Arabzadeh AmirAhmad, Faghfuri Elnaz, Razi Soofiyani Saiedeh, Dalir Abdolahinia Elaheh, Siapush Samaneh, Nejati-Koshki Kazem, Shahrami Bita, Asghariazar Vahid, Pahlavan Yasamin
Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
Adv Pharm Bull. 2023 Mar;13(2):259-268. doi: 10.34172/apb.2023.025. Epub 2022 Apr 4.
Despite the improvements in endovascular techniques during the last decades, there is still an increase in the prevalence of peripheral artery disease (PAD) with limited practical treatment, which timeline impact of any intervention for critical limb ischemia (CLI) is poor. Most common treatments are not suitable for many patients due to their underlying diseases, including aging and diabetes. On the one hand, there are limitations for current therapies due to the contraindications of some individuals, and on the other hand, there are many side effects caused by common medications, for instance, anticoagulants. Therefore, novel treatment strategies like regenerative medicine, cell-based therapies, Nano-therapy, gene therapy, and targeted therapy, besides other traditional drugs combination therapy for PAD, are newly considered promising therapy. Genetic material encoding for specific proteins concludes with a potential future for developed treatments. Novel approaches for therapeutic angiogenesis directly used the angiogenetic factors originating from key biomolecules such as genes, proteins, or cell-based therapy to induce blood vessel formation in adult tissues to initiate the recovery process in the ischemic limb. As PAD is associated with high mortality and morbidity of patients causing disability, considering the limited treatment choices for these patients, developing new treatment strategies to prevent PAD progression and extending life expectancy, and preventing threatening complications is urgently needed. This review aims to introduce the current and the novel strategies for PAD treatment that lead to new challenges for relief the patient's suffered from the disorder.
尽管在过去几十年里血管内技术有所进步,但外周动脉疾病(PAD)的患病率仍在上升,实际治疗手段有限,对严重肢体缺血(CLI)的任何干预措施的长期影响都很差。由于包括衰老和糖尿病在内的基础疾病,大多数常见治疗方法并不适用于许多患者。一方面,由于某些个体的禁忌症,当前疗法存在局限性;另一方面,常见药物(如抗凝剂)会产生许多副作用。因此,除了其他用于PAD的传统药物联合疗法外,再生医学、细胞疗法、纳米疗法、基因疗法和靶向疗法等新型治疗策略被新认为是有前景的疗法。编码特定蛋白质的遗传物质为未来开发的治疗方法带来了潜力。治疗性血管生成的新方法直接利用源自基因、蛋白质或细胞疗法等关键生物分子的血管生成因子,在成年组织中诱导血管形成,从而启动缺血肢体的恢复过程。由于PAD与导致患者残疾的高死亡率和高发病率相关,考虑到这些患者的治疗选择有限,迫切需要开发新的治疗策略来预防PAD进展、延长预期寿命并预防危及生命的并发症。本综述旨在介绍PAD治疗的当前和新型策略,这些策略给缓解患者所患疾病带来了新的挑战。