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Therapeutic Angiogenesis

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Abstract

Supervised exercise training has been recommended as first-line therapy for treatment of peripheral artery disease (PAD) patients with intermittent claudication. Capillary growth in skeletal muscle by angiogenesis is thought to be one of the possible mechanisms underlying the improvement of exercise performance and walking ability by exercise training in patients with PAD. Under normal conditions, exercise training has been demonstrated to increase the capillarity of active muscle. Exercise-induced increase in blood flow and tissue stretch has been proposed as important stimuli for angiogenesis in skeletal muscle. It is postulated that an increase in shear stress with increased blood flow and passive stretch primarily induces angiogenesis by longitudinal division of the vessel and sprouting angiogenesis, respectively. Vascular endothelial growth factor (VEGF) is recognized as the central pro-angiogenic factor strongly associated with angiogenesis. Exercise training induces angiogenesis through activation of various factors, including nitric oxide (NO), hypoxia-inducible factor-1α, and peroxisome proliferator-activated receptor-γ coactivator 1α (PGC-1α), through VEGF expression. However, PAD has been reported to be associated with reduced NO bioavailability represented by endothelial dysfunction or reduced PGC-1α expression in skeletal muscle. Therefore, it remains unclear whether similar mechanisms or angiogenic factors are involved in exercise-induced angiogenesis under normal and pathological conditions.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Tatsuya Maruhashi & Yasuki Kihara

  2. Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan

    Yukihito Higashi

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  1. Tatsuya Maruhashi
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  2. Yasuki Kihara
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  3. Yukihito Higashi
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Correspondence to Tatsuya Maruhashi .

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Editors and Affiliations

  1. Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Yukihito Higashi

  2. Department of Cardiology, Nagoya University, Aichi, Japan

    Toyoaki Murohara

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Maruhashi, T., Kihara, Y., Higashi, Y. (2017). Exercise. In: Higashi, Y., Murohara, T. (eds) Therapeutic Angiogenesis. Springer, Singapore. https://doi.org/10.1007/978-981-10-2744-4_15

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  • DOI: https://doi.org/10.1007/978-981-10-2744-4_15

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