（2）血管新生

抄録

Neovascularization consists of three processes, namely angiogenesis, arteriogenesis, and vasculogenesis, which are involved in the development and progression of diseases such as cancer growth/metastasis, proliferative retinopathy, and atherosclerosis, and in the process of normal physiological phenomena such as embryonic development, wound healing, corpus luteum, and placenta formation process. For its mechanism and control, hypoxia-inducible factor (HIF-1), which is a transcriptional activator stabilized in a hypoxic state due to disruption of blood flow, plays an important role. Neovascularization has been elucidated to be promoted/suppressed by various growth factors such as vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), fibroblast growth factor (FGF), angiopoietin (Ang) and its receptors, adhesion molecules such as vascular endothelial (VE) cadherin, and enzymes. On the basis of these findings, treatments aimed at revascularization in ischemic heart disease and severe lower limb ischemia were applied on a global scale. Recently, vasculogenesis has been shown to occur newly from vascular endothelial progenitor cells (EPC) present in the bone marrow and circulating blood, and is used as a cell source for revascularization therapy in many clinical studies. In this article, we describe the basic concepts of neovascularization, revascularization therapy using peripheral blood stem cells for severe limb ischemic disease, and myocardial regeneration therapy, as well as the trial of EPC amplification for enhancing the therapeutic effect and future prospect.