[Angiogenesis in human cerebral ischemia]. / Implicación de la angiogénesis en la isquemia cerebral humana.

OBJECTIVE: We aimed to review current knowledge about angiogenesis processes following stroke and possible benefit of future therapeutic angiogenic-related treatments. DEVELOPMENT: Angiogenesis is a physiopathologic process where new vessels arise from pre-existing ones within different phases: sprouting and maturation. To modulate angiogenesis there is a balance between several promoters like VEGF, bFGF, MMPs, etc. but also with inhibitors or angiostatic molecules such as angiostatin, endostatin, etc. In human pathologies angiogenesis has a dual effect: useful in wound healing, tissue remodelling or ischemic heart disease but harmful in cancer, rheumatoid arthritis or atheroma plaque instability and rupture. Angiogenesis is involved in some cerebrovascular diseases. Following ischemic stroke there is an overexpression of several molecules related with this process, although its finality remains largely unknown. CONCLUSION: Angiogenesis is activated after stroke modifying capillary network. To obtain advantages from angiogenesis, it will be essential to achieve the temporal profile of these molecules in humans, and to investigate if its effects are different in acute or chronic stroke phases. In the future, angiogenesis modulation could take part of a combined stroke therapy.

Implicación de la angiogénesis en la isquemia cerebral humana / Angiogenesis in human cerebral ischemia

Objetivo. Valorar la implicación del proceso de angiogénesis en el ictus y sus posibles aplicaciones terapéuticas. Desarrollo. La angiogénesis es un proceso fisiopatológico en el que se forman nuevos vasos a partir de otros ya existentes, que se divide en dos fases: sprouting y maduración. La modulación de la angiogénesis es el resultado de un equilibrio molecular entre un gran número de factores promotores o estimuladores (VEGF, bFGF, MMP, etc.), pero también de inhibidores o factores angiostáticos (angiostatina, endostatina, etc.). En patología humana tiene un efecto dual: beneficiosa en la cicatrización de heridas, la remodelación tisular o la isquemia coronaria, pero perjudicial en el cáncer, la artritis reumatoide o la inestabilidad de la placa de ateroma. El proceso de angiogénesis se da en algunas patologías cerebrovasculares; concretamente, tras un ictus sabemos que se sobrexpresan moléculas que regulan este proceso, pero desconocemos la finalidad con la que se produce. Conclusiones. La angiogénesis se activa después del ictus y modifica transitoriamente la red capilar. Para obtener un efecto ventajoso de este proceso será necesario conocer el perfil de expresión de las moléculas reguladoras en el ser humano y conocer si sus efectos son diferentes en la fase aguda y en la subaguda. Modular la angiogénesis podría formar parte de una terapia combinada en el futuro (AU)

Objective. We aimed to review current knowledge about angiogenesis processes following stroke and possible benefit of future therapeutic angiogenic-related treatments. Development. Angiogenesis is a physiopathologic process where new vessels arise from pre-existing ones within different phases: sprouting and maturation. To modulate angiogenesis there is a balance between several promoters like VEGF, bFGF, MMPs, etc. but also with inhibitors or angiostatic molecules such as angiostatin, endostatin, etc. In human pathologies angiogenesis has a dual effect: useful in wound healing, tissue remodelling or ischemic heart disease but harmful in cancer, rheumatoid arthritis or atheroma plaque instability and rupture. Angiogenesis is involved in some cerebrovascular diseases. Following ischemic stroke there is an overexpression of several molecules related with this process, although its finality remains largely unknown. Conclusion. Angiogenesis is activated after stroke modifying capillary network. To obtain advantages from angiogenesis, it will be essential to achieve the temporal profile of these molecules in humans, and to investigate if its effects are different in acute or chronic stroke phases. In the future, angiogenesis modulation could take part of a combined stroke therapy (AU)