Angiopeptin: experimental and clinical studies of inhibition of myointimal proliferation.

Angiopeptin is a long-acting cyclic octapeptide with pharmacologic actions clearly resembling those of the natural hormone somatostatin, but with different binding affinities for the five known somatostatin receptors. It is a potent inhibitor of myointimal migration and proliferation in animal models of angioplasty and organ transplantation. Experimentally, angiopeptin inhibits transplant arteriosclerosis in cardiac, renal and vascular allografts. The mechanisms are thought to involve abrogation of the increase of insulin-like growth factor (IGF-I) and other growth factors that occur in the vascular wall following immune or mechanical injury. Angiopeptin also restores the endothelium-dependent vasodilatory response to acetylcholine. Clinically, angiopeptin is safe in cardiac transplant patients and shows promise in inhibiting coronary transplant arteriosclerosis. Furthermore, in large clinical trials, angiopeptin (given as a continuous infusion for 5 days) inhibits serious clinical events, such as myocardial infarction, death and revascularization at 6 and 12 months following percutaneous transluminal coronary angioplasty. It has few serious side effects.