PlGF and sVEGFR-1 in chronic subdural hematoma: implications for hematoma development

Clinical article

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Object

A considerable body of evidence indicates that inflammation and angiogenesis play a significant role in the development and progression of chronic subdural hematoma (CSDH). While various experimental and clinical studies have implicated placental growth factor (PlGF) in the processes that underpin pathological angiogenesis, no study has thus far investigated its expression in CSDH. The actions of PlGF and its related proangiogenic vascular endothelial growth factor (VEGF) are antagonized by a high-affinity soluble receptor, namely soluble VEGF receptor–1 (sVEGFR-1), and thus the ratio between sVEGFR-1 and angiogenic factors provides an index of angiogenic capacity.

Methods

In the present study, using an automated electrochemiluminescence assay, levels of PlGF and sVEGFR-1 were quantified in serum and hematoma fluid obtained in 16 patients with CSDH.

Results

Levels of PlGF and sVEGFR-1 were significantly higher in hematoma fluid than in serum (p < 0.0001). In serum, levels of sVEGFR-1 were higher than those of PlGF (p < 0.0001), whereas in hematoma fluid this difference was not apparent. Furthermore, the ratio of sVEGFR-1 to PlGF was significantly lower in hematoma fluid than in serum (p < 0.0001).

Conclusions

Given previous evidence indicating a role for PlGF in promoting angiogenesis, inflammatory cell chemotaxis, and stimulation, as well as its ability to amplify VEGF-driven signaling under conditions favoring pathological angiogenesis, enhanced expression of PlGF in hematoma fluid suggests the involvement of this factor in the mechanisms of inflammation and angiogenesis in CSDH. Furthermore, a reduced ratio of sVEGFR-1 to PlGF in hematoma fluid is consistent with the proangiogenic capacity of CSDH. Future studies are warranted to clarify the precise role of PlGF and sVEGFR-1 in CSDH.

Abbreviations used in this paper:CSDH = chronic subdural hematoma, PlGF = placental growth factor, sVEGFR-1 = soluble vascular endothelial growth factor receptor–1; VEGF = vascular endothelial growth factor.

Article Information

Address correspondence to: Theodosis Kalamatianos, Ph.D., Hellenic Centre of Neurosurgical Research “Professor Petros S. Kokkalis,” Poutarchou 3, Athens 106 75, Greece. email: theodosis.kalamatianos@kcl.ac.uk.

Please include this information when citing this paper: published online November 9, 2012; DOI: 10.3171/2012.10.JNS12327.

© AANS, except where prohibited by US copyright law.

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