Gene therapy and angiogenesis in patients with coronary artery disease
Gene therapy and angiogenesis in patients with coronary artery disease
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DOI：
10.1586/erc.10.95
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发表时间：
2010-01-01
影响因子：
2
通讯作者：
Kastrup, Jens
中科院分区：
文献类型：
--
作者：
Kastrup, Jens
并不是所有的严重冠状动脉疾病患者都能用目前推荐的药物和血运重建技术得到满意的治疗。多种血管生长因子具有诱导缺血组织血管生成的潜力。临床试验仅评估了VEGF和FGF在冠状动脉疾病患者中的作用。重组生长因子蛋白或编码生长因子的基因的最初的小型和非盲研究是令人鼓舞的，证明了临床改善和血管生成的证据。然而，随后更大的双盲安慰剂对照试验无法证实早期小型试验中观察到的生长因子蛋白或基因治疗方法的初始高疗效。到目前为止，临床研究都没有任何与基因相关的严重不良事件。未来的试验将集中在是否可以改善临床结果与生长因子的鸡尾酒或基因和干细胞治疗的组合，在严重的冠状动脉疾病患者，不能有效地治疗与目前的治疗策略。
Not all patients with severe coronary artery disease can be treated satisfactorily with current recommended medications and revascularization techniques. Various vascular growth factors have the potential to induce angiogenesis in ischemic tissue. Clinical trials have only evaluated the effect of VEGF and FGF in patients with coronary artery disease. The initial small and unblinded studies with either recombinant growth factor proteins or genes encoding growth factors were encouraging, demonstrating both clinical improvement and evidence of angiogenesis. However, subsequent larger double-blind placebo-controlled trials could not confirm the initial high efficacy of either the growth factor protein or the gene therapy approaches observed in earlier small trials. The clinical studies so far have all been without any gene-related serious adverse events. Future trials will focus on whether an improvement in clinical results can be obtained with a cocktail of growth factors or by a combination of gene and stem cell therapy in patients with severe coronary artery disease, which cannot be treated effectively with current treatment strategies.