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(Circulation Research. 2007;101:232.)
© 2007 American Heart Association, Inc.

Editorials

New Targeted Angiogenic Strategy

Bursting Bubbles

Tomosaburo Takahashi, Hiroaki Matsubara

From the Department of Cardiovascular Medicine (T.T., H.M.), Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Experimental Therapeutics (T.T., H.M.), Translational Research Center, Kyoto University Hospital, Kyoto, Japan.

Correspondence to Tomosaburo Takahashi, Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. E-mail ttaka@koto.kpu-m.ac.jp

See related article, pages 295–303

Key Words: therapeutic angiogenesis • gene therapy • ultrasound • microbubbles

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Although recent procedural advances in revascularization such as percutaneous coronary intervention and coronary artery bypass grafting improve quality of life and prognosis of the patients with ischemic diseases, these is still a subset of patients who are refractory to these conventional therapies and have poor prognosis. Therapeutic angiogenesis might offer a novel approach to these patients. Therapeutic angiogenesis involves an intervention to induce the formation of new blood vessels to restore the arterial blood and oxygen supply to ischemic tissues.¹ Here, the term "angiogenesis" represents the process of new blood vessel formation in general (although the same term is also used to describe a more specific biological process in which the new capillaries sprout from preexisting vessels).

Evolving knowledge of mechanisms of new blood vessel formation has raised the expectations for therapeutic angiogenesis as a treatment option. Recent studies have identified many angiogenic growth factors, vascular transcription factors, and the cells involved in neovascularization.^1,2 Current potential strategies for therapeutic angiogenesis include delivering an angiogenic factor as a protein or a gene, and supplying cells which themselves are vascular progenitors or are releasing angiogenic factors. These strategies have worked in animal studies and in initial small scale open-labeled clinical trials. However, in larger, double-blinded controlled trials, therapeutic angiogenesis approaches have failed to show clinical benefits.^1,2 Why? Perhaps there are subtle differences in angiogenesis between animals and humans, or the ischemic pathophysiology of animal models and human diseases are dissimilar. Another possibility is technical difficulties in translating the biology into the practice.

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Related Article:

Therapeutic Arteriogenesis by Ultrasound-Mediated VEGF₁₆₅ Plasmid Gene Delivery to Chronically Ischemic Skeletal Muscle

Howard Leong-Poi, Michael A. Kuliszewski, Michael Lekas, Matthew Sibbald, Krystyna Teichert-Kuliszewska, Alexander L. Klibanov, Duncan J. Stewart, and Jonathan R. Lindner
Circ. Res. 2007 101: 295-303. [Abstract] [Full Text] [PDF]

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