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The success of many therapies in regenerative medicine requires the ability to control the formation of stable vascular networks within tissues. The formation of new blood vessels, or neovascularization, is mediated, in part, by interactions between endothelial cells (ECs) and insoluble factors in the extracellular microenvironment. These interactions are determined by the chemical, physical, and mechanical properties of the matrix. Understanding how extracellular matrices (ECMs) and synthetic scaffolds influence neovascularization can contribute to the fundamental knowledge of normal and diseased tissue physiology and can be used to guide the design of new therapies. The goal of this review is to provide an overview of the complex role EC-matrix interactions play in neovascularization. A particular emphasis is placed on presenting differences in two subsets of ECM, basement membranes and stromal matrices, and identification of the properties of these matrices that define their biological functions. Attempts to apply information about EC-ECM interactions to enhance vascularization of synthetic materials are presented, and areas in need of further research are identified throughout this review. Our understanding of the role EC-matrix interactions play in neovascularization remains limited, but continued progress in this area could be of significant benefit to the design of clinically applicable engineered tissues.

Background: Therapeutic neovascularization using high growth factor concentrations may lead to transient vessel formation and abnormal microvascular structure. The goal of this study was to quantify temporal and concentration effects of fibroblast growth factor-1 (FGF-1) on the persistence and morphology of microvascular networks., Methods: Endothelial cells were incubated in suspension culture forming aggregates that were embedded in fibrin glue (FG) and stimulated with varying concentrations of FGF-1 with of heparin. Capillary networks formed were quantified for 21 days., Results: High FGF-1 concentrations resulted in rapid and intense sprout formation, with excessive branching. At later times, these vessels regressed, with cellular debris in former vessel locations. At later times, the 1-ng/mL group surpassed the high concentration groups with continuous sprout growth and complete FG vascularization by 23 days., Conclusion: Sustained low levels of FGF-1 maintained a persistent microvascular network response, whereas higher levels resulted in abnormal phenotype followed by vessel regression.

A number of pathological entities and surgical interventions could benefit from therapeutic stimulation of new blood vessel formation. Although strategies designed for promoting neovascularization have shown promise in preclinical models, translation to human application has met with limited success when angiogenesis is used as the single therapeutic mechanism. While clinical protocols continue to be optimized, a number of exciting new approaches are being developed. Bioengineering has played an important role in the progress of many of these innovative new strategies. In this review, we present a general outline of therapeutic neovascularization, with an emphasis on investigations using engineering principles to address this vexing clinical problem. In addition, we identify some limitations and suggest areas for future research.