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CLINICIAN'S CORNER
Modulating Angiogenesis
More vs Less
Branavan Sivakumar, MRCS (Eng);
Lorraine E. Harry, MRCS (Edin);
Ewa M. Paleolog, PhD
JAMA. 2004;292:972-977.
The concept of manipulation of the vascular bed to either increase or decrease the number of blood vessels has attracted considerable interest. This review focuses on angiogenesis as a therapeutic target, particularly in the context of cancer and arthritis, as well as on promoting angiogenesis in cardiovascular disease and the healing of bone fractures. Although once touted almost as a panacea for treatment of tumors, as well as other diseases associated with angiogenesis, such as diabetic retinopathy or rheumatoid arthritis, it is now clear that such enthusiasm was somewhat premature. Similarly, some clinical trials of therapeutic angiogenesis for the management of cardiovascular disease have been disappointing. Nevertheless, this exciting field of research holds promise for more targeted therapies.
Author Affiliations: Kennedy Institute of Rheumatology (Drs Sivakumar, Harry, and Paleolog) and Division of Surgery, Anaesthetics and Intensive Care Charing Cross Campus (Dr Paleolog), Faculty of Medicine, Imperial College, London; Mount Vernon Hospital, West Hertfordshire NHS Trust, Northwood (Dr Sivakumar), United Kingdom.
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