In a previous study, we showed that in situ injection of glycosaminoglycan mimetics called RGTAs (ReGeneraTing Agents) enhanced neovascularization after skeletal muscular ischemia (Desgranges, P., Barbaud, C., Caruelle, J. P., Barritault, D., and Gautron, J. (1999) FASEB J. 13, 761-766). In the present study, we showed that the RGTA OTR4120 modulated angiogenesis in the chicken embryo chorioallantoic membrane assay, in a dosedependent manner. We therefore investigated the effect of OTR4120 on one of the most specific angiogenesis-regulating heparin-binding growth factors, vascular endothelial growth factor 165 (VEGF 165 ). OTR4120 showed high affinity binding to VEGF 165 (K d ؍ 2.2 nM), as compared with heparin (K d ؍ 15 nM), and potentiated the affinity of VEGF 165 for VEGF receptor-1 and -2 and for neuropilin-1. In vitro, OTR4120 potentiated VEGF 165 -induced proliferation and migration of human umbilical vein endothelial cells. In the in vivo Matrigel TM plug angiogenesis assay, OTR4120 in a concentration as low as 3 ng/ml caused a 6-fold increase in VEGF 165 -induced angiogenesis. Immunohistochemical staining showed a larger number of well differentiated VEGFR-2-expressing-cells in Matrigel TM sections of OTR4120-treated plug than in control sections. These findings indicate that OTR4120 enhances the VEGF 165 -induced angiogenesis and therefore may hold promise for treating disorders characterized by deficient angiogenesis.