Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Therapeutic interventions for enhancing collateral development by administration of growth factors: basic principles, early results and potential hazards
Autore:
Epstein, SE; Fuchs, S; Zhou, YF; Baffour, R; Kornowski, R;
Indirizzi:
Washington Hosp Ctr, Inst Cardiovasc Res, MedStar Res Inst, Washington, DC20010 USA Washington Hosp Ctr Washington DC USA 20010 Inst, Washington, DC20010 USA
Titolo Testata:
CARDIOVASCULAR RESEARCH
fascicolo: 3, volume: 49, anno: 2001,
pagine: 532 - 542
SICI:
0008-6363(20010216)49:3<532:TIFECD>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
VASCULAR-PERMEABILITY FACTOR; ENDOTHELIAL-CELL GROWTH; INTRAMUSCULAR GENE-TRANSFER; HYPOXIA-INDUCIBLE FACTOR-1; CORONARY-ARTERY DISEASE; FIBRIN-GEL INVESTMENT; BLOOD-FLOW; ISCHEMIC MYOCARDIUM; VASA VASORUM; FACTOR VEGF;
Keywords:
angiogenesis; collateral circulation; coronory circulation; growth factors;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
109
Recensione:
Indirizzi per estratti:
Indirizzo: Epstein, SE Washington Hosp Ctr, Inst Cardiovasc Res, MedStar Res Inst, Washington, DC20010 USA Washington Hosp Ctr Washington DC USA 20010 gton, DC20010 USA
Citazione:
S.E. Epstein et al., "Therapeutic interventions for enhancing collateral development by administration of growth factors: basic principles, early results and potential hazards", CARDIO RES, 49(3), 2001, pp. 532-542

Abstract

The importance of spontaneously developing collateral vessels to supplement perfusion of tissue rendered ischemic by vascular obstruction was recognized many years ago. However, it was not until potent angiogenesis factors were identified, purified, and produced in sufficient quantities, that the field began its rapid development. In the early 1990s it was first shown that basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) proteins could actually stimulate collateral how. However, additional studies also demonstrated that the duration of exposure of the vessels to angiogenesis factors was critical, and that the administration of proteins, with their relativly brief half-lives, may pose important practical limitations. The demonstration that gene therapy can improve collateral function presents one of the solutions to the conundrum, since gene therapy canbe considered a sophisticated form of a sustained delivery system. The results of several clinical trials have been reported. All involve administration of single angiogenesis agents, and most are Phase I trials. The two studies rising to Phase II status demonstrated no treatment effect on the primary end-point. It may therefore be relevant to consider that the molecular mechanisms responsible for angiogenesis are extraordinarily complex, and anoptimal angiogenesis intervention may require a 'multiple factor' strategy. It is important to note that no serious side-effects ascribable to an angiogenesis agent were recognized in these trials. However, angiogenesis agents are potent molecules with multiple activities. It is therefore possible that they might occasionally cause side-effects, some serious. Among these,based on their biologic activities, are neovascularization of non-targetedtissues, expansion and induction of instability of atherogenic plaque, andgrowth of tumors. In summary, there is ample experimental evidence justifying an optimistic outlook relating to our eventually being successful in enhancing collateral how to ischemic tissue in a clinical setting. However, we are not there yet, and identification of the optimal angiogenesis strategy is still unclear. Additional experimental work, in parallel with large, carefully controlled clinical trials are needed to continue the exciting advances of the last decade, and to achieve the goal of providing patients with alternative potent therapies to improve collateral flow, and thereby to alleviate their symptoms and perhaps to prolong their lives. (C) 2001 Elsevier Science B.V. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 12:36:26