Current Status of Therapeutic Angiogenesis with Protein, Gene and Cell Therapy

Therapeutic angiogenesis, stimulated growth of new vasculature to compensate for tissue ischemia, has been studied in a number of clinical trials in patients with various ischemic vascular diseases. These clinical trials include growth factor protein and gene therapy, as well as cell therapy. However, almost randomized clinical trials using vascular endothelial growth factor and fibroblast growth factor families, delivered as either recombinant protein or gene therapy, have failed to demonstrate improvement in patients with coronary artery or peripheral artery disease until now. However, randomized clinical trials using bone marrow-derived cells demonstrated modest but some significant benefit in patients with myocardial infarction. This report reviews the current status of randomized clinical trials and some non-randomized clinical trials using these therapies, plus related potential problems.