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(Circulation. 1999;99:1726-1732.)
© 1999 American Heart Association, Inc.


Basic Science Reports

Angiogenesis Inhibitors Endostatin or TNP-470 Reduce Intimal Neovascularization and Plaque Growth in Apolipoprotein E–Deficient Mice

Karen S. Moulton, MD; Eric Heller, MS; Moritz A. Konerding, MD; Evelyn Flynn, MS; Wulf Palinski, MD; Judah Folkman, MD

From the Surgical Research Laboratory (K.S.M., E.F., J.F.), Children's Hospital, Boston Mass; Cardiovascular Division (K.S.M.), Brigham and Women's Hospital, Boston, Mass; Harvard Medical School (E.H.), Boston, Mass; the Department of Anatomy (M.A.K.), University of Mainz, Mainz, Germany; and the Department of Medicine (W.P.), University of California, San Diego, Calif.

Correspondence to Karen S. Moulton, Children's Hospital, Surgical Research Laboratory Enders 10, 300 Longwood Ave, Boston, MA 02115. E-mail moulton{at}hub.tch.harvard.edu

Background—Neovascularization within the intima of human atherosclerotic lesions is well described, but its role in the progression of atherosclerosis is unknown. In this report, we first demonstrate that intimal vessels occur in advanced lesions of apolipoprotein E–deficient (apoE -/-) mice. To test the hypothesis that intimal vessels promote atherosclerosis, we investigated the effect of angiogenesis inhibitors on plaque growth in apoE -/- mice.

Methods and Results—ApoE -/- mice were fed a 0.15% cholesterol diet. At age 20 weeks, mice were divided into 3 groups and treated for 16 weeks as follows: group 1, recombinant mouse endostatin, 20 mg · kg-1 · d-1; group 2, fumagillin analogue TNP-470, 30 mg/kg every other day; and group 3, control animals that received a similar volume of buffer. Average cholesterol levels were similar in all groups. Plaque areas were quantified at the aortic origin. Median plaque area before treatment was 0.250 mm2 (range, 0.170 to 0.348; n=10). Median plaque areas were 0.321 (0.238 to 0.412; n=10), 0.402 (0.248 to 0.533; n=15), and 0.751 mm2 (0.503 to 0.838; n=12) for the endostatin, TNP-470, and control groups, respectively (P<=0.0001). Therefore, endostatin and TNP-470 inhibited plaque growth during the treatment period by 85% and 70%. Intimal smooth muscle cell contents of plaques from control and treated mice were similar.

Conclusions—Prolonged treatment with either angiogenesis inhibitor reduced plaque growth and intimal neovascularization in apoE -/- mice. Although the mechanism of plaque inhibition induced by these agents is not established, these results suggest that intimal neovascularization may promote plaque development.


Key Words: angiogenesis • atherosclerosis • apolipoproteins




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R. Khurana, Z. Zhuang, S. Bhardwaj, M. Murakami, E. De Muinck, S. Yla-Herttuala, N. Ferrara, J. F. Martin, I. Zachary, and M. Simons
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Circulation, October 19, 2004; 110(16): 2436 - 2443.
[Abstract] [Full Text] [PDF]


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CirculationHome page
P. R. Moreno, K. R. Purushothaman, V. Fuster, D. Echeverri, H. Truszczynska, S. K. Sharma, J. J. Badimon, and W. N. O'Connor
Plaque Neovascularization Is Increased in Ruptured Atherosclerotic Lesions of Human Aorta: Implications for Plaque Vulnerability
Circulation, October 5, 2004; 110(14): 2032 - 2038.
[Abstract] [Full Text] [PDF]


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CirculationHome page
K. S. Moulton, B. R. Olsen, S. Sonn, N. Fukai, D. Zurakowski, and X. Zeng
Loss of Collagen XVIII Enhances Neovascularization and Vascular Permeability in Atherosclerosis
Circulation, September 7, 2004; 110(10): 1330 - 1336.
[Abstract] [Full Text] [PDF]


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HypertensionHome page
Q. Zhao, M. Ishibashi, K.-i. Hiasa, C. Tan, A. Takeshita, and K. Egashira
Essential Role of Vascular Endothelial Growth Factor in Angiotensin II-Induced Vascular Inflammation and Remodeling
Hypertension, September 1, 2004; 44(3): 264 - 270.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
N. Kipshidze, G. Dangas, M. Tsapenko, J. Moses, M. B. Leon, M. Kutryk, and P. Serruys
Role of the endothelium in modulating neointimal formation: Vasculoprotective approaches to attenuate restenosis after percutaneous coronary interventions
J. Am. Coll. Cardiol., August 18, 2004; 44(4): 733 - 739.
[Abstract] [Full Text] [PDF]


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CirculationHome page
S. E. Epstein, E. Stabile, T. Kinnaird, C. W. Lee, L. Clavijo, and M. S. Burnett
Janus Phenomenon: The Interrelated Tradeoffs Inherent in Therapies Designed to Enhance Collateral Formation and Those Designed to Inhibit Atherogenesis
Circulation, June 15, 2004; 109(23): 2826 - 2831.
[Full Text] [PDF]


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CirculationHome page
D. W. Losordo and S. Dimmeler
Therapeutic Angiogenesis and Vasculogenesis for Ischemic Disease: Part II: Cell-Based Therapies
Circulation, June 8, 2004; 109(22): 2692 - 2697.
[Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
R. Khurana, S. Shafi, J. Martin, and I. Zachary
Vascular Endothelial Growth Factor Gene Transfer Inhibits Neointimal Macrophage Accumulation in Hypercholesterolemic Rabbits
Arterioscler Thromb Vasc Biol, June 1, 2004; 24(6): 1074 - 1080.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
K. S. Meir and E. Leitersdorf
Atherosclerosis in the Apolipoprotein E-Deficient Mouse: A Decade of Progress
Arterioscler Thromb Vasc Biol, June 1, 2004; 24(6): 1006 - 1014.
[Abstract] [Full Text] [PDF]


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HypertensionHome page
J. K. Liao
Statin Therapy: Having the Good Without the Bad
Hypertension, June 1, 2004; 43(6): 1171 - 1172.
[Full Text] [PDF]


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J. Am. Soc. Nephrol.Home page
C. R. Wolfram Kuhlmann, C. Gast, F. Li, M. Schafer, H. Tillmanns, B. Waldecker, and J. Wiecha
Cerivastatin Activates Endothelial Calcium-Activated Potassium Channels and Thereby Modulates Endothelial Nitric Oxide Production and Cell Proliferation
J. Am. Soc. Nephrol., April 1, 2004; 15(4): 868 - 875.
[Abstract] [Full Text] [PDF]


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Arch Intern MedHome page
J. R. Kizer, D. A. Zisman, N. P. Blumenthal, R. M. Kotloff, S. E. Kimmel, R. M. Strieter, S. M. Arcasoy, V. A. Ferrari, and J. Hansen-Flaschen
Association Between Pulmonary Fibrosis and Coronary Artery Disease
Arch Intern Med, March 8, 2004; 164(5): 551 - 556.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
C. Calvi, P. Dentelli, M. Pagano, A. Rosso, M. Pegoraro, S. Giunti, G. Garbarino, G. Camussi, L. Pegoraro, and M. F. Brizzi
Angiopoietin 2 Induces Cell Cycle Arrest in Endothelial Cells: A Possible Mechanism Involved in Advanced Plaque Neovascularization
Arterioscler Thromb Vasc Biol, March 1, 2004; 24(3): 511 - 518.
[Abstract] [Full Text]


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Proc. Natl. Acad. Sci. USAHome page
E. Brakenhielm, N. Veitonmaki, R. Cao, S. Kihara, Y. Matsuzawa, B. Zhivotovsky, T. Funahashi, and Y. Cao
Adiponectin-induced antiangiogenesis and antitumor activity involve caspase-mediated endothelial cell apoptosis
PNAS, February 24, 2004; 101(8): 2476 - 2481.
[Abstract] [Full Text] [PDF]


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CirculationHome page
A. Paul, K. W.S. Ko, L. Li, V. Yechoor, M. A. McCrory, A. J. Szalai, and L. Chan
C-Reactive Protein Accelerates the Progression of Atherosclerosis in Apolipoprotein E-Deficient Mice
Circulation, February 10, 2004; 109(5): 647 - 655.
[Abstract] [Full Text] [PDF]


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CirculationHome page
J. J. Khatri, C. Johnson, R. Magid, S. M. Lessner, K. M. Laude, S. I. Dikalov, D. G. Harrison, H.-J. Sung, Y. Rong, and Z. S. Galis
Vascular Oxidant Stress Enhances Progression and Angiogenesis of Experimental Atheroma
Circulation, February 3, 2004; 109(4): 520 - 525.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
Y. Numaguchi, K. Okumura, M. Harada, K. Naruse, M. Yamada, H. Osanai, H. Matsui, M. Ito, and T. Murohara
Catheter-based prostacyclin synthase gene transfer prevents in-stent restenosis in rabbit atheromatous arteries
Cardiovasc Res, January 1, 2004; 61(1): 177 - 185.
[Abstract] [Full Text] [PDF]


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CirculationHome page
M. Ii and D. W. Losordo
Transplant Graft Vasculopathy: A Dark Side of Bone Marrow Stem Cells?
Circulation, December 23, 2003; 108(25): 3056 - 3058.
[Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
E. Lutgens, R.-J. van Suylen, B. C. Faber, M. J. Gijbels, P. M. Eurlings, A.-P. Bijnens, K. B. Cleutjens, S. Heeneman, and M. J.A.P. Daemen
Atherosclerotic Plaque Rupture: Local or Systemic Process?
Arterioscler Thromb Vasc Biol, December 1, 2003; 23(12): 2123 - 2130.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
K. Pels, C. Deiner, S. E Coupland, M. Noutsias, A. P Sutter, H.-P. Schultheiss, S. Yla-Herttuala, and P. L Schwimmbeck
Effect of adventitial VEGF165 gene transfer on vascular thickening after coronary artery balloon injury
Cardiovasc Res, December 1, 2003; 60(3): 664 - 672.
[Abstract] [Full Text] [PDF]


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Vasc MedHome page
D. V Baklanov, K. G Peters, A. L Seidel, D. A Taylor, and B. H Annex
Neovascularization in intimal hyperplasia is associated with vein graft failure after coronary artery bypass surgery
Vascular Medicine, August 1, 2003; 8(3): 163 - 167.
[Abstract] [PDF]


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FASEB J.Home page
M. H. DEININGER, W. A. WYBRANIETZ, F. T.C. GRAEPLER, U. M. LAUER, R. MEYERMANN, and H. J. SCHLUESENER
Endothelial endostatin release is induced by general cell stress and modulated by the nitric oxide/cGMP pathway
FASEB J, July 1, 2003; 17(10): 1267 - 1276.
[Abstract] [Full Text] [PDF]


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CirculationHome page
D. W. Losordo, J. M. Isner, and L. J. Diaz-Sandoval
Endothelial Recovery: The Next Target in Restenosis Prevention
Circulation, June 3, 2003; 107(21): 2635 - 2637.
[Full Text] [PDF]


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Proc. Natl. Acad. Sci. USAHome page
K. S. Moulton, K. Vakili, D. Zurakowski, M. Soliman, C. Butterfield, E. Sylvin, K.-M. Lo, S. Gillies, K. Javaherian, and J. Folkman
Inhibition of plaque neovascularization reduces macrophage accumulation and progression of advanced atherosclerosis
PNAS, April 15, 2003; 100(8): 4736 - 4741.
[Abstract] [Full Text] [PDF]


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CirculationHome page
R. Hutter, B. V. Sauter, E. D. Reis, M. Roque, D. Vorchheimer, F. E. Carrick, J. T. Fallon, V. Fuster, and J. J. Badimon
Decreased Reendothelialization and Increased Neointima Formation With Endostatin Overexpression in a Mouse Model of Arterial Injury
Circulation, April 1, 2003; 107(12): 1658 - 1663.
[Abstract] [Full Text] [PDF]


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CirculationHome page
P. Libby and D. X.-M. Zhao
Allograft Arteriosclerosis and Immune-Driven Angiogenesis
Circulation, March 11, 2003; 107(9): 1237 - 1239.
[Full Text] [PDF]


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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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Eur Heart JHome page
P.O Bonetti, L.O Lerman, C Napoli, and A Lerman
Statin effects beyond lipid lowering--are they clinically relevant?
Eur. Heart J., February 1, 2003; 24(3): 225 - 248.
[Full Text] [PDF]


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Cardiovasc ResHome page
N van Royen, I Hoefer, I Buschmann, S Kostin, M Voskuil, C. Bode, W Schaper, and J.J Piek
Effects of local MCP-1 protein therapy on the development of the collateral circulation and atherosclerosis in Watanabe hyperlipidemic rabbits
Cardiovasc Res, January 1, 2003; 57(1): 178 - 185.
[Abstract] [Full Text] [PDF]


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J. Neurosci.Home page
M. H. Deininger, B. A. Fimmen, D. R. Thal, H. J. Schluesener, and R. Meyermann
Aberrant Neuronal and Paracellular Deposition of Endostatin in Brains of Patients with Alzheimer's Disease
J. Neurosci., December 15, 2002; 22(24): 10621 - 10626.
[Abstract] [Full Text] [PDF]


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CirculationHome page
A. Hilfiker, D. Hilfiker-Kleiner, M. Fuchs, K. Kaminski, A. Lichtenberg, H.-J. Rothkotter, B. Schieffer, and H. Drexler
Expression of CYR61, an Angiogenic Immediate Early Gene, in Arteriosclerosis and Its Regulation by Angiotensin II
Circulation, July 9, 2002; 106(2): 254 - 260.
[Abstract] [Full Text] [PDF]