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(Circulation. 1999;99:111-120.)
© 1999 American Heart Association, Inc.


Basic Science Reports

Age-Dependent Impairment of Angiogenesis

Presented in preliminary form as finalist presentation for the Melvin Marcus Young Investigator Award at the 70th Scientific Sessions of the American Heart Association, November 9–12, 1997, and published in abstract form (Circulation. 1997;96:I-J).

Alain Rivard, MD; Jean-Etienne Fabre, MD; Marcy Silver, BS; Dongfen Chen, MD; Toyoaki Murohara, MD; Marianne Kearney, BS; Meredith Magner, BS; Takayuki Asahara, MD; Jeffrey M. Isner, MD

From the Departments of Medicine (Cardiology) and Biomedical Research, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, Mass.

Correspondence to Jeffrey M. Isner, MD, St. Elizabeth's Medical Center, 736 Cambridge St, Boston, MA 02135. E-mail jisner{at}opal.tufts.edu

Background—The effect of aging on angiogenesis in ischemic vascular disease has not been studied. Accordingly, we investigated the hypothesis that angiogenesis is impaired as a function of age.

Methods and Results—Forty days after the resection of 1 femoral artery, collateral vessel development was significantly impaired in old (aged 4 to 5 years; n=7) versus young (aged 6 to 8 months; n=6) New Zealand White (NZW) rabbits on the basis of reduced hindlimb perfusion (ischemic: normal blood pressure ratio=0.58±0.05 versus 0.77±0.06; P<0.005), reduced number of angiographically visible vessels (angiographic score=0.48±0.05 versus 0.70±0.05; P<0.01), and lower capillary density in the ischemic limb (130.3±5.8/mm2 versus 171.4±9.5/mm2; P<0.001). Angiogenesis was also impaired in old (aged 2 years) versus young (aged 12 weeks) mice as shown by reduced hindlimb perfusion (measured by laser Doppler imaging) and lower capillary density (353.0±14.3/mm2 versus 713.3±63.4/mm2; P<0.01). Impaired angiogenesis in old animals was the result of impaired endothelial function (lower basal NO release and decreased vasodilation in response to acetylcholine) and a lower expression of vascular endothelial growth factor (VEGF) in ischemic tissues (by Northern blot, Western blot, and immunohistochemistry). When recombinant VEGF protein was administered to young and old rabbits, both groups exhibited a significant and similar increase in blood pressure ratio, angiographic score, and capillary density.

Conclusions—Angiogenesis responsible for collateral development in limb ischemia is impaired with aging; responsible mechanisms include age-related endothelial dysfunction and reduced VEGF expression. Advanced age, however, does not preclude augmentation of collateral vessel development in response to exogenous angiogenic cytokines.


Key Words: growth substances • endothelium • aging • angiogenesis




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D. J. Kurz, S. Decary, Y. Hong, E. Trivier, A. Akhmedov, and J. D. Erusalimsky
Chronic oxidative stress compromises telomere integrity and accelerates the onset of senescence in human endothelial cells
J. Cell Sci., May 1, 2004; 117(11): 2417 - 2426.
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Am. J. Physiol. Heart Circ. Physiol.Home page
L. Lawrenson, J. Hoff, and R. S. Richardson
Aging attenuates vascular and metabolic plasticity but does not limit improvement in muscle VO2 max
Am J Physiol Heart Circ Physiol, April 1, 2004; 286(4): H1565 - H1572.
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Circ. Res.Home page
A. L. Serrano and V. Andres
Telomeres and Cardiovascular Disease: Does Size Matter?
Circ. Res., March 19, 2004; 94(5): 575 - 584.
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Sci Aging Knowl EnvironHome page
M. J. Reed and J. M. Edelberg
Impaired Angiogenesis in the Aged
Sci. Aging Knowl. Environ., February 18, 2004; 2004(7): pe7 - 7.
[Abstract] [Full Text]


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J Am Coll CardiolHome page
R. J. Scheubel, H. Zorn, R.-E. Silber, O. Kuss, H. Morawietz, J. Holtz, and A. Simm
Age-dependent depression in circulating endothelial progenitor cells inpatients undergoing coronary artery bypass grafting
J. Am. Coll. Cardiol., December 17, 2003; 42(12): 2073 - 2080.
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J Am Coll CardiolHome page
S. Dimmeler and M. Vasa-Nicotera
Aging of progenitor cells: limitation for regenerative capacity?
J. Am. Coll. Cardiol., December 17, 2003; 42(12): 2081 - 2082.
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Am. J. Pathol.Home page
A. Germani, A. Di Carlo, A. Mangoni, S. Straino, C. Giacinti, P. Turrini, P. Biglioli, and M. C. Capogrossi
Vascular Endothelial Growth Factor Modulates Skeletal Myoblast Function
Am. J. Pathol., October 1, 2003; 163(4): 1417 - 1428.
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J. Histochem. Cytochem.Home page
E. Sadoun and M. J. Reed
Impaired Angiogenesis in Aging Is Associated with Alterations in Vessel Density, Matrix Composition, Inflammatory Response, and Growth Factor Expression
J. Histochem. Cytochem., September 1, 2003; 51(9): 1119 - 1130.
[Abstract] [Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
T. Koike, R. B. Vernon, M. D. Gooden, E. Sadoun, and M. J. Reed
Inhibited Angiogenesis in Aging: A Role for TIMP-2
J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2003; 58(9): B798 - 805.
[Abstract] [Full Text] [PDF]


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CirculationHome page
C. Patterson
The Ponzo Effect: Endothelial Progenitor Cells Appear on the Horizon
Circulation, June 24, 2003; 107(24): 2995 - 2997.
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Ann. Thorac. Surg.Home page
Y. Ootaki, M. Yamaguchi, N. Yoshimura, S. Oka, M. Yoshida, and T. Hasegawa
Vascular endothelial growth factor in children with congenital heart disease
Ann. Thorac. Surg., May 1, 2003; 75(5): 1523 - 1526.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
H. Masuda and T. Asahara
Post-natal endothelial progenitor cells for neovascularization in tissue regeneration
Cardiovasc Res, May 1, 2003; 58(2): 390 - 398.
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Circ. Res.Home page
N. van Royen, I. Hoefer, M. Bottinger, J. Hua, S. Grundmann, M. Voskuil, C. Bode, W. Schaper, I. Buschmann, and J.J. Piek
Local Monocyte Chemoattractant Protein-1 Therapy Increases Collateral Artery Formation in Apolipoprotein E-Deficient Mice but Induces Systemic Monocytic CD11b Expression, Neointimal Formation, and Plaque Progression
Circ. Res., February 7, 2003; 92(2): 218 - 225.
[Abstract] [Full Text] [PDF]


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CirculationHome page
E. G. Lakatta
Arterial and Cardiac Aging: Major Shareholders in Cardiovascular Disease Enterprises: Part III: Cellular and Molecular Clues to Heart and Arterial Aging
Circulation, January 28, 2003; 107(3): 490 - 497.
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Sci Aging Knowl EnvironHome page
J. M. Edelberg
Auto Repair on the Aging Stem Cell Superhighway
Sci. Aging Knowl. Environ., September 4, 2002; 2002(35): pe13 - 13.
[Abstract] [Full Text]


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Arterioscler. Thromb. Vasc. Bio.Home page
Z. S. Katusic
Therapeutic Angiogenesis: New Indication for Endothelial NO Synthase Gene Transfer
Arterioscler Thromb Vasc Biol, August 1, 2002; 22(8): 1254 - 1255.
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Am. J. Physiol. Heart Circ. Physiol.Home page
J. L. Tuttle, T. L. Hahn, B. M. Sanders, F. A. Witzmann, S. J. Miller, M. C. Dalsing, and J. L. Unthank
Impaired collateral development in mature rats
Am J Physiol Heart Circ Physiol, July 1, 2002; 283(1): H146 - H155.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
T. Krabatsch, R. Petzina, H. Hausmann, A. Koster, and R. Hetzer
Factors influencing results and outcome after transmyocardial laser revascularization
Ann. Thorac. Surg., June 1, 2002; 73(6): 1888 - 1892.
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Circ. Res.Home page
J. M. Edelberg, L. Tang, K. Hattori, D. Lyden, and S. Rafii
Young Adult Bone Marrow-Derived Endothelial Precursor Cells Restore Aging-Impaired Cardiac Angiogenic Function
Circ. Res., May 31, 2002; 90 (10): e89 - e93.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
K. Przyklenk and P. Whittaker
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J. Am. Coll. Cardiol., May 15, 2002; 39(10): 1701 - 1702.
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J. Cell Sci.Home page
S. Marchetti, C. Gimond, K. Iljin, C. Bourcier, K. Alitalo, J. Pouyssegur, and G. Pages
Endothelial cells genetically selected from differentiating mouse embryonic stem cells incorporate at sites of neovascularization in vivo
J. Cell Sci., May 15, 2002; 115(10): 2075 - 2085.
[Abstract] [Full Text] [PDF]


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IOVSHome page
D. G. Espinosa-Heidmann, I. Suner, E. P. Hernandez, W. D. Frazier, K. G. Csaky, and S. W. Cousins
Age as an Independent Risk Factor for Severity of Experimental Choroidal Neovascularization
Invest. Ophthalmol. Vis. Sci., May 1, 2002; 43(5): 1567 - 1573.
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J. Appl. Physiol.Home page
J. M. Edelberg, J. T. Jacobson, D. S. Gidseg, L. Tang, and D. J. Christini
Enhanced myocyte-based biosensing of the blood-borne signals regulating chronotropy
J Appl Physiol, February 1, 2002; 92(2): 581 - 585.
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Cold Spring Harb Symp Quant BiolHome page
K.S. MOULTON
Plaque Angiogenesis: Its Functions and Regulation
Cold Spring Harb Symp Quant Biol, January 1, 2002; 67(0): 471 - 482.
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Cancer Res.Home page
S. Franco, I. Segura, H. H. Riese, and M. A. Blasco
Decreased B16F10 Melanoma Growth and Impaired Vascularization in Telomerase-deficient Mice with Critically Short Telomeres
Cancer Res., January 1, 2002; 62(2): 552 - 559.
[Abstract] [Full Text] [PDF]


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ANN INTERN MEDHome page
S. B. Freedman and J. M. Isner
Therapeutic Angiogenesis for Coronary Artery Disease
Ann Intern Med, January 1, 2002; 136(1): 54 - 71.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
T. Pohl, C. Seiler, M. Billinger, E. Herren, K. Wustmann, H. Mehta, S. Windecker, F. R. Eberli, and B. Meier
Frequency distribution of collateral flow and factors influencing collateral channel development: Functional collateral channel measurement in 450 patients with coronary artery disease
J. Am. Coll. Cardiol., December 1, 2001; 38(7): 1872 - 1878.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
K. Przyklenk, G. Li, and P. Whittaker
No loss in the in vivo efficacy of ischemic preconditioning in middle-aged and old rabbits
J. Am. Coll. Cardiol., November 15, 2001; 38(6): 1741 - 1747.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
P. Abete, N. Ferrara, F. Cacciatore, E. Sagnelli, M. Manzi, V. Carnovale, C. Calabrese, D. de Santis, G. Testa, G. Longobardi, et al.
High level of physical activity preserves the cardioprotective effect of preinfarction angina in elderly patients
J. Am. Coll. Cardiol., November 1, 2001; 38(5): 1357 - 1365.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
S. Takeshita, H. Tomiyama, N. Yokoyama, Y. Kawamura, T. Furukawa, Y. Ishigai, T. Shibano, T. Isshiki, and T. Sato
Angiotensin-converting enzyme inhibition improves defective angiogenesis in the ischemic limb of spontaneously hypertensive rats
Cardiovasc Res, November 1, 2001; 52(2): 314 - 320.
[Abstract] [Full Text] [PDF]


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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
A. S. Khan, C. D. Lynch, D. C. Sane, M. C. Willingham, and W. E. Sonntag
Growth Hormone Increases Regional Coronary Blood Flow and Capillary Density in Aged Rats
J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2001; 56(8): B364 - 371.
[Abstract] [Full Text] [PDF]


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HypertensionHome page
C. Emanueli, M. B. Salis, T. Stacca, L. Gaspa, J. Chao, L. Chao, A. Piana, and P. Madeddu
Rescue of Impaired Angiogenesis in Spontaneously Hypertensive Rats by Intramuscular Human Tissue Kallikrein Gene Transfer
Hypertension, July 1, 2001; 38(1): 136 - 141.
[Abstract] [Full Text] [PDF]


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Arch NeurolHome page
D. Simovic, J. M. Isner, A. H. Ropper, A. Pieczek, and D. H. Weinberg
Improvement in Chronic Ischemic Neuropathy After Intramuscular phVEGF165 Gene Transfer in Patients With Critical Limb Ischemia
Arch Neurol, May 1, 2001; 58(5): 761 - 768.
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Am. J. Physiol. Heart Circ. Physiol.Home page
M. Simons
Therapeutic coronary angiogenesis: a fronte praecipitium a tergo lupi?
Am J Physiol Heart Circ Physiol, May 1, 2001; 280(5): H1923 - H1927.
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Cardiovasc ResHome page
J. Waltenberger
Impaired collateral vessel development in diabetes: potential cellular mechanisms and therapeutic implications
Cardiovasc Res, February 16, 2001; 49(3): 554 - 560.
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FASEB J.Home page
E. VASILE, Y. TOMITA, L. F. BROWN, O. KOCHER, and H. F. DVORAK
Differential expression of thymosin {beta}-10 by early passage and senescent vascular endothelium is modulated by VPF/VEGF: evidence for senescent endothelial cells in vivo at sites of atherosclerosis
FASEB J, February 1, 2001; 15(2): 458 - 466.
[Abstract] [Full Text] [PDF]