Osteogenesis and angiogenesis are two closely correlated processes during bone growth, development, remodelling and repair. Vascular endothelial growth factor (VEGF) is an essential mediator during the process of angiogenesis. Based on an extensive literature search, which was carried out using the PubMed database and the keywords of osteogenesis, VEGF, endochondral ossification and intramembranous ossification, this manuscript reviews the role of VEGF in ossification, with emphasis on its effect in endochondral and intramembranous ossification. Osteogenesis and angiogenesis are closely correlated processes. VEGF acts as an essential mediator during these processes. It not only functions in bone angiogenesis but also in various aspects of bone development.

This study investigated in vitro whether Salvia Miltiorrhiza Bunge (SM) induces vascular endothelial growth factor (VEGF) expression and regulates expression of VEGF receptors 1 (VEGFR-1) and 2 (VEGFR-2) on osteoblasts. MC3T3-E1 cells were cultured with SM and VEGF at points 24, 48 and 72 h. A blank control was included. The mRNA expression of VEGF, VEGFR-1 and VEGFR-2 was examined using real-time polymerase chain reaction. VEGF protein expression was examined using enzyme linked immunosorbent assay. SM increased VEGF mRNA expression by 21% at 24 h (p < 0.05), 5% (p < 0.05) at 48 h and 74% (p < 0.001) at 72 h, while external VEGF intervention decreased the internal VEGF expression by 51% at 24 h (p < 0.001) and increased it by 126% at 72 h (p < 0.001). SM increased VEGF protein at 72 h (p < 0.05). VEGFR-1 mRNA expression, in response to SM, decreased by 8% (p < 0.05) at 72 h and decreased following VEGF at 24 and 72 h by 20% (p < 0.001) and 15%, respectively, (p < 0.001). VEGFR-2 mRNA expression increased following SM at 24 and 48 h by 25% (p < 0.05) and 73% (p < 0.05), respectively, and decreased at 72 h by 13% (p < 0.05). It was concluded that SM modulated expression of VEGF and its receptors in MC3T3-E1 cells.