The effects of surgery, with or without rhGM-CSF, on the angiogenic profile of patients treated for colorectal carcinoma |
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Authors: | Wu Francis P K Westphal Johan R Hoekman Klaas Mels Anneke K Statius Muller Markwin G de Waal Robert W Beelen Rob H J van Leeuwen Paul A M Meijer Sybren Cuesta Miguel A |
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Institution: | Department of Surgery, VU Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. |
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Abstract: | Wound healing is a process with immunological and angiogenic aspects. rhGM-CSF is known to stimulate the immune system and angiogenesis via multiple pathways. In this study we investigated the combined effects of surgery, with or without rhGM-CSF, on angiogenic parameters in patients with a colorectal carcinoma. In this phase II randomized, placebo-controlled trial, 16 patients were assigned to perioperative rhGM-CSF (2.8 microg/kg body weight) treatment or saline. Patients received subcutaneous injections from three days before surgery until four days after. IL-6, VEGF, endostatin and angiostatin levels were measured perioperatively. rhGM-CSF enhanced the production of IL-6 and VEGF, but had no effect on the antiangiogenic agents endostatin and angiostatin. Surgery induced a transient decrease of endostatin. Two types of angiostatin (kringle 1-3 and kringle 1-4) became visible postoperatively. We conclude that this study demonstrated the immediate initiation of angiogenesis postoperatively, reflected by the increase of VEGF and a transient decrease of endostatin, followed by the appearance of two angiostatin bands, which confirms physiological wound healing in these cancer patients. |
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