The expressions of hypoxia inducible factor -1 and angiopoietin -2 in patients with angiodysplasia related gastrointestinal bleeding and treatment with thalidomide
TAN Hong-hong, GE Zhi-zheng, GAO Yun-jie, CHEN Hui-min, CHEN Hai-ying, FANG Jing-yuan, LIU Wen-zhong, XIAO Shu-dong
Published 2011-03-15
Cite as Chin J Dig, 2011,31(03): 160-163. DOI: 10.3760/cma.j.issn.0254-1432.2011.03.004
Abstract
Objective To study the expressions of hypoxia inducible factor (HIF)-1 and angiopoietin (Ang)-2 in repeated gastrointestinal bleeding due to vascular malformation, and the efficacy of treatment with thalidomide. Methods Twenty-five patients with repeated gastrointestinal bleeding due to vascular malformation confirmed by capsule endoscopy or enteroscopy were collected and 18 subjects without severe diseases were served as controls. Ten patients with gastrointestinal vascular malformation, who received 25 mg of thalidomide 4 times daily for 4 months and were followed up for at least one year, were also enrolled. The serum samples from all participauts were detected for expressions of HIF-1 and Ang-2 using enzyme-linked immunosorbent assay (ELISA).The expressions of HIF-1 and Ang-2 were compared between angiodysplasia group and control group.The expressions of HIF-1 and Ang-2 were comparatively evaluated before and after treatment with thalidomide in treatment group. Results The expressions of HIF-1 and Ang-2 in vascular malformation group [( 113. 84 ± 26. 66 ) ng/ml and ( 652. 11 ± 140. 39) ng/ml, respectively] were significantly higher than that of control group [(43.28±17.30) ng/ml and (265.60±53.88) ng/ml,respectively, P=0. 000]. The expression of HIF-1 was positively associated with that of Ang-2. (r=0. 700, P= 0. 000). There was no difference in expressions of HIF-1 and Ang-2 before and after treatment with thalidomide (P=0. 498 and =0. 136, respectively). However, significant reduction of Ang-2 [(113. 80±73. 60) ng/ml(P=0. 003)] was found in 8 effectively treated patients after thalidomide treatment. Conclusions HIF-1 and Ang-2 might play an important role in the formation of vascular malformation. The extent of Ang-2 reduction after thalidomide treatment may be helpful in evaluating its efficacy or prognosis.
Key words:
Obscure gastrointestinal bleeding; Vascular malformation; Angiodysplasia; Hypoxia inducible factor -1; Angiopoietin-2
Contributor Information
TAN Hong-hong
Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China
GE Zhi-zheng
Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China
GAO Yun-jie
Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China
CHEN Hui-min
Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China
CHEN Hai-ying
Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China
FANG Jing-yuan
Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China
LIU Wen-zhong
Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China
XIAO Shu-dong
Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China