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Gayen P, Jan S, Chowdhury N, Ghosh S, Hembram M, Bagchi A, Sinha Roy R. Engineered Bio-inspired Multifunctional Peptide- and Protein-based Therapeutic Biomolecules for Better Wound Care. Chem Asian J 2021; 16:4018-4036. [PMID: 34643055 DOI: 10.1002/asia.202101022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/06/2021] [Indexed: 11/11/2022]
Abstract
Developing non-immunogenic therapeutic biomolecules for facilitating blood clotting followed by wound healing via therapeutic angiogenesis, still remains a formidable challenge. Excessive blood loss of accident victims and battalions cause a huge number of deaths worldwide. Patients with inherited bleeding disorders face acute complications during injury and post-surgery. Biologically-inspired peptide-based hemostat can act as a potential therapeutic for handling coagulopathy. Additionally, non-healing wounds for patients having ischemic diseases can cause severe clinical complications. Advancement in stabilized growth-factor-based proangiogenic therapy may offer effective possibilities for the treatment of ischemic pathology. This review will discuss nature-inspired biocompatible stabilized peptide- and protein-based molecular medicines to serve unmet medical challenges for handling traumatic coagulopathy and impaired wound healing.
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Affiliation(s)
- Paramita Gayen
- Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, 741246, Mohanpur, India
| | - Somnath Jan
- Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, 741246, Mohanpur, India
| | - Nilkanta Chowdhury
- Department of Biochemistry and Biophysics, University of Kalyani, Kalyani, 741235, Nadia, West Bengal, India
| | - Snehasish Ghosh
- Department of Chemical Sciences, Indian Institute of Science Education and Research Kolkata, 741246, Mohanpur, India
| | - Monjuri Hembram
- Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, 741246, Mohanpur, India
| | - Angshuman Bagchi
- Department of Biochemistry and Biophysics, University of Kalyani, Kalyani, 741235, Nadia, West Bengal, India
| | - Rituparna Sinha Roy
- Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, 741246, Mohanpur, India.,Centre for Advanced Functional Materials, Indian Institute of Science Education and Research Kolkata, 741246, Mohanpur, India.,Centre for Climate and Environmental Studies, Indian Institute of Science Education and Research Kolkata, 741246, Mohanpur, India
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Ahtzaz S, Sher Waris T, Shahzadi L, Anwar Chaudhry A, Ur Rehman I, Yar M. Boron for tissue regeneration-it’s loading into chitosan/collagen hydrogels and testing on chorioallantoic membrane to study the effect on angiogenesis. INT J POLYM MATER PO 2019. [DOI: 10.1080/00914037.2019.1581202] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Samreen Ahtzaz
- Interdisciplinary Research Center in Biomedical Materials, COMSATS University, Lahore, Pakistan
| | - Tayyaba Sher Waris
- Interdisciplinary Research Center in Biomedical Materials, COMSATS University, Lahore, Pakistan
| | - Lubna Shahzadi
- Interdisciplinary Research Center in Biomedical Materials, COMSATS University, Lahore, Pakistan
| | - Aqif Anwar Chaudhry
- Interdisciplinary Research Center in Biomedical Materials, COMSATS University, Lahore, Pakistan
| | - Ihtesham Ur Rehman
- Interdisciplinary Research Center in Biomedical Materials, COMSATS University, Lahore, Pakistan
- Engineering Department, Lancaster University, Lancaster, UK
| | - Muhammad Yar
- Interdisciplinary Research Center in Biomedical Materials, COMSATS University, Lahore, Pakistan
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Said SS, O'Neil C, Yin H, Nong Z, Pickering JG, Mequanint K. Concurrent and Sustained Delivery of FGF2 and FGF9 from Electrospun Poly(ester amide) Fibrous Mats for Therapeutic Angiogenesis. Tissue Eng Part A 2016; 22:584-96. [PMID: 26955972 DOI: 10.1089/ten.tea.2015.0493] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Therapeutic angiogenesis has emerged as a potential strategy to treat ischemic vascular diseases. However, systemic or local administration of growth factors is usually inefficient for maintaining the effective concentration at the site of interest due to their rapid clearance or degradation. In this study, we report a differential and sustained release of an angiogenic factor, fibroblast growth factor-2 (FGF2), and an arteriogenic factor, fibroblast growth factor-9 (FGF9), from α-amino acid-derived biodegradable poly(ester amide) (PEA) fibers toward targeting neovessel formation and maturation. FGF2 and FGF9 were dual loaded using a mixed blend and emulsion electrospinning technique and exhibited differential and sustained release from PEA fibers over 28 days with preserved bioactivity. In vitro angiogenesis assays showed enhanced endothelial cell (EC) tube formation and directed migration of smooth muscle cells (SMCs) to platelet-derived growth factor (PDGF)-BB and stabilized EC/SMC tube formation. FGF2/FGF9-loaded PEA fibers did not induce inflammatory responses in vitro using human monocytes or in vivo after their subcutaneous implantation into mice. Histological examination showed that FGF2/FGF9-loaded fibers induced cell niche recruitment around the site of implantation. Furthermore, controlled in vivo delivery of FGF9 to mouse tibialis anterior (TA) muscle resulted in a dose-dependent expansion of mesenchymal progenitor-like cell layers and extracellular matrix deposition. Our data suggest that the release of FGF2 and FGF9 from PEA fibers offers an efficient differential and sustained growth factor delivery strategy with relevance to therapeutic angiogenesis.
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Affiliation(s)
- Somiraa S Said
- 1 Biomedical Engineering Graduate Program, The University of Western Ontario , London, Canada
| | - Caroline O'Neil
- 2 Robarts Research Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario , London, Canada
| | - Hao Yin
- 2 Robarts Research Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario , London, Canada
| | - Zengxuan Nong
- 2 Robarts Research Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario , London, Canada
| | - J Geoffrey Pickering
- 2 Robarts Research Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario , London, Canada .,3 Department of Medicine (Cardiology), The University of Western Ontario , London, Canada .,4 Department of Biochemistry, The University of Western Ontario , London, Canada .,5 Department of Medical Biophysics, The University of Western Ontario , London, Canada
| | - Kibret Mequanint
- 1 Biomedical Engineering Graduate Program, The University of Western Ontario , London, Canada .,6 Department of Chemical and Biochemical Engineering, Faculty of Engineering, The University of Western Ontario , London, Canada
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Caolo V, Vries M, Zupancich J, Houben M, Mihov G, Wagenaar A, Swennen G, Nossent Y, Quax P, Suylen D, Dijkgraaf I, Molin D, Hackeng T, Post M. CXCL1 microspheres: a novel tool to stimulate arteriogenesis. Drug Deliv 2015; 23:2919-2926. [PMID: 26651867 DOI: 10.3109/10717544.2015.1120366] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
CONTEXT After arterial occlusion, diametrical growth of pre-existing natural bypasses around the obstruction, i.e. arteriogenesis, is the body's main coping mechanism. We have shown before that continuous infusion of chemokine (C-X-C motif) ligand 1 (CXCL1) promotes arteriogenesis in a rodent hind limb ischemia model. OBJECTIVE For clinical translation of these positive results, we developed a new administration strategy of local and sustained delivery. Here, we investigate the therapeutic potential of CXCL1 in a drug delivery system based on microspheres. MATERIALS AND METHODS We generated poly(ester amide) (PEA) microspheres loaded with CXCL1 and evaluated them in vitro for cellular toxicity and chemokine release characteristics. In vivo, murine femoral arteries were ligated and CXCL1 was administered either intra-arterially via osmopump or intramuscularly encapsulated in biodegradable microspheres. Perfusion recovery was measured with Laser-Doppler. RESULTS The developed microspheres were not cytotoxic and displayed a sustained chemokine release up to 28 d in vitro. The amount of released CXCL1 was 100-fold higher than levels in native ligated hind limb. Also, the CXCL1-loaded microspheres significantly enhanced perfusion recovery at day 7 after ligation compared with both saline and non-loaded conditions (55.4 ± 5.0% CXCL1-loaded microspheres versus 43.1 ± 4.5% non-loaded microspheres; n = 8-9; p < 0.05). On day 21 after ligation, the CXCL1-loaded microspheres performed even better than continuous CXCL1 administration (102.1 ± 4.4% CXCL1-loaded microspheres versus 85.7 ± 4.8% CXCL1 osmopump; n = 9; p < 0.05). CONCLUSION Our results demonstrate a proof of concept that sustained, local delivery of CXCL1 encapsulated in PEA microspheres provides a new tool to stimulate arteriogenesis in vivo.
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Affiliation(s)
- Vincenza Caolo
- a Department of Physiology , CARIM, Maastricht University , The Netherlands
| | - Mark Vries
- a Department of Physiology , CARIM, Maastricht University , The Netherlands
| | | | | | | | - Allard Wagenaar
- a Department of Physiology , CARIM, Maastricht University , The Netherlands
| | - Geertje Swennen
- a Department of Physiology , CARIM, Maastricht University , The Netherlands
| | - Yaël Nossent
- d Department of Surgery , Leiden University Medical Center , The Netherlands , and
| | - Paul Quax
- d Department of Surgery , Leiden University Medical Center , The Netherlands , and
| | - Dennis Suylen
- e Department of Biochemistry , CARIM, Maastricht University , The Netherlands
| | - Ingrid Dijkgraaf
- e Department of Biochemistry , CARIM, Maastricht University , The Netherlands
| | - Daniel Molin
- a Department of Physiology , CARIM, Maastricht University , The Netherlands
| | - Tilman Hackeng
- e Department of Biochemistry , CARIM, Maastricht University , The Netherlands
| | - Mark Post
- a Department of Physiology , CARIM, Maastricht University , The Netherlands
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Lachaud CC, Rodriguez-Campins B, Hmadcha A, Soria B. Use of Mesothelial Cells and Biological Matrices for Tissue Engineering of Simple Epithelium Surrogates. Front Bioeng Biotechnol 2015; 3:117. [PMID: 26347862 PMCID: PMC4538307 DOI: 10.3389/fbioe.2015.00117] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 08/03/2015] [Indexed: 12/13/2022] Open
Abstract
Tissue-engineering technologies have progressed rapidly through last decades resulting in the manufacture of quite complex bioartificial tissues with potential use for human organ and tissue regeneration. The manufacture of avascular monolayered tissues such as simple squamous epithelia was initiated a few decades ago and is attracting increasing interest. Their relative morphostructural simplicity makes of their biomimetization a goal, which is currently accessible. The mesothelium is a simple squamous epithelium in nature and is the monolayered tissue lining the walls of large celomic cavities (peritoneal, pericardial, and pleural) and internal organs housed inside. Interestingly, mesothelial cells can be harvested in clinically relevant numbers from several anatomical sources and not less important, they also display high transdifferentiation capacities and are low immunogenic characteristics, which endow these cells with therapeutic interest. Their combination with a suitable scaffold (biocompatible, degradable, and non-immunogenic) may allow the manufacture of tailored serosal membranes biomimetics with potential spanning a wide range of therapeutic applications, principally for the regeneration of simple squamous-like epithelia such as the visceral and parietal mesothelium vascular endothelium and corneal endothelium among others. Herein, we review recent research progresses in mesothelial cells biology and their clinical sources. We make a particular emphasis on reviewing the different types of biological scaffolds suitable for the manufacture of serosal mesothelial membranes biomimetics. Finally, we also review progresses made in mesothelial cells-based therapeutic applications and propose some possible future directions.
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Affiliation(s)
- Christian Claude Lachaud
- Andalusian Center for Molecular Biology and Regenerative Medicine - Centro Andaluz de Biología Molecular y Medicina Regenerativa (CABIMER) , Seville , Spain ; Centro de Investigación en Red sobre Diabetes y Enfermedades Metabólicas (CIBERDEM) , Madrid , Spain
| | - Berta Rodriguez-Campins
- Departamento de I+D, New Biotechnic S.A. , Seville , Spain ; Fundación Andaluza de Investigación y Desarrollo (FAID) , Seville , Spain
| | - Abdelkrim Hmadcha
- Andalusian Center for Molecular Biology and Regenerative Medicine - Centro Andaluz de Biología Molecular y Medicina Regenerativa (CABIMER) , Seville , Spain ; Centro de Investigación en Red sobre Diabetes y Enfermedades Metabólicas (CIBERDEM) , Madrid , Spain
| | - Bernat Soria
- Andalusian Center for Molecular Biology and Regenerative Medicine - Centro Andaluz de Biología Molecular y Medicina Regenerativa (CABIMER) , Seville , Spain ; Centro de Investigación en Red sobre Diabetes y Enfermedades Metabólicas (CIBERDEM) , Madrid , Spain
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Phaechamud T, Yodkhum K, Charoenteeraboon J, Tabata Y. Chitosan-aluminum monostearate composite sponge dressing containing asiaticoside for wound healing and angiogenesis promotion in chronic wound. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 50:210-25. [PMID: 25746264 DOI: 10.1016/j.msec.2015.02.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 01/15/2015] [Accepted: 02/06/2015] [Indexed: 12/28/2022]
Abstract
There are many factors that delay healing in chronic wounds including lowering level of growth factors and increasing exudate level comprising high amount of tissue destructive enzymes. Asiaticoside possesses interesting wound healing and angiogenic activities that are employed to stimulate tissue regeneration in wound healing application. This study attempted to develop chitosan-aluminum monostearate (Alst) composite sponge containing asiaticoside for use as an absorbent medical dressing in chronic wound. N-methyl-2-pyrrolidone (NMP) was used to enhance homogeneity of asiaticoside in the polymer composite matrix. The sponge dressings were prepared by lyophilization and dehydrothermal treatment (DHT). Functional group interaction, crystallinity, and morphology of the prepared sponges were investigated using FT-IR, PXRD, and SEM, respectively. Physicochemical properties, porosity, hydrophilic/hydrophobic properties and mechanical property, were evaluated. Wound dressing properties, water vapor transmission rate (WVTR), fluid absorbency, oxygen permeation (OP), and bio-adhesive property, were investigated. In vitro asiaticoside release study was conducted using immersion method. Cytotoxicity was studied in normal human dermal fibroblast (NHDF) and normal human epidermal keratinocyte (NHEK). Angiogenic activity of asiaticoside was evaluated using chick-chorioallantoic membrane (CAM) assay. FT-IR and PXRD results revealed the amidation after DHT to enhance the crystallinity of the prepared sponges. The prepared sponges had high porosity comprising high Alst-loaded amount that exhibited more compact structure. Alst enhanced hydrophobicity therefore it reduced the fluid absorption and WVTR together with bio-adhesion of the prepared sponge dressings. Porosity of all sponges was more than 85% therefore resulting in their high OP. Enhancing hydrophobicity of the material by Alst and more homogeneity caused by NMP eventually retarded the asiaticoside release for 7 days. The sponge extractions were non-toxic to the cells moreover they promoted NHDF and NHEK cell proliferation. Asiaticoside and asiaticoside-contained dressings exhibited dose-dependent angiogenic activity in CAM model.
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Affiliation(s)
- Thawatchai Phaechamud
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Silpakorn University, Nakorn Pathom 73000, Thailand.
| | - Kotchamon Yodkhum
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Silpakorn University, Nakorn Pathom 73000, Thailand.
| | - Juree Charoenteeraboon
- Department of Biopharmacy, Faculty of Pharmacy, Silpakorn University, Nakorn Pathom 73000, Thailand.
| | - Yasuhiko Tabata
- Department of Biomaterials, Field of tissue engineering, Institute for Frontier Medical Science, Kyoto University, Kyoto 606-8507, Japan.
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Haro Durand LA, Vargas GE, Romero NM, Vera-Mesones R, Porto-López JM, Boccaccini AR, Zago MP, Baldi A, Gorustovich A. Angiogenic effects of ionic dissolution products released from a boron-doped 45S5 bioactive glass. J Mater Chem B 2014; 3:1142-1148. [PMID: 32261993 DOI: 10.1039/c4tb01840k] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In regenerative medicine of vascularized tissues, there is a great interest in the use of biomaterials that are able to stimulate angiogenesis, a process necessary for rapid revascularization to allow the transport and exchange of oxygen, nutrients, growth factors and cells that take part in tissue repair and/or regeneration. An increasing number of publications have shown that bioactive glasses stimulate angiogenesis. Because it has been established that boron (B) may play a role in angiogenesis, the aim of this study was to assess the in vivo angiogenic effects of the ionic dissolution products that from a bioactive glass (BG) in the 45S5 system doped with 2 wt% B2O3 (45S5.2B). The pro-angiogenic capacity of 45S5.2B BG was assessed on the vasculature of the embryonic quail chorioallantoic membrane (CAM). Ionic dissolution products from 45S5.2B BG increased angiogenesis. This is quantitatively evidenced by the greater expression of integrin αvβ3 and higher vascular density in the embryonic quail CAM. The response observed at 2 and 5 days post-treatment was equivalent to that achieved by applying 10 µg mL-1 of basic fibroblast growth factor. These results show that the ionic dissolution products released from the bioactive glass 45S5.2B stimulate angiogenesis in vivo. The effects observed are attributed to the presence the ionic dissolution products, which contained 160 ± 10 µM borate.
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Affiliation(s)
- Luis A Haro Durand
- Interdisciplinary Materials Group-IESIING-UCASAL, INTECIN UBA-CONICET, Campus Castañares, A4400EDD, Salta, Argentina.
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Said SS, Pickering JG, Mequanint K. Controlled Delivery of Fibroblast Growth Factor-9 from Biodegradable Poly(ester amide) Fibers for Building Functional Neovasculature. Pharm Res 2014; 31:3335-47. [DOI: 10.1007/s11095-014-1423-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 05/12/2014] [Indexed: 12/27/2022]
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Haro Durand LA, Góngora A, Porto López JM, Boccaccini AR, Zago MP, Baldi A, Gorustovich A. In vitro endothelial cell response to ionic dissolution products from boron-doped bioactive glass in the SiO2–CaO–P2O5–Na2O system. J Mater Chem B 2014; 2:7620-7630. [DOI: 10.1039/c4tb01043d] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
As it has been established that boron (B) may perform functions in angiogenesis and osteogenesis, the controlled and localized release of B ions from bioactive glasses (BGs) is expected to provide a promising therapeutic alternative for regenerative medicine of vascularized tissues, such as bone.
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Affiliation(s)
- Luis A. Haro Durand
- Interdisciplinary Materials Group-IESIING-UCASAL
- INTECIN UBA-CONICET
- Salta, Argentina
- Department of Pathology and Molecular Pharmacology
- IByME-CONICET
| | - Adrián Góngora
- Department of Pathology and Molecular Pharmacology
- IByME-CONICET
- Buenos Aires, Argentina
| | - José M. Porto López
- Research Institute for Materials Science and Technology
- INTEMA-CONICET
- Mar del Plata, Argentina
| | - Aldo R. Boccaccini
- Institute of Biomaterials
- Department of Materials Science and Engineering
- University of Erlangen-Nuremberg
- 91058 Erlangen, Germany
| | - M. Paola Zago
- Institute of Experimental Pathology
- IPE-CONICET
- Salta, Argentina
| | - Alberto Baldi
- Department of Pathology and Molecular Pharmacology
- IByME-CONICET
- Buenos Aires, Argentina
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Finley SD, Dhar M, Popel AS. Compartment model predicts VEGF secretion and investigates the effects of VEGF trap in tumor-bearing mice. Front Oncol 2013; 3:196. [PMID: 23908970 PMCID: PMC3727077 DOI: 10.3389/fonc.2013.00196] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 07/13/2013] [Indexed: 12/19/2022] Open
Abstract
Angiogenesis, the formation of new blood vessels from existing vasculature, is important in tumor growth and metastasis. A key regulator of angiogenesis is vascular endothelial growth factor (VEGF), which has been targeted in numerous anti-angiogenic therapies aimed at inhibiting tumor angiogenesis. Systems biology approaches, including computational modeling, are useful for understanding this complex biological process and can aid in the development of novel and effective therapeutics that target the VEGF family of proteins and receptors. We have developed a computational model of VEGF transport and kinetics in the tumor-bearing mouse, which includes three-compartments: normal tissue, blood, and tumor. The model simulates human tumor xenografts and includes human (VEGF121 and VEGF165) and mouse (VEGF120 and VEGF164) isoforms. The model incorporates molecular interactions between these VEGF isoforms and receptors (VEGFR1 and VEGFR2), as well as co-receptors (NRP1 and NRP2). We also include important soluble factors: soluble VEGFR1 (sFlt-1) and α-2-macroglobulin. The model accounts for transport via macromolecular transendothelial permeability, lymphatic flow, and plasma clearance. We have fit the model to available in vivo experimental data on the plasma concentration of free VEGF Trap and VEGF Trap bound to mouse and human VEGF in order to estimate the rates at which parenchymal cells (myocytes and tumor cells) and endothelial cells secrete VEGF. Interestingly, the predicted tumor VEGF secretion rates are significantly lower (0.007-0.023 molecules/cell/s, depending on the tumor microenvironment) than most reported in vitro measurements (0.03-2.65 molecules/cell/s). The optimized model is used to investigate the interstitial and plasma VEGF concentrations and the effect of the VEGF-neutralizing agent, VEGF Trap (aflibercept). This work complements experimental studies performed in mice and provides a framework with which to examine the effects of anti-VEGF agents, aiding in the optimization of such anti-angiogenic therapeutics as well as analysis of clinical data. The model predictions also have implications for biomarker discovery with anti-angiogenic therapies.
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Affiliation(s)
- Stacey D Finley
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine , Baltimore, MD , USA
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Abstract
INTRODUCTION Therapeutic angiogenesis is a strategy of inducing new collateral vessels and stimulating new capillaries that enhance tissue oxygen exchange in ischemic cardiovascular disorders, including acute myocardial infarction, chronic cardiac ischemia, peripheral artery disease and stroke. AREAS COVERED Over the last 10 years, promising results of early clinical trials have generated great expectation on the potential of therapeutic angiogenesis. However, even if large randomized placebo-controlled and double-blinded Phase II clinical trials have confirmed the feasibility, safety and potential effectiveness of therapeutic angiogenesis, they provided very limited evidence of its efficacy in terms of clinical benefit. EXPERT OPINION Results of the latest trials on therapeutic angiogenesis have not provided satisfactory results. Much is still unknown about the optimal delivery of angiogenic factors. Trials using alternative growth factors, dose regimens and methods of delivery are needed to enhance the treatment benefit of therapeutic angiogenesis.
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Affiliation(s)
- Domenico Ribatti
- University of Bari Medical School, National Cancer Institute, Giovanni Paolo II, Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Piazza G. Cesare, 11, Policlinico, 70124 Bari, Italy.
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