A paracrine loop in the vascular endothelial growth factor pathway triggers tumor angiogenesis and growth in multiple myeloma

Angelo Vacca, Roberto Ria, Domenico Ribatti, Fabrizio Semeraro, Valentin Djonov, Francesco Di Raimondo, Franco Dammacco

Research output: Contribution to journalArticlepeer-review


Background and Objectives. In tumors, vascular endothelial growth factor-A (VEGF-A) stimulates angiogenesis and vascular permeability by activating the tyrosine kinase receptor-2 (VEGFR-2 or KDR/Flk-1) and-1 (VEGFR-1 or Flt-1). Design and Methods. The distribution and function of VEGF homologs and their receptors on bone marrow plasma cells, endothelial cells, and other stromal cells (residual stromal cells) were examined in patients with multiple myeloma (MM). Results. Plasma cells secrete VEGF-A (and VEGF-B, VEGF-C and VEGF-D, albeit marginally) into their conditioned medium (CM). CM VEGF-A stimulates proliferation and chemotaxis in endothelial cells (both being mandatory for angiogenesis) via VEGF receptor-2 (VEGFR-2), and in residual stromal cells via the VEGFR-1. Residual stromal cells secrete VEGF-C and VEGF-D, but little of the other homologs. Their CM VEGF-C and VEGF-D increase in response to plasma cell CM and trigger plasma cell proliferation via VEGFR-3. Proliferation in all cell types parallels VEGFR and extracellular signal-regulated protein kinase-2 (ERK-2) phosphorylation. The homologs and receptors are weakly or inconstantly expressed in patients with monoclonal gammopathies of undetermined significance or vitamin B12/iron deficiency anemias. Interpretation and Conclusions. This study shows that the VEGF pathway is directly involved in tumor angiogenesis and growth in MM. A paracdne VEGF loop for MM progression is suggested. This, in turn, provides a further indication that the VEGF pathway and its signaling proteins may be appropriate targets in the management of MM.

Original languageEnglish
Pages (from-to)176-185
Number of pages10
Issue number2
Publication statusPublished - Feb 1 2003


  • Angiogenesis
  • Endothelial cells
  • Multiple myeloma
  • Stromal cells
  • Tumor growth
  • Vascular endothelial growth factor

ASJC Scopus subject areas

  • Hematology


Dive into the research topics of 'A paracrine loop in the vascular endothelial growth factor pathway triggers tumor angiogenesis and growth in multiple myeloma'. Together they form a unique fingerprint.

Cite this