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VEGF-A and Notch signaling pathways are key players governing tip and stalk cell behavior. Normal sprouting angiogenesis in the mouse retina requires a gradient of the pro-angiogenic factor VEGF-A. This local VEGF-A gradient is produced by the preformed astrocyte network that serves as a guiding scaffold for the developing retinal plexus. In fact, the tip cells are closely attached to the astrocytes, and their filopodia extend along the astrocytes toward higher VEGF-A concentrations in this gradient. Interestingly, if VEGF-A stimulation is blocked using sVEGFR1 or neutralizing the signaling through VEGFR2 with antibodies, the tip cell filopodia are completely retracted in the sprouting retinal front, preventing tip cell migration and thus progression of vascular sprouting seizes. In contrast, stimulation of quiescent vessels with VEGF-A induces filopodia formation and tip cell gene expression, together illustrating that VEGF-A is both necessary and sufficient to induce endothelial tip cells. Similar observations in zebrafishembryogenesis and other tissues in the mouse confirm the general importance of this concept.

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