VEGF enhances angiogenesis and promotes blood-brain barrier leakage in the ischemic brain

TLDR

VEGF is a mitogen that promotes angiogenesis and vascular permeability, yet its role in the ischemic brain is unclear. The study aimed to determine whether VEGF improves cerebral microvascular perfusion and elevates blood‑brain barrier leakage after ischemia. Researchers administered recombinant human VEGF165 to rats with focal cerebral embolic ischemia and assessed angiogenesis, neurological function, and BBB integrity using MRI, 3‑D laser‑scanning confocal microscopy, and functional neurological tests. Late (48‑h) VEGF165 treatment increased angiogenesis in the penumbra and improved neurological recovery, whereas early (1‑h) treatment exacerbated BBB leakage, hemorrhagic transformation, and infarct size, indicating that VEGF promotes angiogenesis and functional recovery but acute inhibition may reduce BBB permeability and hemorrhage risk.

Abstract

VEGF is a secreted mitogen associated with angiogenesis and is also a potent vascular permeability factor. The biological role of VEGF in the ischemic brain remains unknown. This study was undertaken to investigate whether VEGF enhances cerebral microvascular perfusion and increases blood-brain barrier (BBB) leakage in the ischemic brain. Using magnetic resonance imaging (MRI), three-dimensional laser-scanning confocal microscope, and functional neurological tests, we measured the effects of administrating recombinant human VEGF165 (rhVEGF165) on angiogenesis, functional neurological outcome, and BBB leakage in a rat model of focal cerebral embolic ischemia. Late (48 hours) administration of rhVEGF165 to the ischemic rats enhanced angiogenesis in the ischemic penumbra and significantly improved neurological recovery. However, early postischemic (1 hour) administration of rhVEGF165 to ischemic rats significantly increased BBB leakage, hemorrhagic transformation, and ischemic lesions. Administration of rhVEGF165 to ischemic rats did not change BBB leakage and cerebral plasma perfusion in the contralateral hemisphere. Our results indicate that VEGF can markedly enhance angiogenesis in the ischemic brain and reduce neurological deficits during stroke recovery and that inhibition of VEGF at the acute stage of stroke may reduce the BBB permeability and the risk of hemorrhagic transformation after focal cerebral ischemia.