© 2001 by European Society of Cardiology
Copyright © 2001, European Society of Cardiology
Stimulation of arteriogenesis; a new concept for the treatment of arterial occlusive disease
aMax Planck Institute for Physiological and Clinical Research, Department of Experimental Cardiology, Bad Nauheim, Germany
bDepartment of Cardiology and Cardiovascular Pathology, University of Amsterdam, Academic Medical Center, Room B2-250, Meibergdreef 9, 1105 Amsterdam, The Netherlands
* Corresponding author. Tel.: +31-20-566-2749; fax: +31-20-696-2609 vanroyen{at}med1.ukl.uni-freiburg.de
After birth two forms of vessel growth can be observed; angiogenesis and arteriogenesis. Angiogenesis refers to the formation of capillary networks. Arteriogenesis refers to the growth of preexistent collateral arterioles leading to formation of large conductance arteries that are well capable to compensate for the loss of function of occluded arteries. The process of arteriogenesis is initiated when shear stresses increase in the preexistent collateral pathways upon narrowing of a main artery. The increased shear stress leads to an upregulation of cell adhesion molecules for circulating monocytes, which accumulate subsequently around the proliferating arteries and provide the several required cytokines and growth factors. Several strategies are currently tested for their potential to stimulate the process of arteriogenesis. These strategies focus either at shear stress, at direct stimulation of endothelial and smooth muscle cell growth or at the monocytic pathway and promising results were obtained from experimental studies. However, some important questions remain to be answered before arteriogenesis can be brought from bench to bedside.
KEYWORDS HIF-1, hypoxia inducible factor-1; NOS, nitric oxide synthetase; VEGF, vascular endothelial growth factor; FGF-1, fibroblast growth factor 1; MCP-1, monocyte chemoattractant protein-1; TNF-
, tumor necrosis factor-; b-FGF, basic fibroblast growth Factor; MMP, matrix metalloproteinase; GM-CSF, granulocyte-monocyte colony-stimulating factor; ICAM, intercellular adhesion molecule; TGF-β, transforming growth factor-β; IL-1, interleukin 1; PDGF, platelet derived growth factor; TGF-, transforming growth factor-; PIGF, placenta growth factor
1 Dr. J.J. Piek is clinical investigator for the Netherlands Heart Foundation (grant No. D96.020).
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