Arteriogenic growth factors, chemokines and proteases as a prerequisite for arteriogenesis

Frequently, patients with ischemic vascular diseases have developed collateral blood vessels bypassing areas of arterial obstructions. This may support maintenance of organ function and prevent mortality. Mechanisms of collateral artery growth differ from angiogenic capillary growth. Therefore, the term "arteriogenesis" was introduced. The distinct processes contributing to arteriogenesis are controlled by a complex interplay between cellular and molecular factors. The early mechanism includes endothelial cell activation by physical forces, release of chemokines, attraction of blood leukocytes to the collateral vessel wall followed by their adhesion and subsequent transmigration. The proliferation and remodeling phase is characterized by the release of growth factors and proteases, mediating digestion of the external elastic lamina and extracellular matrix and mediating proliferation of vascular wall cells. Maturation of the collateral vessel wall is concluded by the rearrangement of wall cells and a recovery of extracellular structures, resulting in functional arteries with the ability to markedly contribute to blood supply to the affected organ. This review will address the role of chemotactic factors, growth factors and proteases during collateral artery growth.