Therapeutic angiogenesis for ischemic disorders: what is missing for clinical benefits?
The idea of promoting angiogenesis in ischemic tissues remains an undisputed therapeutic approach for the treatment of myocardium and skeletal muscles that lack sufficient blood supply. However, clinical experiences from several large trials indicated that delivery of proangiogenic factors to patients suffering from myocardial infarction and leg ischemia has not shown significant benefits. Despite continuous success in various animal disease models, why has this simple principle not shown proof of concept in patients? What has been missing in the trial deign? What are the differences between animal models and patients? What are the optimal components for promoting functional collateral networks? This brief review discusses molecular mechanisms underlying arteriogenesis and proposes novel approaches for improvement of therapeutic outcomes.
Cao
Yihai
Y
Department of Microbiology and Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden. Yihai.Cao@ki.se
D003131:Combined Modality Therapy; D006801:Humans; D007511:Ischemia / Q000503:physiopathology / Q000628:therapy*; D018919:Neovascularization, Physiologic