Angiogenesis in Wound Repair: Too Much of a Good Thing?

Abstract

Angiogenesis, or the growth of new blood vessels from the preexisting vasculature, is a visible and important component of wound repair. When tissue damage occurs, disruption of the vasculature structure leads to hypoxia. The restoration of normoxia is essential for appropriate and durable tissue repair. Angiogenesis in wounds is regulated by endogenous proangiogenic mediators, which cause rapid growth of a new vascular bed that is much denser than that of normal tissue. Such rapid growth of the capillary bed results in capillaries that are abnormal, and the newly formed vessels are tortuous, dilated, and immature. During wound resolution, this substantial neocapillary bed is pruned back to normal density with attendant maturation. Many poorly healing wounds, including nonhealing ulcers and scars, exhibit an aberrant angiogenic response. The fine-tuning of capillary regrowth in wounds is an area of significant therapeutic potential.

A natural biological adhesive from snail mucus for wound repair

“…The results showed that A. fulica d-SMG and s-GAG could promote neovascularization and accelerate wound healing. The number of wound vessels were decreased on day 14 compared with that of day 7, which may indicate the transition from proliferative phase to remodeling phase, according to the angiogenesis pattern during wound healing 36,37 .…”

PURION® processed human amnion chorion membrane allografts retain material and biological properties supportive of soft tissue repair

“…[51][52][53][54] In a healing wound, the formation of new granulation tissue is accompanied by rapid growth of new capillaries and production of an abundant network of new blood vessels. 55 Previous work demonstrated that DHACM contains both pro-and anti-angiogenic growth factors that differentially regulate angiogenesis depending upon the cellular environment in which it was placed. Additionally, DHACM tissue promoted chemotactic migration of human endothelial cells and endothelial cell proliferation in vitro.…”

Extracellular vesicles from 3D cultured dermal papilla cells improve wound healing via Krüppel-like factor 4/vascular endothelial growth factor A -driven angiogenesis

“…During wound healing, the new capillary bed undergoes remodeling and maturation. Many poorly healed wounds, especially those with full-thickness skin defects, often show abnormal angiogenesis, such as capillary overgrowth and poor mature blood vessel formation, ultimately leading to scar formation [ 3 ]. Scars not only affect the appearance of individuals but also cause a lack of skin appendages, excessive collagen deposition, disordered fiber arrangement, and poor tissue ductility and tension resistance, which seriously affect the patient’s quality of life.…”