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Endothelial cell delivery for cardiovascular therapy
1Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
Insights
Endothelial cell delivery offers a promising therapeutic approach for vascular disease. This strategy utilizes cell-based therapies to maintain prosthetic integrity and treat conditions like restenosis and proliferative vascular arteriopathy.
Area of Science:
- Cardiovascular Biology
- Regenerative Medicine
- Vascular Surgery
Background:
- Obstructive atherosclerotic vascular disease is a major global health concern.
- Endothelial cells play a critical role in vascular health and response to injury.
- Current therapies for vascular disease are limited, necessitating novel approaches.
Purpose of the Study:
- To review the role of endothelial cells in vascular biology and disease.
- To explore endothelial cell delivery as a therapeutic modality for cardiovascular conditions.
- To discuss surgical and interventional approaches for cell-based vascular therapy.
Main Methods:
- Review of normal blood vessel anatomy and endothelium biology.
- Examination of surgical vascular bypass and endothelial cell-seeded grafts.
- Analysis of percutaneous interventions, including endoluminal seeding and gene therapy.
- Discussion of tissue and genetic engineering techniques for vascular grafts.
Main Results:
- Endothelial cell-seeded grafts enhance prosthetic integrity through local delivery of endogenous products.
- Endoluminal endothelial cell seeding shows potential for treating restenosis.
- Gene therapy approaches aim to improve endogenous re-endothelialization.
- Innovations in cell delivery may lead to endothelial cell implants for vascular arteriopathy.
Conclusions:
- Endothelial cell delivery represents a significant advancement in cardiovascular therapy.
- Cell-based strategies offer a promising avenue for managing complex vascular diseases.
- Future innovations may establish endothelial cell implants as a standard treatment for proliferative vascular arteriopathy.
Abstract:
Obstructive atherosclerotic vascular disease stands as one of the greatest public health threats in the world. While a number of therapies have been developed to combat vascular disease, endothelial cell delivery has emerged as a distinct therapeutic modality. In this article, we will review the anatomy of the normal blood vessel and the biology of the intact endothelium, focusing upon its centrality in vascular biology and control over the components of the vascular response to injury so as to understand better the motivation for a cell-based form of therapy. Our discussion of cell delivery for cardiovascular therapy will be divided into surgical and interventional approaches. We will briefly recount the development of artificial grafts for surgical vascular bypass before turning our attention towards endothelial cell seeded vascular grafts, in which endothelial cells effectively provide local delivery of endogenous endothelial secretory products to maintain prosthetic integrity after surgical implantation. New techniques in tissue and genetic engineering of vascular grafts and whole blood vessels will be presented. Methods for percutaneous interventions will be examined as well. We will evaluate results of endoluminal endothelial cell seeding for treatment of restenosis and gene therapy approaches to enhance endogenous re-endothelialization. Finally, we will examine some innovations in endothelial cell delivery that may lead to the development of endothelial cell implants as a novel therapy for controlling proliferative vascular arteriopathy.