Preventing local regeneration of glucocorticoids by 11beta-hydroxysteroid dehydrogenase type 1 enhances angiogenesis

Angiogenesis restores blood flow to healing tissues, a process that is inhibited by high doses of glucocorticoids. However, the role of endogenous glucocorticoids and the potential for antiglucocorticoid therapy to enhance angiogenesis is unknown. Usingin vitroandin vivomodels of angiogenesis in mice, we examined effects of (i) endogenous glucocorticoids, (ii) blocking endogenous glucocorticoid action with the glucocorticoid receptor antagonist RU38486, and (iii) abolishing local regeneration of glucocorticoids by the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11βHSD1). Glucocorticoids, administered at physiological concentrations, inhibited angiogenesis in anin vitroaortic ring model andin vivoin polyurethane sponges implanted s.c. RU38486-enhanced angiogenesis in s.c. sponges, in healing surgical wounds, and in the myocardium of mice 7 days after myocardial infarction induced by coronary artery ligation. 11βHSD1 knockout mice showed enhanced angiogenesisin vitroandin vivowithin sponges, wounds, and infarcted myocardium. Endogenous glucocorticoids, including those generated locally by 11βHSD1, exert tonic inhibition of angiogenesis. Inhibition of 11βHSD1 in liver and adipose has been advocated to reduce cardiovascular risk in the metabolic syndrome: these data suggest that 11βHSD1 inhibition offers a previously uncharacterized therapeutic approach to improve healing of ischemic or injured tissue.