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Angiogenesis gene therapy to rescue ischaemic tissues: achievements and future directions
1Cardiovascular Medicine and Gene Therapy Section, National Laboratory of the National Institute of Biostructures and Biosystems, Viale S. Antonio, 07033 Osilo, Italy.
Insights
Therapeutic angiogenesis stimulates collateral vessel growth to repair tissues damaged by ischaemic diseases, offering new hope for patients unresponsive to traditional revascularization. This approach targets myocardial and peripheral ischaemia, addressing critical needs in cardiovascular medicine.
Area of Science:
- Cardiovascular Medicine
- Regenerative Medicine
- Vascular Biology
Background:
- Ischaemic diseases, including myocardial infarction and peripheral artery disease, result from impaired blood flow due to narrowed or blocked arteries.
- Current revascularization techniques (surgical bypass, angioplasty) are ineffective for patients with extensive arterial occlusion or microcirculation issues.
- Stimulating collateral vessel growth (therapeutic angiogenesis) presents a promising alternative strategy for tissue repair.
Purpose of the Study:
- To review the relevance of therapeutic angiogenesis for promoting tissue repair in ischaemic diseases.
- To discuss vascular growth patterns and delivery systems for angiogenesis gene transfer.
- To evaluate the achievements and future directions of therapeutic angiogenesis in myocardial and peripheral ischaemia.
Main Methods:
- Review of existing literature on therapeutic angiogenesis and gene transfer.
- Analysis of vascular growth mechanisms and patterns.
- Assessment of clinical achievements and safety profiles of angiogenesis therapies.
Main Results:
- Therapeutic angiogenesis aims to enhance the body's natural collateral vessel formation.
- Gene transfer delivery systems are crucial for effective angiogenesis.
- Significant progress has been made in applying therapeutic angiogenesis to myocardial and peripheral ischaemia.
Conclusions:
- Therapeutic angiogenesis holds potential for treating ischaemic diseases where conventional methods fail.
- Further research is needed to optimize delivery systems and improve the safety and efficacy of vascular gene therapy.
- This approach offers a novel strategy for tissue repair and improving outcomes in cardiovascular and peripheral vascular disease.
Abstract:
Ischaemic diseases are characterized by an impaired supply of blood resulting from narrowed or blocked arteries that starve tissues of needed nutrients and oxygen. Coronary-atherosclerosis induced myocardial infarction is one of the leading causes of mortality in developed countries. Ischaemic disease also affects the lower extremities. Considerable advances in both surgical bypassing and percutaneous revascularization techniques have been reached. However, many patients cannot benefit from these therapies because of the extension of arterial occlusion and/or microcirculation impairment. Consequently, the need for alternative therapeutic strategies is compelling. An innovative approach consists of stimulating collateral vessel growth, a natural host defence response that intervenes upon occurrence of critical reduction in tissue perfusion (Isner & Asahara, 1999). This review will debate the relevance of therapeutic angiogenesis for promotion of tissue repair. The following issues will receive attention: (a) vascular growth patterns, (b) delivery systems for angiogenesis gene transfer, (c) achievements of therapeutic angiogenesis in myocardial and peripheral ischaemia, and (d) future directions to improve effectiveness and safety of vascular gene therapy.