Proangiogenic and Profibrotic Markers in Pulmonary Sarcoidosis

  • I. TuletaEmail author
  • L. Biener
  • C. Pizarro
  • G. Nickenig
  • D. Skowasch
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1114)


The aim of our study was to determine the blood levels of vascular endothelial growth factor (VEGF), transforming growth factor (TGF)-β1, fibroblast growth factor (FGF)-2, and platelet-derived growth factor (PDGF)-AB in different stages of pulmonary sarcoidosis. There were 92 patients in sarcoidosis stages I + II, III, and IV enrolled into the study. All the patients underwent lung diffusing capacity and blood sampling. We found that VEGF levels differed significantly between the stage groups with the peak VEGF concentrations in stage III. TGF-β1 levels were similar in stages I + II and III, and tended to be lower in stage IV. The analysis of the subgroups showed increased VEGF and FGF-2, and reduced TGF-β1 concentration in stages I + II patients with relevantly reduced lung diffusing capacity or increased sarcoidosis activity compared to patients with normal lung diffusing capacity or inactive sarcoidosis. A tendency towards increased VEGF, PDGF-AB and TGF-β1 levels was observed in the analogical subgroup analysis within the stage III. We conclude that proangiogenic VEGF, and profibrotic FGF-2 and PDGF-AB may contribute to the progression of sarcoidosis, whereas TGF-β1, with its dual anti-inflammatory and profibrotic actions, may play a dichotomous protective or deleterious role. Reduced diffusing capacity and active sarcoidosis are associated with an unfavorable constellation of the markers studied, which predicts a progressive disease course.


Angiogenesis Fibrosis Granulomatous disorder Inflammation Markers Matrix accumulation Parenchymal disease Pulmonary sarcoidosis Vascular permeability 



We gratefully acknowledge Ms. Sabine Ring for her excellent technical assistance. We would like to thank all patients who participated in the study and the Sarkoidose-Netzwerk for its support.

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • I. Tuleta
    • 1
    Email author
  • L. Biener
    • 1
  • C. Pizarro
    • 1
  • G. Nickenig
    • 1
  • D. Skowasch
    • 1
  1. 1.Department of Internal Medicine II – Cardiology, Pulmonology and AngiologyUniversity of BonnBonnGermany

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