Ocular angiogenesis, the pathologic growth of new blood vessels in the eye, is a leading cause of blindness worldwide. Neovascularization is responsible for many severe ocular disorders, such as corneal conjunctivalization, neovascular glaucoma, diabetic retinopathy, age-related macular degeneration, and retinopathy of prematurity.
1 2 The control of ocular neovascularization would be promising for the treatment of these disorders. Similar to the well-known angiogenic mechanism in tumor growth, neovascularization in the eye is also considered to result from an imbalance between stimulatory and inhibitory angiogenic factors.
3 4 The elevated expression of stimulatory factors and/or the downregulation of inhibitory factors is often observed in pathologic conditions such as ocular inflammation and ischemia.
5 6 7 8 In contrast to these pathologic conditions, ocular tissues are maintained physiologically without the occurrence of neovascularization, and vasculature in the eye is highly restricted despite the presence of many angiogenesis-stimulating molecules in the eye, such as basic fibroblast growth factor (bFGF),
9 10 insulin-like growth factor (IGF)-1,
11 and vascular endothelial growth factor (VEGF).
12 13 These findings suggest the physiological existence in the eye of angiogenesis inhibitors to counterbalance these stimulators. Potent inhibitory factors have been thought to exist in the retinal pigment epithelium (RPE),
14 the vitreous body,
15 16 17 18 19 and the lens,
20 although most of them have not been isolated yet. Up to date, pigment epithelium-derived factor (PEDF), a neurotrophic factor and a member of the serine protease inhibitor superfamily, has been identified as a major angiogenesis inhibitor in the eye.
21 22 23 Recently, we demonstrated that chondromodulin (ChM)-I, a ∼25-kDa glycoprotein purified as a cartilage-derived chondrocyte growth factor,
24 is another angiogenesis inhibitor specifically expressed not only in the cartilaginous tissues but also in the eye.
25 26 27 28 ChM-I is expressed in the ciliary body, the ganglion cell layer of the retina, and the RPE,
27 28 and suppresses proliferation and capillary formation of retinal vascular endothelial cells in vitro and angiogenesis in vivo.
25 28 29 30