Influence of Oxygen Sensitive Vascular Endothelial Growth Factor(VEGF) Gene Expression in Pulmonary Tuberculosis and its Correlation with Erythropoietin and Tumor Necrosis Factor-alpha (TNF-α)

Abstract

Aim and Objectives: The study aimed to evaluate the impact of oxygen sensing vascular endothelial growth factor protein (VEGF) expression and its correlation with erythropoietin (EPO) and inflammatory marker like tumor necrosis factor- alpha (TNF-α) and also association of these oxygen sensing molecular markers with bacterial burden measured in terms of sputum smear acid fast bacilli grading in pulmonary tuberculosis (PTB) patients. Material and Methods: In the present cross sectional study demographic and anthropometric parameters were recorded from 197 newly diagnosed sputum positive PTB cases and 100 healthy controls. The hematological parameters, serum VEGF, EPO and TNF-α were estimated by ELISA methods. The results were analyzed with appropriate statistics using SPSS version 16.0 software. Results: Results on BMI, hematological parameters, serum VEGF and TNF-α showed significant difference between PTB cases and controls. We noted blunted response of EPO to hemoglobin concentration. We reported positive correlation between VEGF and TNF-α, no correlation between VEGF and EPO and negative correlation between TNF-α and EPO in PTB. Serum VEGF and TNF-α levels were positively correlated with bacterial burden while EPO showed negative correlation with bacterial burden in PTB patients. Conclusion: Increased bacterial burden resulted in simultaneous induction of hypoxia and inflammation associated with increased VEGF and TNF-α and relative inadequacy of EPO to hemoglobin level in PTB. Thus we concluded that these oxygen sensing molecular markers could be used as early tool in diagnosing and predicting active PTB and also as marker to measure disease severity and bacterial burden in PTB patients.