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Review
. 2017 May 7;38(18):1365-1371.
doi: 10.1093/eurheartj/ehw547.

Angiogenic gene therapy in cardiovascular diseases: dream or vision?

Seppo Ylä-Herttuala  1   2 , Charles Bridges  3 , Michael G Katz  3 , Petra Korpisalo  1
Affiliations
Review

Angiogenic gene therapy in cardiovascular diseases: dream or vision?

Seppo Ylä-Herttuala et al. Eur Heart J. .

Abstract

Chronic cardiovascular diseases are significant health problems. Although current treatment strategies have tremendously improved disease management, up to 30% of these patients cannot be successfully treated with current treatment approaches and new treatment strategies are clearly needed. Gene therapy and therapeutic vascular growth may provide a new treatment option for these patients. Several growth factors, like vascular endothelial growth factors, fibroblast growth factors and hepatocyte growth factor have been tested in clinical trials. However, apart from demonstration of increased vascularity, very few results with clinical significance have been obtained. Problems with gene transfer efficiency, short duration of transgene expression, selection of endpoints, and suboptimal patients for gene therapy have been recognized. Ongoing gene therapy trials have included improvements in study protocols, vector delivery and endpoints, addressing the identified problems. Better, targeted delivery systems and new, more optimal growth factors have been taken to clinical testing. Recent advances in these areas will be discussed and the concept of angiogenic therapy as a sole treatment is re-evaluated. A combination with regenerative therapies or standard revascularization operations might be needed to improve tissue function and clinical benefits.

Keywords: Angiogenesis; Coronary heart disease; Gene delivery; Gene therapy; Growth factors; Heart failure; Peripheral arterial disease.

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Figures

Figure 1
Figure 1
Growth factor and receptor—families related to blood vessel growth as well as their other functions.
Figure 2
Figure 2
Methods and factors affecting gene delivery and expression efficacy in clinical trials.
Figure 3
Figure 3
Stepwise analysis of gene therapy efficacy in clinical trials.
Figure 4
Figure 4
The dynamic nature of the vasculature in health, disease and development.
See this image and copyright information in PMC

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