Angiogenesis or ‘the growth of new blood vessels’ is an area of intensive activity and interest with respect to cancer, diabetic blindness, age-related macular degeneration, rheumatoid arthritis and psoriasis. It may be appreciated to be a common denominator in society’s most important diseases. The delicate balance of angiogenesis is maintained by angiogenesis-stimulating growth factors (Angiogenin, Angiopoietin-1 Fibroblast growth factors: acidic (aFGF) and basic (bFGF), Granulocyte colony-stimulating factor (G-CSF), etc.) and angiogenesis inhibitors (Angioarrestin, antithrombin III, CD59 complement fragment, Endostatin (collagen XVIII fragment), Fibronectin fragment, etc.).

Central to the angiogenic process are endothelial cells. Driven by angiogenic growth factors, the endothelial cells become activated and upregulate their compilation of genes, proteins and enzymes. Enzymes dissolve tiny holes in the basement membrane surrounding blood vessels and endothelial cells begin to divide and migrate out through the dissolved holes. Adhesion molecules like integrins (avb3, avb5) serve as hooks to help pull the sprouting new blood vessel. Additionally, matrix metalloproteinases help to dissolve the tissue in front of the new vessel. Stabilisation and support for the new vessel is provided by smooth muscle cells.

Inadequate blood vessel grow, contributes to coronary artery disease, stroke, and delays wound healing, therefore therapeutic angiogenesis, aimed at stimulating new blood vessel growth with growth factors, is being developed to treat these conditions.