Serum Ang-1 levels were significantly lower in asthmatics (median 10783.2 pg/ml, 3585.6 - 40027 pg/ml) than in normal controls (median 17203 pg/ml, 5891.8 – 54000 pg/ml) (p<0.01). Angiopoietin-1/Ang-2 were also significantly lower in asthmatics than in normal controls (p<0.01). Whereas serum Ang-2, VEGF and TNF-α levels were similar in two groups. Positive correlation was found between VEGF and duration of asthma (p<0.05). No correlation was found between serum Ang-1, Ang-2, VEGF values and PFT parameters. However negative correlation was detected between serum TNF-α and FEV1 (p<0.05). In conclusion, serum Ang-1 levels and Ang-1/Ang-2 ratio were significantly reduced and balance was towards Ang-2 in asthmatic children. This process may lead to inflammation, destabilisation of blood vessels and trigger remodelling.