Changing the logic of therapeutic angiogenesis for ischemic disease.
The worldwide epidemic of ischemic disease urgently requires innovative treatments. Recently, therapeutic angiogenesis has emerged as a noninvasive supply-side approach, aimed at promoting neovascularization in underperfused tissues through the local delivery of angiogenic growth factors. Successful preclinical studies paved the way for the first clinical trials, with single growth factors given as recombinant proteins or genes. However, clinical results have not matched the initial promises. Our opinion is that the logic of therapeutic angiogenesis needs profound revision. Here, we introduce the concept that pleiotropic agents can stimulate the healing of all the components of ischemic tissue. We also propose prophylactic interventions to delay vascular senescence. The optimization of therapeutic angiogenesis will open unprecedented opportunities for the care of life-threatening ischemic disease.
Emanueli
Costanza
C
Molecular and Cellular Medicine, Porto Conte Ricerche Technological Park and Experimental Medicine, and Gene Therapy, INBB Inter-University Consortium, Via S. Antonio s.n.c., 07033 Osilo (SS), Italy.
Madeddu
Paolo
P
D043925:Angiogenesis Inducing Agents / Q000627:therapeutic use; D000818:Animals; D002986:Clinical Trials as Topic; D006801:Humans; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000628:therapy*; D009389:Neovascularization, Pathologic / Q000628:therapy*; D018919:Neovascularization, Physiologic / Q000502:physiology; D011994:Recombinant Proteins / Q000627:therapeutic use
D043925:Angiogenesis Inducing Agents; D011994:Recombinant Proteins