Increased but ineffectual angiogenic drive in nonhealing venous leg ulcers

Abstract

In nonhealing venous ulcers there is a consistently high level of expression of VEGF, at both the gene transcript and protein level. As our previous data demonstrated that angiogenesis is depressed in these poorly healing ulcers, an increase in VEGF production may indicate an increased but ineffectual angiogenic drive. It is also possible that undiscovered inhibitors are released in the ulcer environment.

Can Venous Ulcer Size be Associated with the Healing Potential of Serum? Pilot Study

“…In fluids of chronic leg ulcers, the expression of VEGF-165 and VEGF receptors is up regulated compared with fluids of uninjured skin of healthy individuals [13,14]. In the present work the amount of seric VEGF-165 was higher than in standardized sera from healthy patients, resembling the results previously mentioned for fluid levels.…”

Chemokines in Wound Healing and as Potential Therapeutic Targets for Reducing Cutaneous Scarring

“…Altered angiogenesis is well recognized as a contributor to delayed healing in diabetic and venous ulcers. 138,139 CXCL12, which exclusively binds to CXCR4, plays a crucial role in EPC migration 140 and dysfunction in its signaling pathways has been implicated in aged and diabetic wound healing in preclinical models. 141 A relative lack of CXCL12, as found in diabetic wounds, lead to decreased cellular migration and angiogenesis as well as increased inflammation.…”

Inhibition of angiogenesis in lipodermatosclerosis: Implication for venous ulcer formation

“…Previously, VEGF was proven to be elevated on transcriptional level in non-healing venous leg ulcers and was found to be elevated in wound fluid as well (18)(19)(20). Lauer et al suggested that VEGF could lose its inefficacy to support the wound healing process due to an increased proteolysis and degradation (21).…”