<table class="infobox infobox-protein">
<tr>
<th class="infobox-header" colspan="2">VEGFR1 (FLT1) Protein</th>
</tr>
<tr>
<td class="label">Structural Feature</td>
<td>Details</td>
</tr>
<tr>
<td class="label">Full length</td>
<td>1,338 amino acids, ~180 kDa</td>
</tr>
<tr>
<td class="label">Extracellular</td>
<td>7 Ig-like domains (aa 1-764)</td>
</tr>
<tr>
<td class="label">Transmembrane</td>
<td>aa 765-787</td>
</tr>
<tr>
<td class="label">Kinase domain</td>
<td>aa 833-1,058</td>
</tr>
<tr>
<td class="label">Soluble form</td>
<td>sVEGFR1 (~110 kDa, Ig domains 1-6)</td>
</tr>
<tr>
<td class="label">UniProt ID</td>
<td>P17948</td>
</tr>
<tr>
<td class="label">Gene</td>
<td>FLT1 (chromosome 13q12)</td>
</tr>
</table>
<table class="infobox infobox-protein">
<tr>
<th class="infobox-header" colspan="2">VEGFR1 (FLT1) Protein</th>
</tr>
<tr>
<td class="label">Structural Feature</td>
<td>Details</td>
</tr>
<tr>
<td class="label">Full length</td>
<td>1,338 amino acids, ~180 kDa</td>
</tr>
<tr>
<td class="label">Extracellular</td>
<td>7 Ig-like domains (aa 1-764)</td>
</tr>
<tr>
<td class="label">Transmembrane</td>
<td>aa 765-787</td>
</tr>
<tr>
<td class="label">Kinase domain</td>
<td>aa 833-1,058</td>
</tr>
<tr>
<td class="label">Soluble form</td>
<td>sVEGFR1 (~110 kDa, Ig domains 1-6)</td>
</tr>
<tr>
<td class="label">UniProt ID</td>
<td>P17948</td>
</tr>
<tr>
<td class="label">Gene</td>
<td>FLT1 (chromosome 13q12)</td>
</tr>
</table>
Vascular Endothelial Growth Factor Receptor 1 (VEGFR1, encoded by the FLT1 gene) is a high-affinity receptor for VEGF family ligands. It plays complex roles in angiogenesis, inflammation, and has been implicated in neurodegenerative disease through its effects on the neurovascular unit, inflammatory responses, and direct neuronal signaling. [@zlokovic2011]
VEGFR1 (FLT1) is a receptor tyrosine kinase of approximately 180 kDa. It consists of:
VEGFR1 is a critical regulator of blood vessel formation during development and in adult physiology. It binds VEGFA with ~10-fold higher affinity than VEGFR2 (KDR/FLK1), but has weaker tyrosine kinase activity, making its signaling more nuanced. VEGFR1 acts in two modes:
VEGFR1 is expressed on hematopoietic stem cells and vascular endothelial progenitors. The VEGFR1+ hematopoietic stem cell niche is located near blood vessels in the bone marrow. PlGF-VEGFR1 signaling supports hematopoietic stem cell mobilization and recruitment to sites of injury.
A unique feature of VEGFR1 is its expression on monocyte/macrophage lineage cells, where it mediates chemotaxis in response to VEGFA and PlGF. This establishes VEGFR1 as a regulator of inflammatory cell recruitment to sites of angiogenesis and tissue damage.
In Alzheimer's disease (AD), VEGFR1 is implicated in neurovascular dysfunction, a recognized component of AD pathogenesis. [@zlokovic2011]
Neurovascular unit dysfunction: The neurovascular unit (NVU), comprising cerebral endothelial cells, pericytes, astrocytes, and neurons, requires coordinated VEGF-VEGFR signaling for maintenance of blood-brain barrier (BBB) integrity and cerebral blood flow. In AD, VEGFR1 expression is dysregulated in brain endothelial cells and pericytes, contributing to:
VEGFR1 is expressed in dopaminergic neurons of the substantia nigra pars compacta (SNpc), where it may modulate neuroprotection. [@liu2018]
Neurotrophic signaling: In PD models, VEGFA (via VEGFR1) provides trophic support to dopaminergic neurons. In vitro studies show that VEGFA treatment protects SNpc neurons from 6-OHDA and MPTP toxicity, and this protection is mediated through VEGFR1 activation of PI3K/Akt and MAPK pathways.
Microglial activation: VEGFR1 on microglia and infiltrating macrophages mediates their chemotaxis toward VEGF gradients. In the PD SNpc, where chronic neuroinflammation drives progression, VEGFR1-mediated microglial recruitment may amplify the inflammatory cascade. Blocking VEGFR1 signaling reduces microglial activation markers (CD68, Iba1) in mouse models.
Angiogenesis in PD: Unlike AD, where angiogenesis is dysregulated and often counterproductive, PD shows reduced angiogenic signaling. VEGFA and VEGFR1 expression are decreased in PD SNpc compared to controls, and this "angiogenic failure" may contribute to the progressive loss of dopaminergic neurons due to reduced vascular support.
Since MS shares neuroinflammatory features with neurodegenerative diseases, VEGFR1 studies in MS are instructive. [@alvarez2011] Active MS lesions show elevated VEGFR1 on endothelial cells and microglia. VEGFR1-mediated angiogenesis is prominent at the borders of chronic active lesions, and anti-VEGF therapy reduces lesion size and inflammatory cell infiltration in EAE models. This suggests VEGFR1 contributes to inflammatory angiogenesis in demyelinating disease.
Following focal cerebral ischemia, VEGFA and VEGFR1 are rapidly upregulated in endothelial cells, astrocytes, and neurons at the ischemic border. [@kande2015] This represents a compensatory angiogenic response. However, excessive or dysregulated VEGFR1 signaling in the post-ischemic brain can promote vascular leakage, blood-brain barrier disruption, and exacerbate inflammation. Therapeutically, moderate enhancement of VEGF/VEGFR signaling improves post-ischemic recovery, while overactivation worsens outcomes.
Given the role of dysregulated angiogenesis and VEGFR1 signaling in AD and cancer, several anti-VEGFR1 strategies have been explored:
For PD, where angiogenic failure may contribute to neuronal loss, pro-angiogenic strategies are being investigated: