Angiodysplasia is the most common vascular lesion of the gastrointestinal tract, and this condition commonly causes gastrointestinal bleeding because the vessels are thin and easily bleed. Vascular endothelial growth factor (VEGF) is an angiogenic peptide that is secreted in response to hypoxia, stimulates proliferation of vascular endothelial cells and increases vessel permeability. GI angiodysplasias are characterized by elevated serum levels of VEGF and thalidomide can potentially affect them. In addition, colonic angiodysplasias stain for both VEGF and basic fibroblast growth factor, another known angiogenic factor, and they also express the VEGF-receptor 1 along their endothelial lining There are case reports of the use of thalidomide for this condition but no prospective studies. There are also case reports and series of this use in other GI bleeding conditions.
There is an ongoing study phase II: Thalidomide Reduces Arteriovenous Malformation Related Gastrointestinal Bleeding, NCT0038993.5. The purpose of this study is to determine whether Thalidomide is effective.
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Asher Korzets , Uzi Gafter , Avri Chagnac , Boris Zingerman , Valeriya Morduchovitz , and Yaacov Ori
Thalidomide: a treatment option for bleeding GI angiodysplasias in dialysed patients
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