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Therapeutic angiogenesis: protein and gene therapy delivery strategies
T K Rosengart1, S R Patel, R G Crystal
1Department of Cardiothoracic Surgery, New York Hospital-Cornell Medical Center, New York, USA.
Insights
Therapeutic angiogenesis promotes new blood vessel growth to treat vascular disease when other methods fail. This approach uses protein or gene delivery to stimulate the body's natural healing processes for better blood flow.
Area of Science:
- Cardiovascular Research
- Regenerative Medicine
- Biotechnology
Background:
- Atherosclerosis treatments like angioplasty and bypass surgery have limitations, including restenosis and graft occlusion.
- Severe or widespread vascular disease limits treatment options for many patients.
- Angiogenesis, the formation of new blood vessels, is a natural response to ischemia, providing collateral circulation.
Purpose of the Study:
- To explore therapeutic angiogenesis as a strategy to improve vascularization in patients with limited treatment options.
- To review existing methods for delivering therapeutic angiogenesis agents.
- To highlight the potential of enhancing the body's natural collateral circulation formation.
Main Methods:
- Review of current therapeutic angiogenesis strategies.
- Discussion of protein-based angiogen delivery (acute and sustained-release).
- Exploration of gene therapy approaches for delivering angiogen-coding genes.
Main Results:
- Therapeutic angiogenesis offers an alternative for patients unsuitable for conventional therapies.
- Both protein and gene-based delivery systems are viable for therapeutic angiogenesis.
- Augmenting native angiogenic processes can enhance collateral vasculature formation.
Conclusions:
- Therapeutic angiogenesis presents a promising strategy to address limitations of current vascular interventions.
- Delivery techniques for protein and gene-based angiogens are advancing.
- Enhancing biological revascularization is key to treating complex vascular pathologies.
Abstract:
Angioplasty and surgical bypass, the primary interventional therapies for the treatment of atherosclerosis, are limited by the development over time of native vessel restenoses and graft occlusions. Furthermore, these therapies are not options for a significant number of individuals in whom the extent of vascular pathology is especially severe or widespread. Angiogenesis, the growth of new vasculature, is a critical biological response to ischemia that provides collateralization, or 'biological revascularization' of vascular obstructions. Therapeutic angiogenesis is a strategy whereby one of several known 'angiogens', mediators that induce angiogenesis, can be administered to augment the native angiogenic processes and enhance the formation of collateral vasculature. This report describes the techniques available for providing therapeutic angiogenesis, including acute and sustained-release techniques to deliver protein angiogens and a number of gene therapy strategies to deliver genes coding for the angiogens.