Protein therapeutics for cardiac regeneration after myocardial infarction.
Although most medicines have historically been small molecules, many newly approved drugs are derived from proteins. Protein therapies have been developed for treatment of diseases in almost every organ system, including the heart. Great excitement has now arisen in the field of regenerative medicine, particularly for cardiac regeneration after myocardial infarction. Every year, millions of people suffer from acute myocardial infarction, but the adult mammalian myocardium has limited regeneration potential. Regeneration of the heart after myocardium infarction is therefore an exciting target for protein therapeutics. In this review, we discuss different classes of proteins that have therapeutic potential to regenerate the heart after myocardial infarction. Protein candidates have been described that induce angiogenesis, including fibroblast growth factors and vascular endothelial growth factors, although thus far clinical development has been disappointing. Chemotactic factors that attract stem cells, e.g., hepatocyte growth factor and stromal cell-derived factor-1, may also be useful. Finally, neuregulins and periostin are proteins that induce cell-cycle reentry of cardiomyocytes, and growth factors like IGF-1 can induce growth and differentiation of stem cells. As our knowledge of the biology of regenerative processes and the role of specific proteins in these processes increases, the use of proteins as regenerative drugs could develop as a cardiac therapy.
Segers
Vincent F M
VF
Provasculon Inc., 14 Cambridge Center, Building 1, Cambridge, MA 02142, USA.
Lee
Richard T
RT
D042501:Angiogenic Proteins / Q000627:therapeutic use; D000818:Animals; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002454:Cell Differentiation / Q000187:drug effects; D002465:Cell Movement / Q000187:drug effects; D049109:Cell Proliferation / Q000187:drug effects; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology*; D018919:Neovascularization, Physiologic / Q000187:drug effects; D011506:Proteins / Q000627:therapeutic use*; D012038:Regeneration / Q000187:drug effects*; D044968:Regenerative Medicine; D013234:Stem Cells / Q000187:drug effects / Q000473:pathology; D057170:Translational Research, Biomedical
D042501:Angiogenic Proteins; D002317:Cardiovascular Agents; D011506:Proteins