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Arteriogenesis: the development and growth of collateral arteries
Armin Helisch1, Wolfgang Schaper
1Department of Experimental Cardiology, Max-Planck-Institute for Physiological and Clinical Research, Bad Nauheim, Germany. a.helisch@kerckhoff.mpg.de
Insights
Arteriogenesis, the formation of collateral arteries, primarily involves remodeling existing vessels, not new growth. Understanding this flow-mediated process is key to treating ischemic vascular diseases.
Area of Science:
- Cardiovascular Biology
- Vascular Medicine
- Regenerative Medicine
Background:
- Atherosclerotic vascular diseases often feature collateral vessels that bypass obstructions, explaining asymptomatic ischemia.
- Arteriogenesis, the formation of these collateral arteries, is distinct from angiogenesis, which occurs in ischemic tissues.
Purpose of the Study:
- To differentiate arteriogenesis from angiogenesis.
- To elucidate the mechanisms underlying collateral artery formation in vascular diseases.
Main Methods:
- Review of observations in animal models and human studies.
- Analysis of the cellular and molecular processes involved in collateral vessel remodeling.
Main Results:
- Arteriogenesis is primarily the remodeling of pre-existing collateral vessels, driven mainly by blood flow.
- This process involves endothelial activation, matrix degradation, leukocyte invasion, and cell proliferation.
- Arteriogenesis can occur independently of significant ischemia, and de novo formation is questionable.
Conclusions:
- Understanding arteriogenesis, a flow-mediated remodeling process, is crucial for developing effective treatments for ischemic vascular diseases.
- Further research into arteriogenesis mechanisms will guide therapeutic strategies.
Abstract:
In patients with atherosclerotic vascular diseases, collateral vessels bypassing major arterial obstructions have frequently been observed. This may explain why some patients remain without symptoms or signs of ischemia. The term "arteriogenesis" was introduced to differentiate the formation of collateral arteries from angiogenesis, which mainly occurs in the ischemic, collateral flow-dependent tissue. Many observations in various animal models and humans support that the remodeling of preexisting collateral vessels is the mechanism of collateral artery formation. This remodeling process seems to be mainly flow-mediated. It involves endothelial cell activation, basal membrane degradation, leukocyte invasion, proliferation of vascular cells, neointima formation (in most species studied), and changes of the extracellular matrix. The contribution of ischemia to arteriogenesis is still unclear, but arteriogenesis clearly can occur in the absence of any significant ischemia. It is questionable, whether collateral arteries also form de novo in ischemic vascular diseases. A better understanding of the mechanisms of arteriogenesis will be important for the design of more effective strategies for the treatment of patients with ischemic vascular diseases.