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Therapeutic angiogenesis: still worth an investment?

Basic Sciences, Pharmacology, Genomics and Cardiovascular Pathology


The session “Therapeutic angiogenesis: still worth an investment” focused on the translational hurdles to be taken for clinical implementation of therapeutic vessel growth in cardiovascular disease: angiogenesis, arteriogenesis and collaterogenesis.

Dr. Faber from Chapel Hill, US, gave an excellent overview of the current knowledge of genetic factors that determine the number of pre-existing collaterals and their diameter, also highlighting once again the functional impact of the collateral network. He found strong correlations between infarct volume and collateral number and diameter in a mouse stroke model and QTL analysis identified a QTL on chromosome 7 to be a major determinant for collateral vessel development.

Dr. Buschmann from Berlin, DE, focused on the basic mechanism that triggers and promotes collateral remodeling. He demonstrated the role of shear forces not only in collateral vessel enlargement but also in their maintenance. This principle was further tested in a clinical setting, showing significant improvements in coronary collateral function by external counterpulsation.

Dr. Sylven from Stockholm, SE, presented data on the additive effects of combined growth factor treatment and new solutions for growth factor delivery. Slow and sustained release of growth factor combinations was achieved by applying LMW alginate, increasing vessel growth and improving LV-function in a rat MI model.

Dr. Yla-Herttuala from Kuopio, FI, pointed out the major difference between experimental studies, where healthy individuals can be successfully treated, and clinical reality. He presented experimental and clinical data on the use of gene transfer for therapeutic angiogenesis. Using VEGF-B 186, angiogenic responses can be provoked specifically in myocardial tissue without inducing typical VEGF related side effects like tissue edema. Dr. Waltenberger from Maastricht, NL, provided an overview of clinical trials on therapeutic vessel growth in cardiovascular disease. Due to the small number of positive trials, he posed the question whether we stimulate the right target and if novel targets are in sight. He concluded that markers to identify responders and non-responders among patients are highly needed.

Altogether, this was a very interesting and integrative session. It seems that therapeutic angiogenesis is still worth an investment if the open questions can be properly addressed.

References


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Therapeutic angiogenesis: still worth an investment?
The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.