Book Review

Angiogenesis: An Integrative Approach from Science to Medicine

N Engl J Med 2008; 359:2505-2506December 4, 2008

Article

Angiogenesis: An Integrative Approach from Science to Medicine
Edited by William D. Figg and Judah Folkman. 601 pp., illustrated. New York, Springer, 2008. $149. ISBN: 978-0-387-71517-9

In 1969, the young surgeon Judah Folkman made a clinical observation that elevated the study of angiogenesis to a scientific discipline and led to new therapies for cancer, eye diseases, and chronic wounds, as well as therapies that are still under development for other diseases. Folkman observed that metastases from richly vascularized retinoblastoma that had seeded the avascular aqueous humor of the eye were incapable of growing beyond a very small size. He deduced from this observation that the acquisition of a vascular supply was a critical event for the ongoing growth of a tumor and its metastasis, and he further speculated in 1971 that “tumor growth is angiogenesis dependent.”

This hypothesis was met with a great deal of skepticism, and Folkman was fond of showing a graph of the number of papers with the word “angiogenesis” in the title that were published over the years. He pointed out that for many years after he proposed his hypothesis, the curve remained flat because his group was virtually the only one working in the field of angiogenesis. In the mid- to-late 1980s, however, this all changed with the discovery of both angiogenic molecules and angiogenesis inhibitors.

Folkman, who died suddenly earlier this year, assembled his final masterpiece in Angiogenesis, a book he coedited with William Figg. It is a fitting memorial to Folkman, who changed the practice of medicine not only by discovering the critical importance of angiogenesis, but also by illuminating a path for clinically relevant discovery that will be followed by generations of researchers.

The introductory chapter on the history of angiogenesis, written by Folkman, is a fascinating firsthand account of the birth and maturation of a biomedical discipline and its effect on clinical medicine. Anyone with even a passing interest in angiogenesis, in the process of scientific discovery, or in therapeutic development will be fascinated by his narrative. The reader simply cannot help being drawn into the book by this story.

The chapters are thoughtfully organized to provide a background on the biology of the angiogenic process, a comprehensive overview of the proteins (both soluble and receptor) that govern angiogenesis, reviews of the key molecular and cellular mechanisms of the angiogenic process, discussion of the methods that are used for the functional assessment of angiogenesis, and information about the clinical translation of these discoveries into the modulation of angiogenesis.

The text, written by well-known contributors to the field, is complemented by a large number of helpful schematics and photomicrographs. The references are extensive and encyclopedic. In summary, if I were to have a single textbook on this subject on my bookshelf, this book would have no competition. It is likely that this will be the authoritative text on angiogenesis for many years to come.

Douglas W. Losordo, M.D.
Northwestern University Feinberg School of Medicine, Chicago, IL 60611
d-losordo@northwestern.edu