http://onlinelibrary.wiley.com/doi/10.1111/j.1549-8719.2012.00207.x/abstract
Abstract
Vascular compromise and the
accompanying perfusion deficits cause or complicate a large array of
disease conditions and treatment failures. This has prompted the
exploration of therapeutic strategies to repair or regenerate
vasculatures thereby establishing more competent microcirculatory beds.
Growing evidence indicates that an increase in vessel numbers within a
tissue does not necessarily promote an increase in tissue perfusion.
Effective regeneration of a microcirculation entails the integration of
new stable microvessel segments into the network via neovascularization.
Beginning with angiogenesis, neovascularization entails an integrated
series of vascular activities leading to the formation of a new mature
microcirculation and includes vascular guidance and inosculation, vessel
maturation, pruning, arterio-venous specification, network patterning,
structural adaptation, intussusception, and microvascular stabilization.
While the generation of new vessel segments is necessary to expand a
network, without the concomitant neovessel remodeling and adaptation
processes intrinsic to microvascular network formation, these additional
vessel segments give rise to a dysfunctional microcirculation. While
many of the mechanisms regulating angiogenesis have been detailed, a
thorough understanding of the mechanisms driving post-angiogenesis
activities specific to neovascularization has yet to be fully realized,
but is necessary in order to develop effective therapeutic strategies
for repairing compromised microcirculations as a means to treat disease.
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