Increased endogenous angiogenic response and hypoxia-inducible factor-1α in human critical limb ischemia  Teik K. Ho, MRCS, Vineeth Rajkumar, MSc, Markella.

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Increased endogenous angiogenic response and hypoxia-inducible factor-1α in human critical limb ischemia  Teik K. Ho, MRCS, Vineeth Rajkumar, MSc, Markella Ponticos, PhD, Patricia Leoni, PhD, Dame Carol M. Black, PhD, David J. Abraham, PhD, Daryll M. Baker, PhD  Journal of Vascular Surgery  Volume 43, Issue 1, Pages 125-133 (January 2006) DOI: 10.1016/j.jvs.2005.08.042 Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 1 Immunohistochemistry demonstrating CD31-positive microvessels. A, B, The CD31-positive microvessels are visible as dark reddish brown against the background of hematoxylin counterstain. An example of a microvessel is indicated by arrow i, and arrow ii indicates an example of a muscle nuclei. Increased immunopositive microvessels were seen in the CLI group (B) compared with controls (A). Such sections were used for quantitative assessment of microvessels and the microvessel-to-muscle fiber ratio (magnification, ×200). C, Boxplot of microvessel density and (D) microvessel-to-muscle fiber ratio. Boxes represent interquartile range, horizontal lines represent group medians, and the whisker caps represent the 5th and 95th percentiles. Microvessel density was 2.7-fold higher in chronic critical limb ischemia (CLI) muscle biopsy specimens than in controls (P < 0.001, Mann-Whitney U test). The capillary-to-muscle fiber ratio was also significantly higher in CLI compared to controls (P = 0.001, Mann-Whitney U test). Journal of Vascular Surgery 2006 43, 125-133DOI: (10.1016/j.jvs.2005.08.042) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 2 Immunohistochemistry demonstrating hypoxia-inducible factor-1α (HIF-1α) expressions in (A) control and (B) critical limb ischemia (CLI) muscles. There was an increased expression in the CLI muscles, demonstrated by the increased immunoreactivity viewed as dark reddish brown (magnification ×200). The HIF-1α levels were then quantified using Western blotting and enzyme-linked immunoabsorbent assay (ELISA) assay. (C) Boxplot of ELISA assay results of HIF-1α levels in the CLI and control biopsies specimens. Boxes represent interquartile range, horizontal lines represent group medians, and the whisker caps represent the 5th and 95th percentiles. The CLI group has significantly higher HIF-1α expression as represented by optical density (OD) compared with the control group (P < 0.001, Mann-Whitney U test). (D) Western blot of HIF-1α in the control and CLI biopsy specimens. Stronger bands were shown from the CLI biopsies (lanes 5 to 8) at the molecular weight of 120 kD, the molecular weight of HIF-1α. The bands were faintly detectable from biopsies from the control group (lanes 1 to 4). Journal of Vascular Surgery 2006 43, 125-133DOI: (10.1016/j.jvs.2005.08.042) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 3 Serial 6-μm cryosections of critical limb ischemia muscle demonstrate the similar distribution pattern of immunoreactivity between (A) CD31 and (B) HIF-1α. This suggested a strong likelihood of colocalization between the two antigens (magnification ×400). The colocalization was further confirmed by using the double immunofluorescence labelling technique, visualized on a representative single microvessel. (C) HIF-1α was labelled with Texas Red (red). (D) Vascular endothelium expressing CD31 antigen was labelled with fluorescein-5-isothiocyanate (FITC) (green). (E) The colocalization of both HIF-1α and CD31-positive vascular endothelium on the same microvessel is demonstrated by yellow color. Journal of Vascular Surgery 2006 43, 125-133DOI: (10.1016/j.jvs.2005.08.042) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions