LAUSR

Vascular endothelial growth factor (VEGF) has been implicated in the pathophysiology of stress-related mental disorders. However, VEGF levels have seldom been compared across mental disorders and never by isoforms. Pathophysiological processes involving leakage of astrocyte-derived extracellular vesicles (EVs) across the blood–brain barrier could be associated with VEGF levels in patients with stress-related mental disorders. This cross-sectional study compared plasma levels of VEGF 121 , VEGF 165 , and VEGF 121  + VEGF 165 (VEGF total ) in patients with stress-induced exhaustion disorder (SED) (n = 31), patients with major depressive disorder (MDD) (n = 31), and healthy controls (n = 61). It also analyzed the correlation between VEGF and astrocyte-derived EVs in plasma. An enzyme-linked immunosorbent assay (ELISA) was used to measure VEGF 121 and VEGF 165 in citrate plasma, and flow cytometry was used to measure astrocyte-derived EVs in plasma. The mean concentration of soluble VEGF 121 (sVEGF 121 ) was significantly higher in patients with SED than healthy controls ( P  = 0.043). Mean sVEGF 165 was significantly lower in patients with MDD than patients with SED ( P  = 0.004) or healthy controls ( P  = 0.037). Mean sVEGF total was significantly higher in patients with SED than in patients with MDD ( P  = 0.021) and also higher in patients with SED than healthy controls ( P  = 0.040). Levels of sVEGF 121 were positively correlated with levels of astrocyte-derived EVs only in patients with SED ( P  = 0.0128). The same was true of levels of sVEGF total and astrocyte-derived EVs ( P  = 0.0046). Differing levels of VEGF isoforms may reflect different pathophysiological mechanisms in SED and MDD. Further research is needed to better understand the potential roles of VEGF isoforms and astrocyte-derived EVs in mental disorders.