{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:26:48Z","timestamp":1761989208448,"version":"3.37.3"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,5,9]],"date-time":"2018-05-09T00:00:00Z","timestamp":1525824000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Hellenic Institute"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>The role of vascular endothelial growth factor (VEGF)\u2010A in the resolution of ventilator\u2010associated pneumonia (VAP) was investigated in clinical and mouse pneumonia models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>VEGF\u2010A was measured for seven consecutive days by an immunosorbent assay in sera of 82 patients with VAP and changes from baseline were correlated with the resolution of VAP. Experimental animals were challenged intratracheally with <jats:italic>Pseudomonas aeruginosa<\/jats:italic>. Mouse bronchoalveolar lavage (BAL) samples and segments of lung tissue were obtained at 24, 48 and 124 h after bacterial challenge. Levels of VEGF\u2010A, tumour Necrosis Factor alpha (TNF\u2010\u03b1), interleukin (IL)\u20101\u03b2, interferon\u2010gamma (IFN\u03b3) and myeloperoxidase (MPO) activity were measured in these samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>VAP resolved in 36.1% of patients with a less than 45% increase of VEGF\u2010A on day 5 compared to 65.2% of patients with a more than 45% increase (<jats:italic>P<\/jats:italic> = 0.014). This was also accompanied by an earlier resolution of VAP (log\u2010rank: 7.99; <jats:italic>P<\/jats:italic> = 0.005) and it was not pathogen\u2010specific. The increase of VEGF\u2010A was an independent variable associated with VAP resolution in forward logistic regression analysis where Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores were included as independent variables. VEGF\u2010A in mouse BAL and lung tissue increased significantly at 124 h but not with the other mediators. In mice pre\u2010treated with bevacizumab, VEGF\u2010A concentrations decreased while TNF\u2010\u03b1 and MPO significantly increased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients, an association between increased levels of circulating VEGF\u2010A and VAP resolution was observed. The mouse study suggests that elevated VEGF\u2010A levels may be associated with lung inflammation resolution.<\/jats:p><jats:p>Clinical trial registration: <jats:bold>NCT00297674 at<\/jats:bold> <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">www.clinicaltrials.gov<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.13320","type":"journal-article","created":{"date-parts":[[2018,5,9]],"date-time":"2018-05-09T11:15:47Z","timestamp":1525864547000},"page":"942-949","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Early increase of VEGF\u2010A is associated with resolution of ventilator\u2010associated pneumonia: Clinical and experimental evidence"],"prefix":"10.1111","volume":"23","author":[{"given":"Ioannis","family":"Strouvalis","sequence":"first","affiliation":[{"name":"4th Department of Internal Medicine Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Routsi","sequence":"additional","affiliation":[{"name":"1st Department of Critical Care Medicine Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Adamopoulou","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratories, Molecular Microbiology Laboratory Technological Institution of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Raftogiannis","sequence":"additional","affiliation":[{"name":"4th Department of Internal Medicine Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Renieris","sequence":"additional","affiliation":[{"name":"4th Department of Internal Medicine Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stylianos E.","family":"Orfanos","sequence":"additional","affiliation":[{"name":"2nd Department of Critical Care Medicine Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia","family":"Kotanidou","sequence":"additional","affiliation":[{"name":"1st Department of Critical Care Medicine Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Labros","family":"Sabracos","sequence":"additional","affiliation":[{"name":"4th Department of Internal Medicine Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4713-3911","authenticated-orcid":false,"given":"Evangelos J.","family":"Giamarellos\u2010Bourboulis","sequence":"additional","affiliation":[{"name":"4th Department of Internal Medicine Medical School, National and Kapodistrian University of Athens  Athens 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