Angiogenesis and angiogenic growth factors as future therapies for cerebrovascular disease

Angiogenesis is defined as the growth and proliferation of blood vessels from existing vascular structures (1, 2). Since blood vessels sub-serve the critical biological function of delivering oxygen and removing toxins from target organs, this part of the circulatory system plays a critical role in normal body homeostasis. Therefore, evolutionary pressures have put a great deal of emphasis on the development of a complex circulatory system in larger animals, and the growth of new blood vessels in the adult is tightly regulated to prevent disruption of the delicate homeostatic balance. In a number of physiologic and pathologic states, however, metabolic changes in a target organ may result in the need to modulate the delivery of oxygen and the removal of waste products, which may best be achieved by an increased vascular supply to that organ. This chapter will: (i) review some basic concepts of blood vessel growth and development (i.e., angiogenesis); (ii) describe some of the growth factors and receptors that mediate angiogenesis; (iii) discuss examples of the signal transduction pathways that appear to be critical for this process; (iv) highlight potential targets for therapeutic angiogenesis agents that have been studied in different human disease states with basic fibroblast growth factor.