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Angiogenesis and its Relationship to Cancer and Other Degenerative Diseases
Angiogenesis is a natural physiological function. It refers to the process by which new blood vessels form and grow. For a cogent summary of the process of Angiogenesis, see the Angiogenesis Foundation's Page on "Understanding Angiogenesis." This page provides "Facts and Figures," as well as "Historical Highlights of the Angiogenesis Field."
Angiogenesis is also involved in the progression of different diseases. Cancerous tumors, for example, require a network of blood vessels to act as conduits for oxygen and nutrients. In addition, this vascular network allows cancerous cells to invade the rest of the body, a process called metastasis.
For a general overview of cancer-related information, see our page on Facts About Cancer.
Angiogenesis inhibitors block the formation of these new blood vessels. Without the nourishment these blood vessels supply, cancerous cells are starved, and tumors cannot grow.
How Angiogenesis Promotes the Development of Cancer
Angiogenesis performs a critical role in the development of cancer.
Solid tumors smaller than 1 to 2 cubic millimeters are not vascularized. To spread, they need to be supplied by blood vessels that bring oxygen and nutrients and remove metabolic wastes.
Beyond the critical volume of 2 cubic millimeters, oxygen and nutrients have difficulty diffusing to the cells in the center of the tumor, causing a state of cellular hypoxia that marks the onset of tumbrel angiogenesis.
New blood vessel development is an important process in tumor progression. It favors the transition from hyperplasia to neoplasm i.e. the passage from a state of cellular multiplication to a state of uncontrolled proliferation characteristic of tumor cells.
Neovascularization also influences the dissemination of cancer cells throughout the entire body eventually leading to metastasis formation. The vascularization level of a solid tumor is thought to be an excellent indicator of its metastatic potential.
Role of Angiogenesis in Psoriasis
Chronic inflammation of the tissue underlying the epidermis in psoriatic skin creates a strong angiogenic signal. Several studies have shown a high detectable blood flow in the psoriatic plaques. For a general overview of psoriasis-related information, see our page on Facts About Psoriasis.
The inducing factors for new blood vessels depends, among other things, on many angiogenic growth factors. These are present in psoriatic patches and produced by keratinocytes.
This supports observations that the psoriasis initiating factor resides in the keratinocyte and that a significant vascular proliferation is required to cause hyperplasia of the epidermis. Hence, inhibiting neovascularization would be an indirect means of counteracting psoriatic plaque formation. Shark Cartilage , a angiogenesis inhibitor is currently being studied as potential therapy for psoriasis.
More than six million people suffer from psoriasis in North America. Up to 250,000 new cases are diagnosed every year. The overall cost of treating psoriasis in the United States is about $3 billion to $5 billion per year.
Current systemic treatments for psoriasis have significant side effects. The most used treatments for psoriasis are topical applications. Current treatments include keratolytic agents, corticosteroids, tar (especially coal tar), vitamin D3 derivatives, anthralin and topical antimitotic agents. These treatments, however, are often messy, have an unpleasant odor, and are repetitive and tedious for patients.
More practical systemic treatments are riskier due to potential side effects. The most common is the antimitotic agent, methotrexate. Other treatments are PUVA and UVBs. Some combination of phototherapy and another antipsoriatic agent can be used. All of these treatments have side effects of varying significance. Using antiangiogenic agents to treat psoriasis is a relatively new approach.