Local Endovascular Delivery, Gene Therapy, and Cell Transplantation for Peripheral Arterial Disease

Abstract

ࡗ ࡗAdvances in catheter technology, gene identification, and cell biology may provide novel treatment options for patients with peripheral arterial disease (PAD) who are not candidates for standard revascularization procedures. Animal studies and recent results in human beings suggest that transfer of growth factors or regulatory genes and transplantation of progenitor cells may provide novel therapy options by inducing therapeutic angiogenesis or by inhibiting restenosis. This review will discuss the development of a variety of catheters for localized endovascular delivery, as well as the various cellular and genetic strategies that exist to restore blood flow to ischemic tissue and to reduce neointimal hyperplasia. J Endovasc Ther 2004;11(Suppl II):II-151-II-162

The metamorphosis of vascular stents: passive structures to smart devices

“…190 Genes encoding for regulatory proteins such as thymidine kinase and cytosine deaminase, which impair cell cycle during the S phase of the cell cycle, have been employed in GES. 191 GES with cytosine deaminase gene have exhibited higher apoptosis levels of vascular smooth muscle cells and enhanced inhibition of neointimal formation. 192 Recent strategies have employed vascular gene therapy that simultaneously targeted multiple pathways resulting in pleiotropic effects that accelerated re-endothelialization apart from decreasing intimal hyperplasia.…”

Growth factors for therapeutic angiogenesis in peripheral arterial disease

“…In addition to enhancing EPC migration and proliferation, FGF proteins also stimulate other cell lines, including fibroblasts, vascular smooth muscle, and myoblasts [27]. Like VEGF, FGF binds to tyrosine kinase receptors: FGFR-1, 2, 3 and 4 [28].…”