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Titolo:
Focal angiogenic therapy for myocardial ischemia
Autore:
Symes, JF;
Indirizzi:
Tufts Univ, Sch Med, St Elizabeths Med Ctr Boston, Div Cardiothorac Surg, Boston, MA 02111 USA Tufts Univ Boston MA USA 02111 iv Cardiothorac Surg, Boston, MA 02111 USA
Titolo Testata:
JOURNAL OF CARDIAC SURGERY
fascicolo: 4, volume: 15, anno: 2000,
pagine: 283 - 290
SICI:
0886-0440(200007/08)15:4<283:FATFMI>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
ENDOTHELIAL GROWTH-FACTOR; CORONARY-ARTERY DISEASE; TRANSMYOCARDIAL LASER REVASCULARIZATION; COLLATERAL VESSEL DEVELOPMENT; GENE-THERAPY; REFRACTORY ANGINA; CONTROLLED TRIAL; VEGF121 CDNA; BLOOD-FLOW; IMPAIRMENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Symes, JF 11 Nevins St,Suite 306, Boston, MA 02135 USA 11 Nevins St,Suite306 Boston MA USA 02135 Boston, MA 02135 USA
Citazione:
J.F. Symes, "Focal angiogenic therapy for myocardial ischemia", J CARDIAC S, 15(4), 2000, pp. 283-290

Abstract

Background. Therapeutic angiogenesis, which involves the administration ofangiogenic cytokines to stimulate collateral formation and improve myocardial perfusion, is being tested as an alternative treatment for patients with medically intractable angina who are no longer candidates for conventional revascularization techniques. Methods: Administration of recombinant protein formulations for these growth factors and transfection of the DNA itself have proven effective in animal models. At present, transfection of the DNA (gene therapy) appears preferable in that a single administration achieves a prolonged but transient, localized exposure of the ischemic tissues tothe angiogen. The important technical aspects of surgical gene therapy viaa mini thoracotomy incision are described. Results: Four Phase I clinical trials of angiogenic therapy recently have been reported, two involving administration of the recombinant protein combined with coronary bypass and two involving gene therapy alone. These studies have shown that this approachis relatively safe; the early evidence of efficacy is encouraging. The largest study reported six-month follow-up on 30 patients who received plasmidDNA for vascular endothelial growth factor-165 (VEGF(165)) and documented improvement in angina, treadmill exercise tolerance, and myocardial perfusion in the majority of patients studied. Conclusions: These preliminary results will need to be supported by randomized clinical trials in which angiogenic therapy alone is compared to standard medical therapy or a placebo. Catheter-based intramyocardial gene transfer and combined coronary arterial bypass grafting or transmyocardial laser revascularization plus gene therapytrials are also underway. If proven effective, angiogenic therapy may provide a relatively noninvasive modality for revascularization of ischemic myocardium not amenable to current techniques.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 06:36:51