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Topic: Current Concepts in Wound Healing

Role of angiogenesis and angiogenic

factors in acute and chronic wound healing

Thittamaranahalli Muguregowda Honnegowda , Pramod Kumar ,
1,2
1
Echalasara Govindarama Padmanabha Udupa , Sudesh Kumar , Udaya Kumar , Pragna Rao 3
4
4
3
1 Department of Plastic Surgery and Burns, Kasturba Medical College, Manipal 576104, Karnataka, India.
2 Department of Plastic Surgery, King Abdulaziz Specialist Hospital, Sakaka 42421, Al‑Jouf, Saudi Arabia.
3 Department of Biochemistry, Kasturba Medical College, Manipal 576104, Karnataka, India.
4 Department of Surgery, District Government Hospital, Udupi 576108, Karnataka, India.
Address for correspondence: Dr. Pramod Kumar, Department of Plastic Surgery and Burns, King Abdulaziz Specialist Hospital,
Sakaka 42421, Al‑Jouf, Saudi Arabia. E‑mail: pkumar86@hotmail.com

ABSTRACT
Angiogenesis plays a crucial role in wound healing by forming new blood vessels from preexisting vessels
by invading the wound clot and organizing into a microvascular network throughout the granulation
tissue. This dynamic process is highly regulated by signals from both serum and the surrounding
extracellular matrix environment. Vascular endothelial growth factor, angiopoietin, fibroblast growth
factor and transforming growth factor‑beta are among the potent angiogenic cytokines in wound
angiogenesis. Specific endothelial cell ECM receptors are critical for morphogenetic changes in blood
vessels during wound repair. In particular integrin (αvβ3) receptors for fibrin and fibronectin, appear to
be required for wound angiogenesis: αvβ3 is focally expressed at the tips of angiogenic capillary sprouts
invading the wound clot, and any functional inhibitors of αvβ3 such as monoclonal antibodies, cyclic
RGD peptide antagonists, and peptidomimetics rapidly inhibit granulation tissue formation. In spite of
clear knowledge about influence of many angiogenic factors on wound healing, little progress has been
made in defining the source of these factors, the regulatory events involved in wound angiogenesis and
in the clinical use of angiogenic stimulants to promote repair.
Key words:
Angiogenic factors, endothelium, extracellular matrix protein, granulation tissue, wound healing

INTRODUCTION In 1960s, research began in the field of angiogenesis
to determine how new blood vessels enhance solid
[6]
Neovascularization or angiogenesis is important for tumor growth. Physiologists later discovered that
wound healing as it involves the growth of new capillaries neovascularization occurs during tissue regeneration.
[7]
to form granulation tissue. [1‑4] Three to five days after Proliferating capillaries bring oxygen and micronutrients
tissue injury, new capillaries become visible in the wound to growing tissues and remove catabolic waste products.
bed as granulation tissue, which acts as a matrix for These vessels are present in the endothelium that secretes
proliferating blood vessels, migrating fibroblasts and new paracrine factors to promote survival of adjacent cells by
[5]
collagen. Impaired granulation is a hallmark of chronic preventing apoptosis or programmed cell death. Because
[8]
wounds encountered with diabetes and venous or arterial
insufficiency. This is an open access article distributed under the terms of the Creative Commons
Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix,
Access this article online tweak, and build upon the work non-commercially, as long as the author is credited
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How to cite this article: Honnegowda TM, Kumar P, Udupa EG,
Kumar S, Kumar U, Rao P. Role of angiogenesis and angiogenic factors
DOI:
10.4103/2347-9264.165438 in acute and chronic wound healing. Plast Aesthet Res 2015;2:243-9.
Received: 20-10-2014; Accepted: 28-01-2015

© 2015 Plastic and Aesthetic Research | Published by Wolters Kluwer - Medknow 243