The angiogenic factors and their soluble receptors in sepsis: friend, foe, orboth?

Excerpt

The endothelium represents an important source of, and a target for, inflammation insepsis. Angiogenic factors and their receptors, including vascular endothelialgrowth factor (VEGF)/VEGF receptor and the angiopoietin/Tie2 signaling pathways,have recently received great attention in critically ill patients, including thosewith sepsis [1‐3], because of their pivotal roles in both angiogenesis and microvascularpermeability. VEGF, as the most potent proangiogenic factor, has already beenidentified as an important target for cancer therapy. Disassembly of an intactendothelial cell junction is necessary for the angiogenesis process. The endothelialbarrier-breaking properties are indeed an important part of the VEGF role in theregulation of angiogenesis. However, a high dose or prolonged duration of VEGF maylead to excessive barrier-breaking effects. The favorable results observed with theonly US Food and Drug Administration-approved anti-VEGF agent, bevacizumab, by Jeongand colleagues [4] are likely to provide potential advances for future therapeuticopportunities in sepsis. …