Angiogenesis Gene Therapy
| Autor: | Richard B. Devereux, Leonard Y. Lee, Ronald G. Crystal, Rory Hachamovitch, Massimiliano Szulc, Peter M. Okin, Neil R. Hackett, O. Wayne Isom, Geoffrey Bergman, Manish Parikh, Paul Kligfield, Martin Lesser, Taliba Foster, Rebecca T. Hahn, Todd K. Rosengart, Tina M. Grasso, Shailen R. Patel, Timothy A. Sanborn, Martin R. Post |
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| Rok vydání: | 1999 |
| Předmět: |
Adult
Male Vascular Endothelial Growth Factor A Pathology medicine.medical_specialty DNA Complementary Angiogenesis Genetic Vectors Ischemia Neovascularization Physiologic Coronary Disease Endothelial Growth Factors Severity of Illness Index Adenoviridae Injections Neovascularization Coronary artery disease chemistry.chemical_compound Coronary circulation Coronary Circulation Physiology (medical) Humans Medicine Therapeutic angiogenesis Coronary Artery Bypass Aged Aged 80 and over Lymphokines Vascular Endothelial Growth Factors business.industry Myocardium Genetic Therapy Middle Aged medicine.disease Combined Modality Therapy Vascular endothelial growth factor Vascular endothelial growth factor A Treatment Outcome medicine.anatomical_structure chemistry Exercise Test Female medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation. 100:468-474 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/01.cir.100.5.468 |
| Popis: | Background —Therapeutic angiogenesis, a new experimental strategy for the treatment of vascular insufficiency, uses the administration of mediators known to induce vascular development in embryogenesis to induce neovascularization of ischemic adult tissues. This report summarizes a phase I clinical experience with a gene-therapy strategy that used an E1 − E3 − adenovirus (Ad) gene-transfer vector expressing human vascular endothelial growth factor (VEGF) 121 cDNA (Ad GV VEGF121.10) to induce therapeutic angiogenesis in the myocardium of individuals with clinically significant coronary artery disease. Methods and Results —Ad GV VEGF121.10 was administered to 21 individuals by direct myocardial injection into an area of reversible ischemia either as an adjunct to conventional coronary artery bypass grafting (group A, n=15) or as sole therapy via a minithoracotomy (group B, n=6). There was no evidence of systemic or cardiac-related adverse events related to vector administration. In both groups, coronary angiography and stress sestamibi scan assessment of wall motion 30 days after therapy suggested improvement in the area of vector administration. All patients reported improvement in angina class after therapy. In group B, in which gene transfer was the only therapy, treadmill exercise assessment suggested improvement in most individuals. Conclusions —The data are consistent with the concept that direct myocardial administration of Ad GV VEGF121.10 to individuals with clinically significant coronary artery disease appears to be well tolerated, and initiation of phase II evaluation of this therapy is warranted. |
| Databáze: | OpenAIRE |
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