Vascular endothelial growth factors: biology and current status of clinical applications in cardiovascular medicine.
Members of the vascular endothelial growth factor (VEGF) family are among the most powerful modulators of vascular biology. They regulate vasculogenesis, angiogenesis, and vascular maintenance during embryogenesis and in adults. Because of their profound effects on blood vessels, VEGFs have received much attention regarding their potential therapeutic use in cardiovascular medicine, especially for therapeutic vascular growth in myocardial and peripheral ischemia. However, completed randomized controlled VEGF trials have not provided convincing evidence of clinical efficacy. On the other hand, recent preclinical proangiogenic VEGF studies have given insight, and anti-VEGF studies have shown that the disturbance of vascular homeostasis by blocking VEGF-A may lead to endothelial dysfunction and adverse vascular effects. Excess VEGF-A may contribute to neovascularization of atherosclerotic lesions but, currently, there is no evidence that transient overexpression by gene transfer could lead to plaque destabilization. Here, we review the biology and effects of VEGFs as well as the current status of clinical applications and future perspectives of the therapeutic use of VEGFs in cardiovascular medicine.
Ylä-Herttuala
Seppo
S
Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute, Kuopio University, Kuopio, Finland. seppo.ylaherttuala@uku.fi
Rissanen
Tuomas T
TT
Vajanto
Ismo
I
Hartikainen
Juha
J
D000818:Animals; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D002319:Cardiovascular System / Q000187:drug effects*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D004195:Disease Models, Animal; D004730:Endothelium, Vascular / Q000187:drug effects; D006801:Humans; D018919:Neovascularization, Physiologic / Q000187:drug effects; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D042442:Vascular Endothelial Growth Factors / Q000627:therapeutic use*
D042442:Vascular Endothelial Growth Factors