A shift of the angiogenic balance to the proangiogenic state, termed the "angiogenic switch," is a hallmark of
cancer progression. Here we devise a strategy for identifying genetic participants of the angiogenic switch based on inverse regulation of genes in human endothelial cells in response to key endogenous pro- and antiangiogenic
proteins. This approach reveals a global network pattern for vascular homeostasis connecting known angiogenesis-related genes with previously unknown signaling components. We also demonstrate that the angiogenic switch is governed by simultaneous regulations of multiple genes organized as transcriptional circuitries. In
pancreatic cancer patients, we validate the transcriptome-derived switch of the identified "angiogenic network:" The angiogenic state in
chronic pancreatitis specimens is intermediate between the normal (angiogenesis off) and neoplastic (angiogenesis on) condition, suggesting that aberrant proangiogenic environment contributes to the increased
cancer risk in patients with
chronic pancreatitis. In knockout experiments in mice, we show that the targeted removal of a hub node (peroxisome proliferative-activated
receptor delta) of the angiogenic network markedly impairs angiogenesis and
tumor growth. Further, in
tumor patients, we show that peroxisome proliferative-activated
receptor delta expression levels are correlated with advanced pathological
tumor stage, increased risk for
tumor recurrence, and distant
metastasis. Our results therefore also may contribute to the rational design of antiangiogenic
cancer agents; whereas "narrow" targeted
cancer drugs may fail to shift the robust angiogenic regulatory network toward antiangiogenesis, the network may be more vulnerable to multiple or broad-spectrum inhibitors or to the targeted removal of the identified angiogenic "hub" nodes.