Pharmacological revascularisation in coronary and peripheral vascular disease.
Therapeutic angiogenesis is a novel approach to the treatment of ischaemic or occlusive coronary and peripheral vascular disease. The therapeutic concept is based on the restoration of distal blood flow by the enlargement of existing vessels and tissue perfusion by the induction of new capillaries. Initial studies have focused on the direct application of endothelial growth factors, vascular endothelial growth factor and fibroblast growth factor, or the delivery of genes using either a plasmid or adenoviral vector. Recently, new angiogenic agents such as hypoxia inducible factor-1alpha, fibroblast growth factor-4, Del-1 and hepatocyte growth factor have entered clinical testing. Moreover, stem-cell therapy or factors mobilising bone marrow progenitor cells have provided evidence for a new avenue for therapeutic angiogenesis. Numerous preclinical studies and several initial clinical trials have provided encouraging data in support of the feasibility of promoting biological revascularisation by the administration of angiogenic factors or cells.
Tarzami
Sima T
ST
Lilly Reseach Laboratories, Cardiovascular Division, Lilly Corporate Center, Indianapolis, IN 46285, USA.
Singh
Jai Pal
JP
D043925:Angiogenesis Inducing Agents / Q000494:pharmacology; D000818:Animals; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D005346:Fibroblast Growth Factors / Q000502:physiology; D006801:Humans; D018919:Neovascularization, Physiologic / Q000502:physiology*; D016491:Peripheral Vascular Diseases / Q000503:physiopathology*; D042461:Vascular Endothelial Growth Factor A / Q000502:physiology*
D043925:Angiogenesis Inducing Agents; D042461:Vascular Endothelial Growth Factor A; D005346:Fibroblast Growth Factors