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Programming Stem Cells for Therapeutic Angiogenesis Using Biodegradable Polymeric Nanoparticles
Published on: September 27, 2013
Therapeutic angiogenesis: a fantastic new adventure
Kishore J Harjai1, Pertha Chowdhury, Cindy L Grines
1Section on Cardiology, William Beaumont Hospital, 3601 W. 13 Mile Rd., Royal Oak, MI 48073, USA.
Insights
Therapeutic angiogenesis offers a promising new treatment for patients with coronary artery disease whose symptoms persist despite medical care and cannot undergo traditional revascularization. This approach aims to stimulate new blood vessel growth, acting as natural bypasses for improved heart function.
Area of Science:
- Cardiovascular Medicine
- Regenerative Medicine
- Molecular Biology
Background:
- Many patients with coronary artery disease (CAD) experience symptoms unresponsive to standard medical treatments.
- These patients are often ineligible for conventional revascularization procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).
- This unmet clinical need necessitates exploration of alternative therapeutic strategies for ischemic heart disease.
Purpose of the Study:
- To review the components and potential of therapeutic angiogenesis as an alternative revascularization strategy for CAD.
- To discuss gene and protein-based approaches for stimulating the growth of new blood vessels.
- To outline key elements for clinical trials investigating angiogenesis in ischemic heart disease.
Main Methods:
- Review of current research in gene and protein-based therapeutic angiogenesis.
- Analysis of critical components: growth factors, vectors, delivery routes, and therapeutic targets.
- Discussion of desired therapeutic effects and quantifiable clinical endpoints for angiogenesis trials.
Main Results:
- Therapeutic angiogenesis, utilizing gene or protein-based strategies, shows promise for promoting collateral blood vessel development.
- Key components like growth factors and delivery methods are crucial for successful angiogenesis.
- Preliminary studies suggest potential for both adjunct and stand-alone therapy in non-revascularizable CAD.
Conclusions:
- Therapeutic angiogenesis is a promising novel therapy for the ischemic heart, particularly for patients with refractory symptoms and limited revascularization options.
- Future applications may include adjunct therapy to conventional revascularization or a primary treatment for non-revascularizable disease.
- Further research and clinical trials are essential to optimize and validate angiogenesis strategies for cardiovascular disease management.
Abstract:
A significant proportion of patients with coronary artery disease have symptoms refractory to medical treatment, yet are unsuitable for conventional revascularization techniques, like percutaneous coronary intervention and coronary artery bypass surgery. Such patients are potential candidates for alternative forms of coronary revascularization, like therapeutic angiogenesis. This strategy is designed to promote the development of supplemental collateral blood vessels that will act as endogenous bypass conduits. Two major avenues for achieving therapeutic angiogenesis are currently under intense investigation: gene therapy (the introduction of new genetic material into somatic cells to synthesize proteins that are missing, defective, or desired for specific therapeutic purposes) and protein-based therapy (administration of the growth factors, instead of the genes encoding for the growth factors responsible for angiogenesis). This article provides a concise review of the "components" of gene and protein-based therapy, namely, the growth factors, the vector (for gene therapy), the route of delivery, the therapeutic target, the desired therapeutic effect, and quantifiable clinical end points for trials of angiogenesis. Based on preliminary studies, the authors believe that therapeutic angiogenesis represents a promising novel therapy for treatment of the ischemic heart. In the future, angiogenesis will likely be offered as an adjunct to conventional revascularization strategies in subsets of patients who are only "suboptimally" revascularized with conventional techniques, and might evolve into a stand-alone treatment for some patients with nonrevascularizable disease.
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