Tumor Angiogenesis Flashcards

1
Q

Define angiogenesis

A

The sprouting of vessels from established vasculature (sometimes referred to in the context of remodeling)

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2
Q

Define vasculogenesis

A

The de novo differentiation of precursor cells to differentiated endothelial cells and the assembly of them into vessels (often associated during embryonic development)

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3
Q

What are characteristics of abnormal vasculature?

A
  • leaky blood vessels (tortuous and dilated)
  • haphazard vessel interconnection pattern
  • aberrant morphology of endothelial cell lining
  • pericytes are loosely attached or absent
  • basement membrane is thick, thin, or absent

**tumor vascular beds are highly unstructured and chaotic

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4
Q

What would be the benefit of halting tumor angiogenesis?

A

Would be able to keep the tumor dormant (cannot increase growth without angiogenic switch)

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5
Q

Define angiogenic switch

A

A discrete step in tumor development that can occur at different stages in the tumor progression pathway depending on the nature of the tumor and its microenvironment

**Not sure what triggers the switch… hypoxia maybe?

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6
Q

What maintains vessel growth homeostasis?

A

A balance betwee pro- and anti-angiogenic molecules

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7
Q

Give characteristics of a stalk cell

A
  • Proliferate when stimulated with VEGF-A
  • Form vascular lumen
  • Establish firm adherens junctions (between cells)
  • Deposit basement membrane
  • Can be induced to become new tip cells
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8
Q

Give characteristics of a tip cell

A
  • RARELY proliferates
  • Single highly polarized endothelial cells
  • Numerour actin rich filopodia protrusions
  • Induced by VEGF-A (receptor on filopodia)
  • Lacks vascular lumen
  • Specialized for guided migration
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9
Q

What are the two main signaling pathways studied extensively in tip versus stalk cell specification?

A

VEGF and Notch signaling pathways

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10
Q

Describe the VEGF signaling pathway

A

VEGF binds one of many variations of the receptor (tyrosine kinase receptors) which trigger migration, proliferation, cell survival and vascular permeability of the endothelial cell

**neurophillins (e.g. NRP2) help the process

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11
Q

Describe the notch signaling pathway

A

Ligand binds the notch receptor, stimulating proteases which cleave off the “NICD”… The “Notch Intracellular Domain” translocates to the nucleus and influences transcription

**notch signaling mediates lateral inhibition (e.g. helps formation of arteries and veins in pairs)

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12
Q

What are the general steps to form a stable vessel?

A
  1. Select a tip cell (most VEGF, gradient downwards)
  2. Tip cell guidance and stalk elongation
  3. Sprout fusion and lumen formation -> perfusion
  4. Maturation and quiescence of phalanx cells
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13
Q

What is the idea of metronomic chemotherapy?

A

Give low dose (lower than maximum tolerable dose MTD) therapy each day without giving breaks

**often given with combinational attacks (e.g. anti-angiogenic, pro-apoptotic, etc)

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14
Q

What role do normal endothelial cells play in metronomic therapy?

A

They are partly responsible for the therapy’s effectiveness because of their ability to better recover under the metronomic schedule than the conventional chemo schedule

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15
Q

What is vessel normalization?

A

To correct the structure and function of tumor vessels we then are able to deliver drugs and perhaps even contain the tumor from spreading

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16
Q

What are the features of a tumor vascular bed?

A
  • Spatial/temporal heterogeneity in tumor blood flow
  • Pressure (tumor cells are tightly packed) compresses blood and lymph vessels -> impairs flow and therefore immune function
  • Hypoxia renders tumor cells resistant to radiation and cytotoxic drugs

**All of these select for more malignant cells with increased metastatic potential

17
Q

What is the “normalization window”

A

The narrow therapeutic dose and schedule that is right for each individual patient for vessel normalization therapy

18
Q

How has wet-AMD benefitted from angiogenesis research?

A

It has been shown that wet age-related macular degeneration (AMD) benefits from blood vessel reduction accomplished by injection of anti-VEGF