
[Cancer Research 60, 4719-4724, September 1, 2000]
© 2000 American Association for Cancer Research
Fibrinogen E-fragment Inhibits the Migration and Tubule Formation of Human Dermal Microvascular Endothelial Cells in Vitro
Carolyn A. Bootle-Wilbraham1,
S. Tazzyman,
J. M. Marshall and
Claire E. Lewis1
Tumor Targeting Group, Section of Pathology, Division of Genomic Medicine, University of Sheffield Medical School, Sheffield S10 2RX [C. A. B-W., S. T., C. E. L.], and Oxford Bioresearch Laboratory, Magdalen Centre, Oxford OX4 4GA [J. M. M.], United Kingdom
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ABSTRACT
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Angiogenesis, the development of new blood vessels from an existing
vascular bed, is essential for the growth and spread of malignant
tumors. Several endogenous angiogenesis inhibitors have been discovered
and shown to suppress endothelial cell function in vitro
and tumor growth in vivo. Several of these are proteolytic
fragments of larger, endogenous proteins. Here we show that a
Mr 50,000 polypeptide derived from the plasmin
cleavage of fibrinogen, fibrinogen E-fragment, inhibits endothelial
cell migration and tubule formation induced by both proangiogenic
growth factors, vascular endothelial growth factor and basic fibroblast
growth factor, in vitro.
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Introduction
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Angiogenesis, the outgrowth of new capillaries from preexisting
vessels, is a complex multistep process that involves the degradation
of components of the extracellular matrix and then the migration,
proliferation, and differentiation of endothelial cells to form sprouts
and tubules and eventually new vessels (1)
. This is a
critical step in the growth of tumors and is thought to result from a
change in the local balance of proangiogenic and antiangiogenic
factors. Proangiogenic growth factors such as
VEGF2
and bFGF are produced by both malignant cells and such stromal cells as
macrophages to maintain a high level of angiogenesis in tumors
(2)
. Conversely, a number of endogenous inhibitors have
also been discovered and are currently being evaluated in clinical
trials for the treatment of cancer. Angiostatin and endostatin are
formed by the proteolytic cleavage of plasminogen and collagen XVIII,
respectively. Both factors suppress endothelial cell responses to VEGF
and bFGF in vitro and markedly reduce the vascularization
and growth of experimental tumors in animal models (3)
. In
the present report, we have investigated the angiogenic properties of
another endogenous protein found in tumors, fibrinogen, and some of its
major breakdown products. Fibrinogen, the soluble circulating precursor
of fibrin, is a dimeric molecule containing pairs of nonidentical
chains, i.e., the
-, ß-, and
-chains. These are
arranged as three discrete domains, the two outer D-domains and the
central E-domain (4)
. Fibrinogen can be digested either by
plasmin or thrombin. Plasmin cleavage of each fibrinogen molecule gives
rise to two D fragments, a number of smaller fragments including a
small peptide, ß 1-42 (the amino terminal of the ß chain), and one
E fragment (called fibrinogen E-fragment) consisting of the
NH2-terminal regions of the
-, ß-, and
-chains
chains held together by disulfide bonds (5)
. By contrast,
cleavage of fibrinogen by thrombin produces a fibrin monomer and two
copies of fibrinopeptides A and B (Fig. 1
; Ref. 4
). Fibrinogen has been shown to accumulate mainly around leaky
blood vessels in solid tumors (6)
and to polymerize at the
host-tumor interface to form fibrin networks that promote tumor
angiogenesis by supporting the adhesion, migration, proliferation, and
differentiation of endothelial cells (7)
. Fibrin
E-fragment, produced by proteolytic cleavage of fibrin, stimulates
angiogenesis in the chick chorioallantoic membrane assay
(8)
. Here we have compared the effects of fibrinogen and
its breakdown products on the proliferation, migration, and tubule
formation of HuDMECs in response to VEGF and bFGF in vitro.
We confirm the proangiogenic effects of fibrin E-fragment and
demonstrate for the first time that fibrinogen E-fragment is a potent
inhibitor of angiogenesis in vitro.

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Fig. 1. Schematic illustration of the role of the enzymes,
plasmin and thrombin, in the generation of the fibrin(ogen) breakdown
products. Fibrinogen consists of two of each of the polypeptide chains,
, ß, and , joined by disulfide bonds to form a symmetric
dimeric structure. The NH2-terminal regions of all six
chains form the central E-domain. This fibrinogen molecule, when
cleaved by plasmin, releases two D-fragments (the COOH termini of the
-, ß-, and -chains), one E-fragment (the NH2
termini of the - and -chains), and several smaller fragments
including a small peptide, ß 1-42 (the NH2 terminus of
the ß-chain). Cleavage by thrombin releases the two fibrinopeptides A
and B (FpA and FpB) from the NH2
termini of the - and ß-chains, respectively, exposing
polymerization sites that form electrostatic bonds between the E-domain
of one molecule and the D-domain of an adjacent one. Factor XIIIa, a
transglutaminase, then introduces -glutamyl- -amino-lysine
isopeptide cross-links between D-domains of adjacent fibrin monomers,
generating a stable polymer known as fibrin. This can then be broken
down by plasmin cleavage in the three-stranded coils found between the
D- and E-domains, yielding D-dimer, D-fragment, and fibrin E-fragment
(which lacks the fibrinopeptides A and B) and smaller fragments
(4)
.
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Materials and Methods
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Cell Culture.
Adult HuDMECs were obtained commercially (TCS Biologicals,
Buckinghamshire, United Kingdom) and cultured in microvascular
endothelial cell growth medium. This medium contains heparin (10
ng/ml), hydrocortisone, human epidermal growth factor (10 ng/ml), human
fibroblast growth factor (10 ng/ml; such endothelial growth factors are
necessary for routine passaging of HuDMECs in culture), and dibutyryl
cyclic AMP. This was supplemented with 5% heat-inactivated FCS, 50
µg/ml gentamicin, and 50 ng/ml amphotericin B (TCS Biologicals).
Cells were grown at 37°C in a 100% humidified incubator with a gas
phase of 5% CO2 and routinely screened for
Mycoplasma. Prior to their use in the assays indicated
below. HuDMECs were grown to 80% confluency, incubated in
DMEM + 1% FCS for 2 h, then harvested with 0.05%
trypsin solution, washed twice, and resuspended to the cell density
required for each assay (see below).
Proteins and Peptides.
Commercial human fibrinogen (plasminogen/plasmin and thrombin free) was
obtained from Enzyme Research Laboratories (Swansea, United Kingdom).
The fibrinogen did not clot at any point during the experiments,
indicating that there was no enzyme activity within the preparation to
change its conformation. Human fibrinogen E-fragment was purchased from
Diagnostica Stago (Asnieres, France). This was produced by plasmin
cleavage of fibrinogen and purified by electrophoresis,
immunoelectrophoresis, ion exchange, and gel filtration. To generate
human fibrin E-fragment, fibrinogen E-fragment was digested with human
thrombin (Sigma-Aldrich Co, Dorset, United Kingdom), as described
previously (9)
. To control for the possible effects of
trace amounts of thrombin in the fibrin E-fragment preparation on our
assays, the same amount of thrombin (0.5 unit/ml) was added to control
media used in experiments using fibrin E-fragment. HPLC-purified
fibrinopeptide was obtained commercially from Bachem Ltd. (Saffron
Walden, United Kingdom). This peptide was included in the study because
the NH2 termini of the two
fragments are retained in
the fibrinogen E-fragment but are missing in the fibrin E-fragment
(i.e., because the fibrinopeptide A portion of this is
missing). We, therefore, compared the effects of equimolar amounts of
fibrinopeptide A and fibrinogen E-fragment in the assays described
below to ascertain whether effects induced by fibrinogen E-fragment
were attributable to an active site located in the fibrinopeptide A
part of the molecule. Human recombinant endostatin (originally obtained
from Calbiochem, La Jolla, CA) was a kind gift from E. Bishop
(BioCure Ltd., Aberdeen, United Kingdom).
Migration Assay.
The Boyden chamber technique was adapted from Malinda et al.
(10)
and used to evaluate HuDMEC migration across a porous
membrane toward a concentration gradient of 10 ng/ml of recombinant
human VEGF or bFGF (R&D Systems Ltd., Abingdon, United Kingdom). The
Neuro Probe 48-well microchemotaxis chamber (Neuro Probe, Inc., Cabin
John, MD) was used with 8-µm pore size polycarbonate membranes (Neuro
Probe, Inc.) coated with 100 µg/ml collagen type IV. Ten ng/ml VEGF
or bFGF alone or with various concentrations of fibrinogen, fibrinogen
E-fragment, fibrin E-fragment, or fibrinopeptide A were dissolved in
DMEM + 1% FCS and placed in the lower wells. The
collagen-coated membrane was then placed over this, and 50 µl of
25 x 104 HuDMECs/ml (in DMEM containing 1%
FCS) were added to the upper chamber. The chambers were then incubated
at 37°C for 4.5 h. After this, chambers were dismantled, the
membrane was removed, and nonmigrated cells were scraped from the upper
surface. Migrated cells on the lower surface were fixed with methanol,
stained with Hema "Gurr" rapid staining kit (Merck, Leics, United
Kingdom), and counted using a light microscope (x160) in three random
fields/well. Each test condition was carried out in three replicate
wells, and each experiment was repeated three times.
Tubule Formation Assay.
Twenty-four-well plates were coated with 30 µl/well of GF-reduced
Matrigel (Becton Dickinson Labware, Bedford, MA). Endothelial cells
plated on this matrix migrate and differentiate into tubules within
6 h of plating as described previously (11)
. HuDMECs
were seeded at a density of 4 x 104
cells/ml and incubated for 6 h in 500 µl of either
DMEM + 1% FCS alone (control) or this medium ± 10 ng/ml VEGF or bFGF in the presence or absence of whole
fibrinogen or one of the fibrin(ogen) degradation products. Assessment
of tubule formation involved fixing the cell preparation in 70%
ethanol at 4°C for 15 min, rinsing in PBS, and staining with H&E.
Three random fields of view in three replicate wells for each test
condition were visualized under low power (x40), and color images were
captured using a Fuji digital camera linked to a Pentium III computer
with a frame grabber board. Tubule formation was assessed by counting
the number of tubule branches and the total area covered by tubules in
each field of view using image analysis software supplied by Scion
Image.
Proliferation Assay.
The MTT assay was used as described previously (12)
to
assess HuDMEC proliferation induced by 10 ng/ml VEGF or bFGF in the
absence or presence of fibrinogen or a fibrin(ogen) breakdown product.
HuDMECs were seeded into 96-well microtiter plates at 3 x 104 cells/ml in DMEM + 1% FCS (±10
ng/ml VEGF or bFGF in the presence or absence of whole fibrinogen or
one of the fibrin(ogen) degradation products) for 4.5 and 6 h. At
these time points, a quarter volume of MTT solution (2 mg MTT/ml PBS)
was added to each well, and each plate was incubated for 4 h at
37°C, resulting in an insoluble purple formazan product. The medium
was aspirated, and the precipitates were dissolved in 100 µl of DMSO
buffered at pH 10.5. The absorbance was then read at 540 nm using a
Dynex ELISA plate reader.
Cytotoxicity Assay.
HuDMECs were seeded at a density of 12 x 105 cells/well in a 24-well plate in the absence or
presence of fibrinogen or a fibrin(ogen) degradation product. After
6 h, both live cells (after removal by trypsinization) and dead
(floating) cells were harvested, and cell viability of all cells
present was assessed using propidium iodide staining of 5000 cells in
each of triplicate samples per treatment using a FACScan (Becton
Dickinson) equipped with a blue laser excitation of 15 mW at 488 nm.
The data were collected and analyzed using Cell Quest software (Becton
Dickinson).
Statistical Analysis.
All experiments were performed at least three times, and data were
analyzed using the Mann-Whitney U test, a nonparametric test that does
not assume a Gaussian distribution in the data being analyzed.
P
0.05 was taken as significant.
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Results and Discussion
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HuDMECs were seen to migrate across collagen-coated filters in the
chemotaxis assay and form tubules on GF-reduced Matrigel in the absence
of exogenous stimuli (although it should be noted that a residual level
of GFs is present even in GF-reduced Matrigel). Both cell activities
were significantly (P < 0.001) increased
when 10 ng/ml of VEGF were added to the medium (Figs. 2
, 3
,AI and AIII, and
4A). Exposure to fibrinogen E-fragment significantly (P < 0.001) inhibited both VEGF-induced migration (Fig. 2A)
and tubule formation, as assessed by either total tubule
area (Fig. 3
, AII and B) or the number of
branches (data not shown) of HuDMECs in a dose-dependent manner. None
of the doses of fibrinogen E-fragment tested in this study altered cell
migration in the absence of VEGF (Fig. 2A)
. The inhibitory
effects of fibrinogen E-fragment were not attributable to a cytostatic
or cytotoxic effect of this molecule at 10 and 100 nM,
because neither concentration had any notable effect on HuDMEC
proliferation or viability in control medium or medium containing 10
ng/ml VEGF. However, the marked decrease in HuDMEC migration and tubule
formation evident at the highest dose of fibrinogen E-fragment tested
(1 µM) may have been attributable, at least in part, to a
cytotoxic effect, because this dose resulted in a marginal but
significant (P < 0.05) reduction in the
viability and proliferation of HuDMECs (data not shown).

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Fig. 2. Mean (bars, SE) number of HuDMECs migrating
across a collagen-coated filter in response to control medium (no VEGF
or bFGF) or medium containing 10 ng/ml VEGF in the absence or presence
of various concentrations of fibrinogen E-fragment (A) or
endostatin (B). Representative data from one experiment are
given because similar results were obtained in two other identical
experiments. *, P < 0.001 compared with
positive control (VEGF alone); , P < 0.01
compared with negative control (no VEGF). Essentially similar results
were obtained when VEGF was replaced by 10 ng/ml bFGF (data not
shown).
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Fig. 3. Comparison of the effects of fibrinogen E-fragment
or endostatin on tubule formation by HuDMECs in vitro.
A, tubule formation in the GF-reduced Matrigel assay (x40)
in the absence of exogenous factors (control, I) or the
presence of 100 nM fibrinogen E-fragment (II),
10 ng/ml VEGF (III), or 100 nM endostatin
(IV). B and C, mean (bars,
SE) area of tubule formation in the absence ( ) or presence of
various concentrations of fibrinogen E-fragment or endostatin
(shaded columns). HuDMECs were grown on GF-reduced Matrigel
in DMEM + 1% FCS with either VEGF (10 ng/ml;
B) or bFGF (10 ng/ml; C). Each test condition was
carried out in three replicate wells, with total tubule area measured
in three randomly selected fields of view per well (i.e.,
n = 9). Representative data from one
experiment are given because essentially similar results were obtained
in three identical experiments. *, P < 0.05 compared with control group. , P 0.02 compared with the same dose of fibrinogen E-fragment. ,
fibrinogen E-fragment; , endostatin.
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Essentially similar results were obtained in these studies when VEGF
was replaced by 10 ng/ml bFGF in the Matrigel assay (Fig. 3C)
or the proliferation, cytotoxicity, and chemotaxis
assays (data not shown). This suggests that fibrinogen E-fragment
inhibits HuDMEC activity at a postreceptor locus common to both VEGF
and bFGF signaling in human endothelial cells. The putative receptor(s)
that bind fibrinogen E-fragment on endothelial cells have yet to be
defined, although Dejana et al. (13)
indicated
that fibrinogen E-fragment may be capable of binding the fibrinogen
receptor in vitro. However, RGD motifs in the D-domains of
the fibrinogen molecule mediate binding of this protein to the
fibrinogen receptor (14)
. These sites are absent in
fibrinogen E-fragment, therefore, binding to the fibrinogen receptor
would involve a novel, non-RGD region of this fragment. It is not known
whether this receptor is involved in the inhibitory effects of
fibrinogen E-fragment demonstrated here, and a distinct
receptor/signaling pathway may be involved.
It could be argued that the inhibitory effects of fibrinogen
E-fragment are attributable to an indirect rather than a direct effect
on endothelial cells, because there is no effect seen on nonstimulated
endothelial cells. For example, fibrinogen has recently been shown to
be capable of binding to such proangiogenic factors as bFGF
(15)
and could thereby block the proangiogenic function(s)
of such cytokines. It is not known, however, whether fibrinogen can
also bind VEGF or whether fibrinogen E-fragment, like its parent
molecule, can bind either GF. It was also possible that fibrinogen
E-fragment may bind nonspecifically to the filter in the chemotaxis
assay and/or constituents of the Matrigel matrix in the tubule
formation assay, thereby reducing endothelial cell adhesion and
function. Because one or both of these could, in theory, have been
responsible, wholly or in part, for the inhibition of HuDMEC migration
and tubule formation by fibrinogen E-fragment recorded in this study,
we repeated these studies but this time preexposed endothelial cells to
fibrinogen E-fragment prior to their use in the migration or tubule
formation assay. Exposure of HuDMECs to 10 and 100 nM
fibrinogen E for 1 h prior to the assays was sufficient to
cause similar levels of inhibition in VEGF/bFGF-induced migration and
tubule formation as that seen when fibrinogen E-fragment was present
throughout the assay (data not shown).
To assess the antiangiogenic potential of fibrinogen E-fragment, the
level of endothelial cell inhibition was compared with that elicited by
the well-characterized antiangiogenic agent, endostatin. Others have
reported that 700 ng/ml (35 nM) endostatin is highly
effective in blocking angiogenesis in vitro
(16)
; therefore, various concentrations in this range were
used in the present study. Fibrinogen E-fragment produced similar or
greater levels of inhibition than seen by any concentration of
endostatin (Figs. 2B
and 3
, AIV and 3,
B and C). This finding suggests that, whatever
the mechanism subserving its effect, fibrinogen E-fragment is a potent,
new antagonist of angiogenic growth factors in vitro.
It may be important to note that the effects of fibrinogen E-fragment
are not confined to endothelial cells. This polypeptide is known to
also inhibit the migratory activity of neutrophils (17)
,
stimulate fibrinogen release by hepatocytes (18)
, and
enhance the release of interleukin 6 by macrophages (19)
.
Further studies are required to see whether these and possibly other
effects of fibrinogen E-fragment, as yet undefined, will result in
limiting side effects during or after its administration in
vivo.
The antiangiogenic effects of fibrinogen E-fragment contrast with
results obtained using equimolar amounts of fibrinogen, fibrin
E-fragment, and fibrinopeptide A. To compare the effects of these
proteins/peptides to those of fibrinogen E-fragment (and thus
accurately establish their structure-function relationships), most of
the experiments we report in the paper were performed in the same
experiments (where the dimensions of the assay/equipment would allow
this). Both fibrinogen and fibrin E-fragment significantly
(P < 0.001) increased control and
VEGF-induced migration of HuDMECs at doses of 100 nM (Fig. 4A)
. Furthermore, both 100 nM fibrin E-fragment
and 100 nM and 1 µM fibrinogen significantly
(P < 0.05) enhanced basal and VEGF-induced
tubule formation (Fig. 4B)
. This accords well with previous
reports showing that fibrinogen stimulates endothelial cell migration
(13)
. Fibrin E-fragment has also been shown to be
proangiogenic, possibly because of conformational changes induced
within the fragment by thrombin cleavage of fibrinopeptide A. Ten and
100 nM fibrinogen E-fragment appeared to increase the
proliferation rate of HuDMECs. However, as with fibrinogen E-fragment,
the highest dose (1 µM) of fibrin E-fragment tested was
cytotoxic for HuDMECs and triggered a significant
(P < 0.001) decrease in cell viability and
proliferation (data not shown). This in turn caused marked reductions
in HuDMEC migration and tubule formation in our assays systems (Fig. 4)
. Similar results were obtained when VEGF was replaced by 10 ng/ml
bFGF in these assays.

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Fig. 4. Effects of various fibrinogen breakdown products;
fibrin E-fragment, and whole fibrinogen on HuDMEC migration
(A) or tubule formation in the GF-reduced Matrigel
assay assessed as area (B) in the absence or presence
of 10 ng/ml VEGF. Data are provided as means (bars, SE), and
all doses cited are in nM. Representative data from one
experiment are given because similar results were obtained in two other
identical experiments (and another set of three experiments in which
VEGF was replaced by 10 ng/ml bFGF). Each test condition was carried
out in three replicate wells, with cell migration or total tubule area
measured in three randomly selected fields of view per well
(i.e., n = 9). *,
P < 0.001 compared with respective group
(i.e., either with or without fibrinogen or fibrin
E-fragment) with no VEGF. , P < 0.01
compared with respective group (i.e., either with or without
VEGF) with no fibrinogen or fibrin E-fragment. , no VEGF;
, VEGF (10
ng/ml).
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Fibrinogen E- and fibrin E-fragments differ mainly in that the
latter is denuded of fibrinopeptide A by thrombin cleavage. We,
therefore, investigated whether the antiangiogenic function of
fibrinogen E-fragment resides in this part of the molecule by testing
the effects of equimolar amounts of fibrinopeptide A alone on HuDMEC
migration and tubule formation. This fragment did not exert a
significant effect on either HuDMEC activity in either assay (data not
shown), suggesting that the active site resides either in the central E
domain of the fibrinogen E-fragment or in the fibrinopeptide A part of
the NH2 terminus of the
chain, but is only held in the
correct confirmation for biological activity when it is attached to the
rest of the fragment.
In summary, this report is the first to demonstrate the antiangiogenic
activity of fibrinogen E-fragment in vitro. Moreover, the
fact that it inhibits VEGF and bFGF-induced changes in endothelial cell
function but leaves cells unaffected in the absence of these angiogenic
stimuli bids well for the likely specificity of its effects in
vivo. It remains to be seen whether the in vivo effects
of fibrinogen E-fragment are confined to areas of such growth
factor-induced angiogenic activity as occurs in tumors or whether it
also disrupts the activity of cells lining quiescent, normal vessels.
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ACKNOWLEDGMENTS
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We thank Drs. Douglas Thompson and Chris Stirk for helpful
advice in the preparation of the manuscript.
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FOOTNOTES
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
1 To whom requests for reprints should be
addressed, at Section of Pathology, The University of Sheffield, Beech
Hill Road, Sheffield S10 2RX, United Kingdom. 
2 The abbreviations used are: VEGF, vascular
endothelial growth factor; bFGF, basic fibroblast growth factor;
HuDMEC, human dermal microvascular endothelial cell; MTT,
3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide; GF,
growth factor. 
Received 4/ 3/00.
Accepted 7/17/00.
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Hemostatic Regulators of Tumor Angiogenesis: A Source of Antiangiogenic Agents for Cancer Treatment?
J Natl Cancer Inst,
November 19, 2003;
95(22):
1660 - 1673.
[Abstract]
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J. R. Merchan, B. Chan, S. Kale, L. E. Schnipper, and V. P. Sukhatme
In Vitro and In Vivo Induction of Antiangiogenic Activity by Plasminogen Activators and Captopril
J Natl Cancer Inst,
March 5, 2003;
95(5):
388 - 399.
[Abstract]
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M. Crowther, N. J. Brown, E. T. Bishop, and C. E. Lewis
Microenvironmental influence on macrophage regulation of angiogenesis in wounds and malignant tumors
J. Leukoc. Biol.,
October 1, 2001;
70(4):
478 - 490.
[Abstract]
[Full Text]
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