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**VEGF-B186** is an isoform of human vascular endothelial growth factor B, specifically the full-length, 186-amino-acid form, predominantly associated with angiogenesis in cardiac tissue. Its mechanism of action involves binding to **VEGF receptor 1 (VEGFR-1)** on endothelial cells, which promotes angiogenesis by recruiting endothelial progenitor cells, upregulating proangiogenic factors, and improving myocardial perfusion[^1][^3]. After proteolytic processing, VEGF-B186 also binds to neuropilin 1 (NRP1) and neuropilin 2 (NRP2), though the angiogenic effect prior to processing is more pronounced[^3][^1]. While effective at inducing vascular growth, studies have suggested risks for ventricular arrhythmias mediated via NRP1 following gene transfer[^1][^3]. It has been developed and studied primarily for **cardiac therapeutic angiogenesis** (particularly after myocardial ischemia), with candidate applications in coronary heart disease, and, more broadly, tissue rescue following ischemic insult.
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