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Vascular endothelial growth factor receptor 2, Vascular endothelial growth factor receptor 3 (VEGFR2, VEGFR3)

Target
VEGFR2, VEGFR3
Molecular classification
Receptor tyrosine kinase, Receptor, Enzyme (Tyrosine kinase family)
01

Overview

Vascular endothelial growth factor receptor 2 (VEGFR2) and vascular endothelial growth factor receptor 3 (VEGFR3) are transmembrane receptor tyrosine kinases primarily expressed on endothelial cells. VEGFR2 is the principal mediator of angiogenesis, controlling endothelial cell proliferation, migration, survival, and vascular permeability in response to VEGF-A, and is critical for vascular development and neovascularization in both physiological and pathological conditions such as cancer and eye disease[3][5][7][8]. VEGFR3 primarily regulates lymphangiogenesis via binding to VEGF-C and VEGF-D, and is essential for lymphatic vascular development and function[1][4][7]. Both receptors have a similar modular structure with seven extracellular immunoglobulin-like domains, a single transmembrane domain, and a split intracellular tyrosine kinase domain[1][3][5]. They are established therapeutic targets in oncology and vascular-related diseases, with multiple approved drugs targeting one or both receptors via antibody and small molecule mechanisms[3][5][6]. Major therapeutic challenges include management of side effects such as hypertension and edema, and resistance mechanisms arising during long-term therapy[5][7].

Other names
VEGFR2: Kinase insert domain receptor (KDR)VEGFR2: Fetal liver kinase 1 (Flk-1)VEGFR3: Fms-like tyrosine kinase 4 (FLT4)
02

Mechanism of action

Inhibition of VEGF ligand binding (antibodies or ligand traps); Inhibition of receptor tyrosine kinase activity (small molecule tyrosine kinase inhibitors); Disruption of downstream signaling pathways leading to blockade of angiogenesis and/or lymphangiogenesis, endothelial cell proliferation, migration, and survival[3][5][6]

03

Biological functions

Angiogenesis (formation of blood vessels): mainly VEGFR2[5][7][8]Lymphangiogenesis (formation of lymph vessels): mainly VEGFR3[1][3][4]Endothelial cell proliferation and survival (predominantly VEGFR2)[5][7][8]Vascular permeability regulation (VEGFR2)[7]Embryonic vascular and hematopoietic development (VEGFR2)[5][8]
04

Disease associations

Cancer (tumor angiogenesis and metastasis)[1][3][4][8]Vascular diseases (including retinopathies, macular degeneration, atherosclerosis, hypertension)[3][5][7]Lymphedema (VEGFR3)[1][4][7]Inflammation[3][5][7][8]Neurodegenerative disease (contribution suggested for VEGFR2)[7]Others: developmental disorders[5][8]
05

Safety considerations

Hypertension (due to decreased nitric oxide-mediated vasodilation)[3][5]Proteinuria and renal toxicityImpaired wound healingHemorrhage and thromboembolic eventsGastrointestinal perforation (rare, but a serious risk with VEGF inhibitors)[3][5]Lymphedema (notably with excessive VEGFR3 inhibition)[1][7]
06

Interacting drugs

Bevacizumab (inhibits VEGF-A/VEGFR2)[3][5]

3 more in the full profile.

07

Biomarkers

VEGFR2 and VEGFR3 expression levels in tumor or endothelial tissue (immunohistochemistry, RNA)[3][5]Circulating VEGF-A, VEGF-C, or VEGF-D (ligand levels)Phosphorylated VEGFR2/3 as markers of activation[3][5][7]

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