J Vasc Surg 45(Suppl A): A48-A56

The Chemokine System in Arteriogenesis and Hind Limb Ischemia

Paula K. Shireman, The South Texas Veterans Health Care System, San Antonio, TX, Departments of Surgery and Medicine, Sam and Ann Barshop Institute for Longevity and Aging Studies, The University of Texas Health Science Center, San Antonio, TX;

Please send correspondences to: Paula K. Shireman, M.D., Associate Professor, Division of Vascular Surgery, MC 7741, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, Office: (210) 567-5715, Fax: (210) 567-1762, Email: ude.ASCSHTU@namerihS

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Abstract

Chemokines (chemotactic cytokines) are important in the recruitment of leukocytes to injured tissues and as such, play a pivotal role in arteriogenesis and the tissue response to ischemia. Hind limb ischemia represents a complex model with arteriogenesis (collateral artery formation) occurring in tissues with normal perfusion while areas exhibiting ischemic necrosis undergo angiogenesis and skeletal muscle regeneration; monocytes/macrophages play an important role in all three of these processes. In addition to leukocyte trafficking, chemokines are produced by and chemokine receptors are present on diverse cell types, including myoblasts, endothelial and smooth muscle cells. Thus, the chemokine system may have direct effects, as well as inflammatory-mediated effects, on arteriogenesis, angiogenesis and skeletal muscle regeneration. This article will review the complexity of the hind limb ischemia model and the role of the chemokine system in arteriogenesis and the tissue response to ischemia. Special emphasis will be placed on the roles of monocytes/macrophages and CCL2/monocyte chemotactic protein-1 (MCP-1) in these processes.

Clinical Relevance

Lower extremity amputations following acute and chronic tissue ischemia are a common problem despite the success of arterial bypass surgery. A better understanding of the mechanisms involved in the development of collateral arteries and the tissue response to ischemia could contribute to the design of new and adjuvant therapies for limb salvage.

Abstract

Footnotes

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