血管内皮生长因子治疗性血管生成作用与缺血性脑血管病

Therapeutic angiogenesis of vascular endothelial growth factor for ischemic cerebrovascular diseases

血管内皮生长因子是血管特异性生长因子,能特异性地作用于血管内皮细胞,诱导血管生成,在血管发生和血管形成过程中起重要作用。传统观念认为,成年脑部血管内皮细胞是不能增殖的,但近期的动物实验发现局灶性脑缺血后可诱导缺血半暗带区的新生血管形成。这种脑血管生成是通过血管生长因子与内皮细胞上表达的酪氨酸受体结合而调控的。但是这种血管形成数量有限,并不足以挽救血液灌注不足引起的损害。新近的研究已经证实,外源性给予血管生长因子能刺激侧枝循环形成和增加局部血流,并且已在外周动脉闭塞性疾病和心肌缺血中成功应用,这种新的刺激和诱导新生血管形成新颖方法—治疗性血管生成,为治疗缺血性脑血管病提供了一条全新的思路。

Vascular endothelial growth factor has also been termed vascular-specific growth factor that is specific for the vascular endothelium. It appears to play an important role in both vasculogenesis and angiogenesis. It has been reported previously that in the adult brain vascular endothelial cells appear to stop growth, but recent evidence indicates that ischemia could improve formation of new blood vessels in ischemic penumbra following focal cerebral ischemia, The pattern of brain angiogenesis is regulated through vascular growth factor binding tyrosine kinase receptors which are expressed on endothelial cells. But the number of new blood vessels is too limited to be enough for the ischemia-induced hypopeffusion. Administration of exogenous vascular growth factor can accelerate collateral circulation and improve regional cerebral blood flow in the ischemic brain. The conceptual basis for therapeutic angiogenesis has been established in patients presenting with limb ischemia and myocardial infarction. Therapeutic angiogenesis with vascular endothelial growth factor may be a clinically promising strategy in ischemic brain disease.