SUMMARYBiallelic inactivation of the von Hippel-Lindau (VHL) tumor suppressor gene predisposes human patients to the development of highly vascularized neoplasms in multiple organ systems. We show that zebrafish vhl mutants display a marked increase in blood vessel formation throughout the embryo, starting at 2 days post-fertilization. The most severe neovascularization is observed in distinct areas that overlap with high vegfa mRNA expression, including the vhl mutant brain and eye. Real-time quantitative PCR revealed increased expression of the duplicated VEGFA orthologs vegfaa and vegfab, and of vegfb and its receptors flt1, kdr and kdr-like, indicating increased vascular endothelial growth factor (Vegf) signaling in vhl mutants. Similar to VHL-associated retinal neoplasms, diabetic retinopathy and age-related macular degeneration, we show, by tetramethyl rhodaminedextran angiography, that vascular abnormalities in the vhl -/-retina lead to vascular leakage, severe macular edema and retinal detachment. Significantly, vessels in the brain and eye express cxcr4a, a marker gene expressed by tumor and vascular cells in VHL-associated hemangioblastomas and renal cell carcinomas. VEGF receptor (VEGFR) tyrosine kinase inhibition (through exposure to sunitinib and 676475) blocked vhl -/--induced angiogenesis in all affected tissues, demonstrating that Vegfaa, Vegfab and Vegfb are key effectors of the vhl -/-angiogenic phenotype through Flt1, Kdr and Kdr-like signaling. Since we show that the vhl -/-angiogenic phenotype shares distinct characteristics with VHL-associated vascular neoplasms, zebrafish vhl mutants provide a valuable in vivo vertebrate model to elucidate underlying mechanisms contributing to the development of these lesions. Furthermore, vhl mutant zebrafish embryos carrying blood vessel-specific transgenes represent a unique and clinically relevant model for tissue-specific, hypoxia-induced pathological angiogenesis and vascular retinopathies. Importantly, they will allow for a cost-effective, non-invasive and efficient way to screen for novel pharmacological agents and combinatorial treatments. Yancopoulos et al., 2000;Carmeliet, 2005). Recently, it was shown that autocrine VEGFA signaling is also required for vascular homeostasis (Lee et al., 2007). VEGFA acts through two high affinity receptor tyrosine kinases, FLT-1 (VEGFR1) and . KDR is thought to mediate most of the angiogenic functions of VEGFA, whereas FLT1 may act as a sink for VEGFA, or as a decoy receptor to negatively regulate signaling through KDR (Yancopoulos et al., 2000).
Disease Models & Mechanisms DMMOverproduction of hypoxia-inducible mRNAs, including VEGFA, is a hallmark of the highly vascularized neoplasms associated with biallelic inactivation of the VHL tumor suppressor gene, including hemangioblastomas of the retina and central nervous system (CNS), and clear cell renal cell carcinoma (ccRCC) (Maher et al., 1991;Maher and Kaelin, 1997;Van Poppel et al., 2000;Lonser et al., 2003). Hemangioblastomas are the most common manifestati...