Gene therapy and angiogenesis in patients with coronary artery disease.
Not all patients with severe coronary artery disease can be treated satisfactorily with current recommended medications and revascularization techniques. Various vascular growth factors have the potential to induce angiogenesis in ischemic tissue. Clinical trials have only evaluated the effect of VEGF and FGF in patients with coronary artery disease. The initial small and unblinded studies with either recombinant growth factor proteins or genes encoding growth factors were encouraging, demonstrating both clinical improvement and evidence of angiogenesis. However, subsequent larger double-blind placebo-controlled trials could not confirm the initial high efficacy of either the growth factor protein or the gene therapy approaches observed in earlier small trials. The clinical studies so far have all been without any gene-related serious adverse events. Future trials will focus on whether an improvement in clinical results can be obtained with a cocktail of growth factors or by a combination of gene and stem cell therapy in patients with severe coronary artery disease, which cannot be treated effectively with current treatment strategies.
Kastrup
Jens
J
Cardiac Catheterization Laboratory 2014, The Hearth Centre, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. jens.kastrup@rh.regionh.dk
D043925:Angiogenesis Inducing Agents / Q000008:administration & dosage*; D000818:Animals; D002986:Clinical Trials as Topic; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000628:therapy*; D005346:Fibroblast Growth Factors / Q000008:administration & dosage; D015316:Genetic Therapy / Q000379:methods*; D006801:Humans; D018919:Neovascularization, Physiologic; D012720:Severity of Illness Index; D042442:Vascular Endothelial Growth Factors / Q000008:administration & dosage
D043925:Angiogenesis Inducing Agents; D042442:Vascular Endothelial Growth Factors; D005346:Fibroblast Growth Factors