Angiogenesis Therapy Moves beyond Cancer

Doctors in different subspecialties, have, over the years, learned that people with Down syndrome have unsurpassed protection against certain diseases. Cancer is almost unheard of among people with this syndrome, according to oncologists. Noncongenital heart problems rarely afflict this population, according to cardiologists. And diabetic retinopathy never develops among people with both Down syndrome and diabetes, according to endocrinologists. But, until recently, most doctors only knew that Down syndrome provided protection; they did not know why.

They knew that people with Down syndrome had 3 copies of chromosome 21 (trisomy 21), but no one made the link between the extra chromosome and the protective effects of Down syndrome.

Then, in 2003, researchers discovered that the extra copy of chromosome 21 in Down syndrome provides the body an extra copy of collagen XVIII, from which endostatin is derived. Endostatin plays a key role in inhibiting angiogenesis, the growth of blood vessels. Uncontrolled growth of blood vessels is a characteristic of cancer, heart disease, and diabetic retinopathy—all the diseases that Down syndrome protects against, apparently because of the powerful inhibiting effects of all that extra endostatin.

“Isn't it amazing? The endostatin appears to protect them against these seemingly disparate diseases,” said Judah Folkman, MD, director of the vascular biology program at Boston's Children's Hospital and professor of cell biology at Harvard Medical School. The endostatin findings provided proof that these diseases are not, in fact, so disparate after all, and brought focus to the fact that many diseases besides cancer arise from the same process of pathologic angiogenesis. In the past 20 years, researchers have identified more than 70 diseases that depend on angiogenesis—various types of cancer, heart and vascular diseases, many eye disorders, rheumatoid arthritis, Crohn disease, psoriasis, and endometriosis, among others.

Angiogenesis researchers have long worked to use blood vessel …