Angiogenesis expands the vascular network during normal development and in response to angiogenic stress. Dysregulation of this dynamic process contributes to tumor progression and to the pathogenesis of many diseases. Evidence suggests that the alpha2beta1 integrin, a collagen and laminin receptor, plays an important role in angiogenesis. In the wound-healing and tumor microenvironment, deletion of the alpha2beta1 integrin has been reported to increase neoangiogenesis. In contrast, small molecule inhibitor (SMI) targeting of the alpha2 integrin blocks sprouting angiogenesis.

To reconcile these divergent findings and gain a fuller understanding of alpha2beta1 integrin's role in angiogenesis we turned to the retina. The retinal model is uniquely suited for angiogenesis investigations as the retinal vasculature develops postnatally in a 2-dimensional plane in a well-characterized manner. Evaluation of the alpha2-null retina reveals a constellation of defects and delays in vascular development, including delayed vessel outgrowth, and increased vessel irregularity and decreased plexus density at the vascular front.

Additionally we determined that alpha2 integrin-deletion has a protective effect in an oxygen-induced retinopathy model of retinopathy of prematurity (ROP) in mice by inhibiting both hyperoxia-induced vaso-obliteration and hypoxia-induced pathologic neovascularization. Confirming this result, our analysis of human microarray data shows, for the first time, that preterm infants with lower ITGA2 expression are less likely to suffer from ROP. This work clarifies the role of alpha2beta1 integrin in sprouting angiogenesis and raises the intriguing possibility of alpha2 integrin targeted therapies for prevention of ROP.

These changes are reminiscent of changes observed in other models with dysregulated notch signaling. Recent studies reported that the alpha2beta1 integrin regulates sprouting angiogenesis by inducing DLL4 in ‘tip cells’. We show, for the first time, notch induced downregulation of alpha2beta1 integrin expression in ‘stalk cells’. Together these results suggest that the alpha2beta1 integrin coordinates endothelial notch signaling by stabilizing tip-stalk status. The apparent discrepancy between the effects of the alpha2 integrin inhibition and integrin-deletion may reflect differences between acute and chronic upregulation of notch signaling. We propose that synergistic use of notch and alpha2 integrin targeted therapies may provide enhanced anti-tumor angiogenesis.

Citation Format: Aasakiran Madamanchi, Megan Capozzi, Ling Geng, Zhengzhi Li, Zhonghua Zhang, Richard Friedman, Kent Dickeson, John Penn, Mary Zutter. Alpha2beta1 integrin regulation of endothelial notch signaling in the retina. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3900. doi:10.1158/1538-7445.AM2013-3900