The molecular pathways involved in neovascularization of regenerating tissues and tumor angiogenesis resemble each other. However, the regulatory mechanisms of neovascularization under neoplastic circumstances are unbalanced leading to abnormal protein expression patterns resulting in the formation of defective and often abortive tumor vessels. Because gliomas are among the most vascularized tumors, we compared the protein expression profiles of proliferating vessels in glioblastoma with those in tissues in which physiological angiogenesis takes place. By using a combination of laser microdissection and LTQ Orbitrap mass spectrometry comparisons of protein profiles were made. The approach yielded 29 and 12 differentially expressed proteins for glioblastoma and endometrium blood vessels, respectively. The aberrant expression of five proteins, i.e. periostin, tenascin-C, TGFbeta induced protein, integrin alpha-V, and laminin subunit beta-2 were validated by immunohistochemistry. In addition, pathway analysis of the differentially expressed proteins was performed and significant differences in the usage of angiogenic pathways were found. We conclude that there are essential differences in protein expression profiles between tumor and normal physiological angiogenesis. Molecular & Cellular Proteomics 11: 10.1074/mcp.M111.008466, 1-9, 2012.Neovascularization is a complex process taking place under physiological and pathological circumstances. There is large overlap in the cellular components, regulatory factors, and signaling mechanisms acting in the angiogenic process of regeneration, embryonic development, and tumor vascularization (1). In both physiological and pathological neovascularization signaling mechanisms, growth factors and their receptors, cell adhesion molecules and their specific extracellular matrix ligands take part (2). Angiocrine molecules like basic fibroblast growth factor and vascular endothelial growth factor and their receptors have been identified in the context of physiological and tumor angiogenesis (3). It is believed that the angiogenic switch is always triggered by hypoxia, starting with the up-regulation of vascular endothelial growth factor. The process of neovascularization consists not only of sprouting angiogenesis, but also of activation of endothelial precursor cells with the capacity to form de novo blood vessels (vasculogenesis). Vasculogenesis is also part of tumor vascularization but there is dispute about its relative importance (4, 5). Despite the similarities there are obvious differences between physiological vascularization and angiogenesis in tumors. Under physiological conditions, the regulatory mechanisms are well-coordinated and balanced and endothelial cell functions are tightly orchestrated by both pro-and anti-angiogenic factors. In tumor angiogenesis however, there is an excess of pro-angiogenic factors leading to uncoordinated proliferation and tubulogenesis of endothelial cells and migration of mural cells like pericytes (6). It is likely that the molecular diff...