Vascular endothelial growth factors: biology and current status of clinical applications in cardiovascular medicine

• Published in: Journal of the American College of Cardiology Vol. 49; no. 10; pp. 1015 - 1026
• Main Authors: Ylä-Herttuala, Seppo, Rissanen, Tuomas T, Vajanto, Ismo, Hartikainen, Juha
• Format: Journal Article
• Language: English
• Published: United States Elsevier Limited 13.03.2007
• Subjects: Angiogenesis; Animals; Arterial Occlusive Diseases - diagnosis; Arterial Occlusive Diseases - drug therapy; Arterial Occlusive Diseases - mortality; Biology; Cardiology; Cardiovascular System - drug effects; Clinical trials; Coronary Artery Disease - diagnosis; Coronary Artery Disease - drug therapy; Coronary Artery Disease - mortality; Disease Models, Animal; Endothelium, Vascular - drug effects; Gene therapy; Heart attacks; Homeostasis; Humans; Hypoxia; Ischemia; Muscular system; Musculoskeletal system; Neovascularization, Physiologic - drug effects; Peripheral Vascular Diseases - diagnosis; Peripheral Vascular Diseases - drug therapy; Peripheral Vascular Diseases - mortality; Permeability; Prognosis; Proteins; Randomized Controlled Trials as Topic; Risk Factors; Rodents; Snakes; Survival Analysis; Treatment Outcome; Vascular endothelial growth factor; Vascular Endothelial Growth Factors - therapeutic use
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2006.09.053

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.