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VEGF enhances angiogenesis and promotes blood–brain barrier leakage in the ischemic brain
Open accessAbstract
VEGF is a secreted mitogen associated with angiogenesis and is also a potent vascular permeability factor. The biological role of VEGF in the ischemic brain remains unknown. This study was undertaken to investigate whether VEGF enhances cerebral microvascular perfusion and increases blood-brain barrier (BBB) leakage in the ischemic brain. Using magnetic resonance imaging (MRI), three-dimensional laser-scanning confocal microscope, and functional neurological tests, we measured the effects of administrating recombinant human VEGF(165) (rhVEGF(165)) on angiogenesis, functional neurological outcome, and BBB leakage in a rat model of focal cerebral embolic ischemia. Late (48 hours) administration of rhVEGF(165) to the ischemic rats enhanced angiogenesis in the ischemic penumbra and significantly improved neurological recovery. However, early postischemic (1 hour) administration of rhVEGF(165) to ischemic rats significantly increased BBB leakage, hemorrhagic transformation, and ischemic lesions. Administration of rhVEGF(165) to ischemic rats did not change BBB leakage and cerebral plasma perfusion in the contralateral hemisphere. Our results indicate that VEGF can markedly enhance angiogenesis in the ischemic brain and reduce neurological deficits during stroke recovery and that inhibition of VEGF at the acute stage of stroke may reduce the BBB permeability and the risk of hemorrhagic transformation after focal cerebral ischemia.
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“As a pleiotropic growth factor, VEGF is responsible for multiple important physiological functions, particularly BBB permeability [44, 50, 51].”
From Chronic stress-induced depression requires the recruitment of peripheral Th17 cells into the brain (2022) · cites this paper as [50]
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“Similar findings about the importance of timing for administration of a neurorestorative therapy for stroke have been reported for VEGF94 and modulators of matrix metallo proteinases.95”
From Promoting brain remodelling and plasticity for stroke recovery: therapeutic promise and potential pitfalls of clinical translation (2012) · cites this paper as [94]
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“The VEGF, a key angiogenic and permeability factor (24, 25), increases cerebral microvascular perfusion and induces neurological recovery when administered 48 h after ischemic stroke (38).”
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“Iron chelator treatment attenuated iron accumulation and suppressed neuroinflammation, which further decreased the BBB impairment and the damage of dopaminergic neurons (OlmedoDiaz et al., 2017; Tai et al., 2020; Han et al., 2021; Riederer et al., 2021; Zhao et al., 2021).”
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“Additionally, upon VEGF administration, both rat and mouse models have been shown to have higher new vessel density and better functional recovery (Zhang et al., 2000; Hayashi et al., 2003).”
BackgroundDetrimental Roles of Hypoxia-Inducible Factor-1α in Severe Hypoxic Brain Diseases
Choi, Y. K. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25084465 · Cited by 45
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“mechanism which underlie reduced CBF in DLB and found that (i) the levels of ET-1 and ACE, two potent vasoconstrictors that are upregulated in the cerebral cortex in AD, were unchanged in DLB (ii); VEGF, a potent pro-angiogenic factor (41, 64), is reduced in DLB (iii); FVIIIRA level, a good surrogate marker of capilli…”
BackgroundActivation of PI3 Kinase/Akt Signaling in Chronic Subdural Hematoma Outer Membranes
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“The up-regulation of VEGF found in brain tissues after SAH may exacerbate BBB disruption [38,39]; in strong support, several studies showed that inhibition of VEGF significantly attenuated brain edema induced by cerebral ischemia/reperfusion [40] and SAH [4].”
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“85,86 Possible mechanisms include VEGF-mediated dissociation of tight junction proteins like occludin and ZO-1, increased activity of permeability factors like nitric oxide (NO) and MMPs, and enhanced vesicular transport across endothelial cells.”
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“Previous studies have shown that administration of recombinant human VEGF165 exacerbates the breakdown of BBB integrity, which can be prevented by inhibiting VEGF at an early stage of ischemic stroke [46, 47].”
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“Similarly, delayed administration of BDNF conjugated to the anti-transferrin receptor antibody at 2 hours after MCAO also displayed neurorescue effects on the ischemic rat brain (104, 105).”
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“Other cytokines, such as the vascular endothelial growth factor (VEGF), also known as vascular permeability factor [20], may increase barrier permeability and disturb barrier function [21-23].”
BackgroundHuang, Y., Mao, Y. Q., Li, H., Shen, G., & Nan, G. (2018) · Biochemistry and Cell Biology · doi:10.1139/bcb-2017-0291 · Cited by 40
Prodjohardjono, A., Vidyanti, A. N., Susianti, N. A., Sudarmanta, Sutarni, S., & Setyopranoto, I. (2020) · PLoS ONE · doi:10.1371/journal.pone.0239370 · Cited by 39
“Intravenous administration of VEGF given at 48 hours after ischemia showed attenuation of neurobehavioral function in rats [16].”
MethodRole of diabetes in stroke: Recent advances in pathophysiology and clinical management
Bradley, S., Spring, K. J., Beran, R. G., Chatzis, D., Killingsworth, M. C., & Bhaskar, S. M. M. (2021) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3495 · Cited by 42
“leakage and haemorrhagic transformation, in the early phase of hyper‐acute stroke (1 h), and aids angiogenesis in the ischaemic penumbra in the subacute post‐stroke phase (48 h).(76) This is important as BBB disruption can cause parenchymal damage.”
BackgroundHaris, M., Husain, N., Singh, A. K., Husain, M., Srivastava, S., Srivastava, C., Behari, S., Rathore, R. K. S., Saksena, S., & Gupta, R. K. (2008) · Journal of Computer Assisted Tomography · doi:10.1097/rct.0b013e31816200d1 · Cited by 40
“It has been reported that high VEGF expression in enhancing tumor is associated with increased BBB permeability.(42,43) Earlier, Maia et al(44) have reported high VEGF expression in nonenhancing HGA as well as LGA.”
BackgroundInhibition of integrin αvβ3 reduces blood–brain barrier breakdown in focal ischemia in rats
Shimamura, N., Matchett, G. A., Solaroğlu, İ., Tsubokawa, T., Ohkuma, H., & Zhang, J. H. (2006) · Journal of Neuroscience Research · doi:10.1002/jnr.21073 · Cited by 40
“Several studies have shown that VEGF worsens early outcomes in focal ischemia (Zhang et al., 2000; Kaya et al., 2005) and that VEGF is up-regulated immediately after ischemic stroke (Fig.”
BackgroundRole of blood vessels in the neuronal migration
Saghatelyan, A. (2009) · Seminars in Cell and Developmental Biology · doi:10.1016/j.semcdb.2009.04.006 · Cited by 45
Neuroprotection and neuroplasticity – A holistic approach and future perspectives
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“Vascular endothelial growth factor (VEGF) exacerbates cerebral edema in the acute phase after a stroke and is responsible for vascular remodelling in the late phase [23].”
BackgroundRen, C., Wang, B. Z., Li, N., Jin, K., & Ji, X. (2015) · Aging and Disease · doi:10.14336/ad.2014.1126 · Cited by 39
“Intravenous VEGF-A also increased microvessel density in the cortical ischemia penumbra [36].”
BackgroundPark, H. W., Moon, H.-E., Kim, H. R., Paek, S. L., Kim, Y., Chang, J. W., Yang, Y. S., Kim, K., 오원일, Hwang, J. H., et al. (2015) · Journal of Neuroscience Research · doi:10.1002/jnr.23616 · Cited by 39
“…ischemia, topical administration of VEGF to the brain surface reduces the infarct size (Hayashi et al., 1998), intravenous application of VEGF improves neurological outcome (Zhang et al., 2000), and intraparenchymal administration of the anti-VEGF Ab increases the infarct size (Bao et al., 1999).”
BackgroundMolecular and Cellular Responses to Interleukin-4 Treatment in a Rat Model of Transient Ischemia
Lively, S. S., Hutchings, S., & Schlichter, L. C. (2016) · Journal of Neuropathology & Experimental Neurology · doi:10.1093/jnen/nlw081 · Cited by 40
“VEGF-A regulates angiogenesis, vascular permeability (64), neutrophil transmigration (42, 43), and increases blood vessel leakiness after ischemia (65).”
BackgroundLin, R., Cai, J., Kenyon, L. C., Iozzo, R. V., Rosenwasser, R. H., & Iacovitti, L. (2018) · Stem Cells · doi:10.1002/stem.2947 · Cited by 40
Stowe, A. M., Plautz, E. J., Nguyen, P., Frost, S. B., Eisner‐Janowicz, I., Barbay, S., Dancause, N., Sensarma, A., Taylor, M. D., Zoubina, E. V., et al. (2007) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1038/sj.jcbfm.9600560 · Cited by 38
“One transcriptional target of post-stroke HIF-1a is the gene encoding VEGF, which has been implicated in the post-stroke recovery processes of angiogenesis and neuroprotection (Sun et al, 2003; Wang, 2003; Zhang et al, 2000).”
BackgroundProtective effect of albumin on VEGF and brain edema in acute ischemia in rats
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“Both CTRL and SCZ iPSCs successfully yielded pure BMECs (Fig.”
BackgroundActivation of estrogen receptor β reduces blood–brain barrier breakdown following ischemic injury
Shin, J. A., Yang, S., Jeong, S. I., Park, H. J., Choi, Y., & Park, E. (2013) · Neuroscience · doi:10.1016/j.neuroscience.2013.01.031 · Cited by 40
Dynamic regulation of aquaporin-4 water channels in neurological disorders
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“Among them, the human VEGF-A is a Janus-faced molecule, since together with its proangiogenic and neuroprotective effects, it disrupts the BBB integrity, leading to edema, hemorrhage, and brain damage [[4], [13], [14], [15]].”
BackgroundThe role of non-coding RNAs in neuroprotection and angiogenesis following ischemic stroke
Heydari, E., Alishahi, M., Ghaedrahmati, F., Winlow, W., Khoshnam, S. E., & Anbiyaiee, A. (2019) · Metabolic Brain Disease · doi:10.1007/s11011-019-00485-2 · Cited by 39
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Astrocyte Gliotransmission in the Regulation of Systemic Metabolism
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Experimental therapy with tissue kallikrein against cerebral ischemia
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VEGF regulates the blood‑brain barrier through MMP‑9 in a rat model of traumatic brain injury
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Endothelial Cells and Astrocytes: A Concerto en Duo in Ischemic Pathophysiology
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“Perlecan domain V increased expression of vascular endothelial growth factor (VEGF), thus promoting angiogenesis, and interestingly did not lead to increased BBB permeability [73] even though VEGF is known to increase BBB permeability after ischemia [74].”
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“Thus, a proposed therapeutic regimen could potentially consist of the early inhibition of VEGF function to minimize the formation of brain edema, followed by later active VEGF treatment leading to angiogenesis and neuro-protection [25].”
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“To corroborate this, c-Yes-knockout mice, although fertile, have defects in pIgApIgR transcytosis (21, 39), whereas in c-Src-knockout mice, which are infertile (14), VEGF, which is known to promote blood-brain barrier leakage (53), fails to compromise the blood-brain barrier (14).”
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Inflammatory Markers and Severity of Intracerebral Hemorrhage
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“Late restoration of cerebral microcirculatory flow may involve increased collateral circulation and angiogenesis in the penumbra (Zhang et al., 2000; Zhang and Chopp, 2002; Nishimura et al., 2010).”
Basic Mechanisms in Intracranial Large-Artery Atherosclerosis: Advances and Challenges
Arenillas, J. F., & Álvarez‐Sabín, J. (2005) · Cerebrovascular Diseases · doi:10.1159/000089359 · Cited by 37
CREB activation mediates VEGF‐A’s protection of neurons and cerebral vascular endothelial cells
Lee, H., Chang, Y., Tu, Y., & Huang, C. (2010) · Journal of Neurochemistry · doi:10.1111/j.1471-4159.2010.06584.x · Cited by 36
Metadata
- Authors
- Zhang, Z. G., Zhang, L., Jiang, Q., Zhang, R., Davies, K., Powers, C., Bruggen, N. V., & Chopp, M.
- Affiliations
- Henry Ford Health (US)
- Henry Ford Hospital (US)
- Genentech (US)
- Oakland University (US)
- Corresponding author
- Chopp, Michael
- Venue
- Journal of Clinical Investigation
- Published
- 2000-10-01
- Volume
- 106
- Issue
- 7
- Pages
- 829-838
- ISSN
- 0021-9738 (ISSN-L)
- PMC
- PMC517814
- OpenAlex
- W2084498863
- Cited by
- 1,296
- References
- 75
- Citations by year
- 2026: 32 · 2025: 49 · 2024: 53 · 2023: 52 · 2022: 64 · 2021: 73 · 2020: 58 · 2019: 42 · 2018: 59 · 2017: 59 · 2016: 61 · 2015: 49 · 2014: 70 · 2013: 70 · 2012: 64
- FWCI
- 13.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01ns033627-08)
- National Institute of Neurological Disorders and Stroke (P01NS23393, R01NS-33627, P01NS023393)
- Topics
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Angiogenesis and VEGF in Cancer
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Keywords
- vascular endothelial growth factor, angiogenesis, blood-brain barrier disruption, cerebral ischemia, hemorrhagic transformation, ischemic penumbra, neurological recovery, VEGF inhibition, stroke
- MeSH terms
- Animals, Blood-Brain Barrier, Brain Ischemia, Image Processing, Computer-Assisted, Lymphokines, Magnetic Resonance Imaging, Male, Microcirculation, Neovascularization, Pathologic, Regional Blood Flow, Endothelial Growth Factors, Treatment Outcome, Rats, Wistar, Stroke, Vascular Endothelial Growth Factors, Vascular Endothelial Growth Factor A, Rats
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