Therapeutic angiogenesis: protein and gene therapy delivery strategies

Angioplasty and surgical bypass, the primary interventional therapies for t he treatment of atherosclerosis, are limited by the development over time o f native Vessel restenoses and graft occlusions. Furthermore, these therapi es are not options for a significant number of individuals in whom the exte nt of vascular pathology is especially severe or widespread. Angiogenesis, the growth of new vasculature, is a critical biological response to ischemi a that provides collateralization, or 'biological revascularization' of vas cular obstructions. Therapeutic angiogenesis is a strategy whereby one of s everal known 'angiogens,' mediators that induce angiogenesis, can be admini stered to augment the native angiogenic processes and enhance the formation of a collateral vasculature, This report describes the techniques availabl e for providing therapeutic angiogenesis, including acute and sustained-rel ease techniques to deliver protein angiogens and a number of gene therapy s trategies to deliver genes coding for the angiogens. J Cardiovasc Risk 6:29 -40 (C) 1999 Lippincott Williams & Wilkins.