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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
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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
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