Pretreatment with anti-VEGF therapy may exacerbate inflammation in experimental acute colitis

J Pediatr Surg. 2012 Feb;47(2):347-54. doi: 10.1016/j.jpedsurg.2011.11.028.

Abstract

Aim: Our previous investigations of angiogenesis in inflammatory bowel disease showed that vascular endothelial growth factor (VEGF) blockade reduced colonic neovascularization and inflammation. We hypothesized that pretreatment with bevacizumab, a monoclonal anti-VEGF antibody, would attenuate the severity of angiogenesis and inflammation in a murine model of colitis.

Methods: C57BL/6 mice were treated with intraperitoneal injections of bevacizumab (250 μg/dose) before induction of colitis with dextran sulfate sodium (DSS). The colons were examined at predetermined time points. Colonic inflammation and microvessel density were assessed microscopically.

Results: All mice acutely developed melena and weight loss (18.8% ± 1.1% control vs 20.2% ± 1.1% treated, P = .37) and regained a similar weight percentage after the recovery (26.5% ± 4.0% vs 20.9% ± 4.4%, P = .37). Microvessel density acutely increased in both groups in response to DSS, with a trend toward inhibited angiogenesis in the treated group at the conclusion of the acute phase (194,100 ± 14,240 vs 149,400 ± 17,590 μm(2), P = .11). Bevacizumab-treated mice exhibited significantly increased inflammation after the acute phase (8.3 ± 0.8 vs 13.0 ± 2.0, P = .05), but were similar to control after the recovery (7.3 ± 1.5 vs 5.5 ± 1.0, P = .27).

Conclusions: Preemptive VEGF inhibition does not significantly attenuate angiogenesis and, in fact, worsens inflammation in a model of acute colitis. Preventive VEGF blockade may disrupt healing and exacerbate injury via alternative angiogenic or inflammatory pathways.

MeSH terms

  • Acute Disease
  • Animals
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antibodies, Monoclonal, Humanized / toxicity*
  • Bevacizumab
  • Colitis / chemically induced*
  • Colitis / complications
  • Dextran Sulfate / toxicity
  • Disease Progression
  • Inflammation
  • Melena / chemically induced
  • Mice
  • Mice, Inbred C57BL
  • Microvessels / pathology
  • Neovascularization, Pathologic / drug therapy
  • Neovascularization, Pathologic / prevention & control
  • Premedication / adverse effects*
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Weight Loss

Substances

  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • vascular endothelial growth factor A, mouse
  • Bevacizumab
  • Dextran Sulfate