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Growth factors and the vessel wall
1Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia 30322.
Heart Disease and Stroke : a Journal for Primary Care Physicians
|March 1, 1993
Summary
Vascular restenosis, often following procedures like percutaneous coronary intervention (PCI), is an overactive healing response. Therapies targeting common mediators, not single growth factors, may offer more effective treatments for this condition.
Area of Science:
- Cardiovascular Biology
- Vascular Medicine
- Regenerative Medicine
Background:
- The vascular tree possesses sophisticated injury and stress response mechanisms.
- Restenosis after procedures like percutaneous transluminal coronary angioplasty (PTCA) involves activated growth mechanisms.
- Hypertension and hemodynamic stress also trigger distinct vascular growth responses.
Purpose of the Study:
- To understand the complex mechanisms underlying vascular restenosis.
- To identify potential therapeutic targets for preventing excessive vascular repair.
- To explore novel treatment strategies based on common mediator pathways.
Main Methods:
- Review and synthesis of existing knowledge on vascular response to injury and stress.
- Analysis of growth factor involvement and their spatio-temporal distribution.
- Evaluation of therapeutic strategies targeting common mediators versus single factors.
Main Results:
- Restenosis is characterized as an exaggerated reparative response.
- The vast number and distribution of growth factors suggest single-factor therapies are unlikely to succeed.
- Common mediators like extracellular matrix and downstream cellular effectors are promising therapeutic targets.
Conclusions:
- Therapies targeting common mediators of vascular repair may be more effective than those targeting individual growth factors.
- Future therapies should focus on cell-cell and cell-matrix interactions.
- Tissue-specific and time-focused interventions leveraging normal vascular adaptation mechanisms hold promise.