[Perspectives of gene therapy in ischemic syndromes of the lower limbs].
In recent years, new knowledge has been provided from the study of the biological mechanisms underlying the angiogenic process, i.e. the development of a new vasculature from preexisting blood vessels. These advances suggested a possible new approach for the therapy of peripheral obstructive arterial disease, based on the treatment of ischemic tissues with angiogenic growth factors. As demonstrated by experimental studies in animal models, a therapeutic effect can be reached as the newly formed vascular network, functioning as a biologic by-pass, restores a normal blood supply to the ischemic territories. New techniques of gene therapy proved effective in reaching sustained concentrations of angiogenic factors in the target tissues. This paper will briefly describe the methodological background, the results of the early clinical applications of angiogenic gene therapy and the open questions that need to be addressed before this new approach can be proposed as an effective option instead of existing medical and surgical therapies.
Melillo
G
G
Laboratorio di Patologia Vascolare, IRCCS Istituto Dermopatico dell'Immacolata, Roma.
Capogrossi
M C
MC
D001157:Arterial Occlusive Diseases / Q000628:therapy*; D016228:Endothelial Growth Factors; D005346:Fibroblast Growth Factors; D015316:Genetic Therapy; D006801:Humans; D007866:Leg / Q000098:blood supply; D008222:Lymphokines; D018919:Neovascularization, Physiologic; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D016228:Endothelial Growth Factors; D008222:Lymphokines; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D005346:Fibroblast Growth Factors