When this balance is disturbed, the result is either too much or too little angiogenesis. Abnormal blood vessel growth, either excessive or insufficient, is now recognized as a “common denominator” underlying many deadly and debilitating conditions, including cancer, skin diseases, age-related blindness, diabetic ulcers, cardiovascular disease, stroke, and many others. The list of diseases that have angiogenesis as an underlying mechanism grows longer every year.

All cancerous tumors, for example, release angiogenic growth factor proteins that stimulate blood vessels to grow into the tumor, providing it with oxygen and nutrients. Antiangiogenic therapies literally starve the tumor of its blood supply by interfering with this process. A new class of cancer treatments that block angiogenesis are now approved and available to treat cancers of the colon, kidney, lung, breast, and liver, as well as multiple myeloma and bone gastrointestinal stromal tumors. Some older drugs have been rediscovered to block angiogenesis, as well. These are being used to treatment angiogenesis-dependent conditions, such as hemangiomas, colon polyps, and precancerous skin lesions.

Therapeutic angiogenesis, in contrast, stimulates angiogenesis where it is required but lacking. This technique is used to replenish the blood supply to chronic wounds to speed healing, and it prevents unnecessary amputations. New research suggests this approach can be also used to save limbs afflicted with poor circulation, and even oxygen-starved hearts. Therapeutic angiogenesis may even help to regenerate damaged or lost tissues in ways that were previously considered impossible, such as with nerves and brain tissue.

Authors of this section: William Li, M.D., Michelle Hutnik, D.Sc., Roderick Smith M.S., and Vincent Li, M.D.

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