Morehouse School of Medicine, Cardiovascular Research Institute, 720 Westview Drive SW, Atlanta, GA, 30310, USA.
Department of Biochemistry, Spelman College, 350 Spelman Lane, Atlanta, GA, 30314, USA.
J Mol Med (Berl). 2019 Feb;97(2):141-151. doi: 10.1007/s00109-018-1729-3. Epub 2018 Dec 15.
Ischemic heart disease (IHD) is caused by the narrowing of arteries that work to provide blood, nutrients, and oxygen to the myocardial tissue. The worldwide epidemic of IHD urgently requires innovative treatments despite the significant advances in medical, interventional, and surgical therapies for this disease. Angiogenesis is a physiological and pathophysiological process that initiates vascular growth from pre-existing blood vessels in response to a lack of oxygen. This process occurs naturally over time and has encouraged researchers and clinicians to investigate the outcomes of accelerating or enhancing this angiogenic response as an alternative IHD therapy. Therapeutic angiogenesis has been shown to revascularize ischemic heart tissue, reduce the progression of tissue infarction, and evade the need for invasive surgical procedures or tissue/organ transplants. Several approaches, including the use of proteins, genes, stem/progenitor cells, and various combinations, have been employed to promote angiogenesis. While clinical trials for these approaches are ongoing, microvesicles and exosomes have recently been investigated as a cell-free approach to stimulate angiogenesis and may circumvent limitations of using viable cells. This review summarizes the approaches to accomplish therapeutic angiogenesis for IHD by highlighting the advances and challenges that addresses the applicability of a potential pro-angiogenic medicine.
缺血性心脏病（IHD）是由为心肌组织提供血液、营养和氧气的动脉狭窄引起的。尽管在医学、介入和外科治疗方面取得了重大进展，但全球范围内 IHD 的流行仍然迫切需要创新的治疗方法。血管生成是一种生理和病理生理过程，它会在缺氧时从预先存在的血管中启动血管生长。这个过程是随着时间自然发生的，这促使研究人员和临床医生研究加速或增强这种血管生成反应作为 IHD 替代疗法的效果。治疗性血管生成已被证明可以使缺血性心脏组织再血管化，减少组织梗死的进展，并避免需要侵入性手术或组织/器官移植。已经采用了几种方法，包括使用蛋白质、基因、干细胞/祖细胞以及各种组合，来促进血管生成。虽然这些方法的临床试验仍在进行中，但微泡和外泌体最近被研究为一种无细胞方法来刺激血管生成，并可能规避使用活细胞的局限性。这篇综述总结了通过强调解决潜在促血管生成药物适用性的挑战和进展，来实现 IHD 治疗性血管生成的方法。
