Expression of the Growth Factors in the Endotheliocytes of Arteriovenous Malformations and Arterial Aneurisms as a Marked Sign of Their Differential Diagnosis
The aim of the investigation is to study the peculiarities of angiogenic mediator expression in the endotheliocytes and their proliferative activity in the arteriovenous malformations (AVM) and arterial aneurisms (AA) as well. It gives an opportunity to prescribe a pathogenetically substantiated treatment and reveal the complication development risk according to the expression level.
Materials and Methods. Under studies there has been surgical and sectional material of 35 patients (17 females and 18 males) at the age of 18—65 years with AVM and AA of the brain vessels. They have been treated at the hospital from 2002 to 2009.
The immunohistochemical investigation of the expression of the vascular endothelial growth factor (EFG), transforming growth factor β3 (TGF), basic factor of the fibroblast growth β-FGF and proliferation marker Ki-67 has been made with an immunoperoxidase method. The nuclei were stained with a hematoxylin.
Results. A significantly increased expression of a TGF-β3 has been revealed in all the AVM observations in the endotheliocytes. An increase of a TGF-β3 expression has not been revealed.
A vascular EFG expression is moderately increased in the AVM endothelium; but it is not increased in the AA endothelium. The β-FGF expression in both cases is low or insignificantly increased. However, it was higher in the AVM endothelium.
Conclusion. The revealed peculiarities of the growth factor expression in the AVM endotheliocytes appear to reflect the differences in the morphogenesis and pathogenesis of the given formations. An increased proliferative activity of the endothelium in the AVM is likely to be the basis of the disease recurrence. A receptor profile assessment is crucially important to prognose and to prescribe a pathogenetically substantiated treatment. The research proves that the receptors expression level is a specific marked sign of the given pathology. In cases of the EFG high expression it may be evidence of high probability of the AVM progression, which leads to the clinical symptoms. Moreover, it may be the reason for the complication development and a lethal outcome.
