Shindo Tomohiko, Shimokawa Hiroaki
Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Ann Vasc Dis. 2020 Jun 25;13(2):116-125. doi: 10.3400/avd.ra.20-00010.
Along with the progress of global aging, the prognosis of severe ischemic heart disease (IHD) remains poor, and thus the development of effective angiogenic therapy remains an important clinical unmet need. We have developed low-energy extracorporeal cardiac shock wave therapy as an innovative minimally invasive angiogenic therapy and confirmed its efficacy in a porcine chronic myocardial ischemia model in animal experiments as well as in patients with refractory angina. Since ultrasound is more advantageous for clinical application than shock waves, we then aimed to develop ultrasound therapy for IHD. We demonstrated that specific conditions of low-intensity pulsed ultrasound (LIPUS) therapy improve myocardial ischemia in animal models through the enhancement of angiogenesis mediated by endothelial mechanotransduction. To examine the effectiveness of our LIPUS therapy in patients with severe angina pectoris, we are now conducting a prospective multicenter clinical trial in Japan. Furthermore, to overcome the current serious situation of dementia pandemic but with no effective treatments worldwide, we have recently demonstrated that our LIPUS therapy also improves cognitive impairment in mouse models of Alzheimer's disease and vascular dementia. Here, we summarize the progress in our studies to develop angiogenic therapies with sound waves.
随着全球老龄化进程的推进,严重缺血性心脏病(IHD)的预后仍然很差,因此开发有效的血管生成疗法仍然是临床上尚未满足的重要需求。我们已经开发出低能量体外心脏冲击波疗法作为一种创新的微创血管生成疗法,并在动物实验中的猪慢性心肌缺血模型以及难治性心绞痛患者中证实了其疗效。由于超声在临床应用中比冲击波更具优势,因此我们随后致力于开发针对IHD的超声疗法。我们证明,低强度脉冲超声(LIPUS)疗法的特定条件通过增强内皮机械转导介导的血管生成来改善动物模型中的心肌缺血。为了检验我们的LIPUS疗法对严重心绞痛患者的有效性,我们目前正在日本进行一项前瞻性多中心临床试验。此外,为了克服目前全球痴呆大流行但尚无有效治疗方法的严峻形势,我们最近证明,我们的LIPUS疗法还可改善阿尔茨海默病和血管性痴呆小鼠模型中的认知障碍。在此,我们总结了我们在开发声波血管生成疗法研究中的进展。