VASCULAR ENDOTHELIAL GROWTH FACTOR (VEGF) IN HUMAN PERIOSTEUM SHOWS A CHARACTERISTIC CHANGE OF EXPRESSION WITH FRACTURE
H.E. Bourke, A. Sandison*, I.D. McCarthy, S.P.F. Hughes, I.L.H. Reichert
Departments of Musculoskeletal Surgery and Histopathology*,
Charing Cross Hospital, Imperial College, London, UK

Vascular Endothelial Growth Factor (VEGF) has been shown to stimulate angiogenesis and to possess direct vasoactive properties. We hypothesise that the expression of VEGF periosteum will show a distinct response to fracture.

We investigated the expression of VEGF in human periosteum, using immunohistochemistry. Periosteum was collected from two distinct groups of patients, aged 16 - 45: control (n = 5) and fracture (n = 12).

In the control group the periosteum showed abundant but delicate blood vessels staining throughout for VEGF. In the fracture group the vasculature in the periosteum demonstrated a characteristic, time-dependent course of expression of VEGF.

Our study shows for the first time the expression of VEGF in normal periosteum and during fracture healing. Interestingly, activated vessels in the early healing phase show little expression of VEGF. There appears to be a critical time point at 48 hours following which angiogenesis sets in, possibly initiated by VEGF.