Raised levels of latent collagenase activating angiogenesis factor (ESAF) are present in actively growing human intracranial tumours.

Endothelial cell stimulating angiogenesis factor (ESAF) is a potent, low molecular mass mitogen, specific for endothelial cells. In common with various protein growth factors, it displays angiogenic activity in a variety of biological test systems. However, it differs from these other factors by virtue of its low molecular mass and its ability to activate latent matrix metalloproteinases in a dose dependent manner. This activity has been used to quantify the factor in both normal and diseased brain tissue. The concentration of ESAF determined in biopsies from different types of intracranial tumours varied: in some tumour types the level was close to that of control samples whereas in others it rose to levels comparable to those encountered in the pineal gland, the richest source of ESAF in mature mammals. Tumours considered to be benign contained significantly less ESAF than those neoplasms classified as being malignant (P = 0.025). There was also a correlation between the mitotic activity of tumour samples, as determined by conventional H & E histochemical staining and the ESAF concentration present. These findings agree with previous studies in which elevated ESAF levels have been found in tissue where proliferation of vascular elements has been observed.