Vascular endothelial growth factors in cardiovascular medicine

被引:58
作者
Testa, Ugo [1 ]
Pannitteri, Gaetano [2 ]
Condorelli, Gian Luigi [3 ,4 ]
机构
[1] Attilio Reale Univ Rome La Sapienza, Dept Hematol Oncol & Mol Med, Ist Super Sanita, Rome, Italy
[2] Attilio Reale Univ Rome La Sapienza, Dept Heart & Great Vessels, Rome, Italy
[3] Univ Calif San Diego, Div Cardiol, Dept Med, La Jolla, CA 92093 USA
[4] Ist Ricovero & Cura Carattere Sci Multimed, Milan, Italy
关键词
atherosclerosis; endothelial growth factors; gene therapy; heart ischemic disease;
D O I
10.2459/JCM.0b013e3283117d37
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The discovery of vascular endothelial growth factors (VEGFs) and their receptors has considerably improved the understanding of the development and function of endothelial cells. Each member of the VEGF family appears to have a specific function: VEGF-A induces angiogenesis (i.e. growth of new blood vessels from preexisting ones), placental growth factor mediates both angiogenesis and arteriogenesis (i.e. the formation of collateral arteries from preexisting arterioles), VEGF-C and VEGF-D. act mainly as lymphangiogenic factors. The study of the biology of these endothelial growth factors has allowed a major progress in the comprehension of the genesis of the vascular system and its abnormalities observed in various pathologic conditions (atherosclerosis and coronary artery disease). The role of VEGF in the atherogenic process is still unclear, but actual evidence suggests both detrimental (development of a neoangiogenetic process within the atherosclerotic plaque) and beneficial (promotion of collateral vessel formation) effects. VEGF and other angiogenic growth factors (fibroblast growth factor), although initially promising in experimental studies and in initial phase I/II clinical trials in patients with ischemic heart disease or peripheral arterial occlusive disease, have subsequently failed to show significant therapeutic improvements in controlled clinical studies. Challenges still remain about the type or the combination of angiogenic factors to be administered, the form (protein vs. gene), the route, and the duration of administration. J Cardiovasc Med 9:1190-1221 (C) 2008 Italian Federation of Cardiology.
引用
收藏
页码:1190 / 1221
页数:32
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