Ever since proangiogenic
growth factors have been used as a vascular medicine to treat tissue
ischemia, efforts have been increasingly made to develop a method to enhance efficacy of
growth factors in recreating microvascular networks, especially at low dose. To this end, we hypothesized that
polysaccharides substituted with
sulfate groups would amplify
growth factor receptor activation and stimulate phenotypic activities of endothelial cells involved in neovascularization. We examined this hypothesis by modifying
alginate with a controlled number of
sulfates and using it to derive a complex with
vascular endothelial growth factor (
VEGF), as confirmed with fluorescence resonance energy transfer (FRET) assay. Compared with the bare
VEGF and with a mixture of
VEGF and unmodified
alginates, the
VEGF complexed with
alginate sulfates significantly reduced the dissociation rate with the
VEGFR-2, elevated
VEGFR-2 phosphorylation level, and increased the number of endothelial sprouts in vitro. Furthermore, the
VEGF-
alginate sulfate complex improved recovery of perfusion in an ischemic hindlimb of a mouse due to the increase of the capillary density. Overall, this study not only demonstrates an important cofactor of
VEGF but also uncovers an underlying mechanism by which the cofactor mitigates the
VEGF-induced signaling involved in the binding kinetics and activation of VEGFR. We therefore believe that the results of this study will be highly useful in improving the therapeutic efficacy of various
growth factors and expediting their uses in clinical treatments of
wounds and tissue defects.