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Angiogenesis
Angiogenesis Inhibition - Anti Angiogenesis DrugProcess of AngiogenesisFor many tumours, there is a progressive slowing of the rate of growth as the tumours become larger. This occurs for many reasons, but outgrowing the blood supply is paramount. New vessel formation (angiogenesis) is stimulated by a variety of peptides produced both by tumour cells and by host inflammatory cells, such as the vascular endothelial growth factors (VEGFs), basic fibroblast growth factor (bFGF) and angiopoietin 2. Inhibition of angiogenesis is a potentially novel method of cancer therapy, as new vessel formation within and around tumours not only provides the cancer with nutrients and oxygen, but permits haematogenous spread, or metastasis. Invasion and metastasisCancers spread by both local invasion and by metastasis in vessels of the blood or lymphatic systems. Infiltration into surrounding tissues is associated with loss of cell-cell cohesion. Cohesion is mediated by active homotypic cell adhesion molecules (CAMs). The cadherin molecules are transmembrane glycoproteins able to mediate cellular attachment. Epithelial cadherin (E-cadherin) is expressed by many carcinomas and loss of E-cadherin expression is associated with an increase in invasion of the tumour. Invasion is partly determined by the balance of activators to inhibitors of proteolysis. Secretion of proteolytic enzymes, including the matrix metalloproteinases (particularly the collagenases), occurs from adjacent fibroblasts owing to failure of production of tissue inhibitors. Angiogenesis BalanceThe balance between the expression and activity of the matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) is important for tumour growth, invasion, metastasis and angiogenesis. Some TIMPs may regulate cell proliferation and survival of cancer cells independently of MMP activity.
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