title: Angiogenic gene therapy in cardiovascular diseases: dream or vision?
abstract: Chronic cardiovascular diseases are significant health problems. Although current treatment strategies have tremendously improved disease management, up to 30% of these patients cannot be successfully treated with current treatment approaches and new treatment strategies are clearly needed. Gene therapy and therapeutic vascular growth may provide a new treatment option for these patients. Several growth factors, like vascular endothelial growth factors, fibroblast growth factors and hepatocyte growth factor have been tested in clinical trials. However, apart from demonstration of increased vascularity, very few results with clinical significance have been obtained. Problems with gene transfer efficiency, short duration of transgene expression, selection of endpoints, and suboptimal patients for gene therapy have been recognized. Ongoing gene therapy trials have included improvements in study protocols, vector delivery and endpoints, addressing the identified problems. Better, targeted delivery systems and new, more optimal growth factors have been taken to clinical testing. Recent advances in these areas will be discussed and the concept of angiogenic therapy as a sole treatment is re-evaluated. A combination with regenerative therapies or standard revascularization operations might be needed to improve tissue function and clinical benefits.
authors.affiliation: Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, P.O. Box 1627, Kuopio 70211, Finland.|Heart Center, Kuopio University Hospital, Puijonlaaksontie 2, 70210 Kuopio, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Ylä-Herttuala
authors.affiliation: Cardiovascular Research Center, Mount Sinai School of Medicine, 1470 Madison Avenue, New York, New York 10029, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Bridges
authors.affiliation: Cardiovascular Research Center, Mount Sinai School of Medicine, 1470 Madison Avenue, New York, New York 10029, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Katz
authors.affiliation: Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, P.O. Box 1627, Kuopio 70211, Finland.
authors.forename: Petra
authors.initials: P
authors.lastname: Korpisalo
mesh_terms: D043925:Angiogenesis Inducing Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000628:therapy*; D002986:Clinical Trials as Topic; D005544:Forecasting; D018014:Gene Transfer Techniques; D015316:Genetic Therapy / Q000379:methods*; D005822:Genetic Vectors; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D017202:Myocardial Ischemia / Q000628:therapy; D018579:Patient Selection; D016491:Peripheral Vascular Diseases / Q000628:therapy; D042442:Vascular Endothelial Growth Factors / Q000235:genetics
chemical_list: D043925:Angiogenesis Inducing Agents; D042442:Vascular Endothelial Growth Factors
keywords: Angiogenesis; Coronary heart disease; Gene delivery; Gene therapy; Growth factors; Heart failure; Peripheral arterial disease