Rakue H, Nakajima H, Katoh T, Usui M, Amemiya T, Miyagi M, Hara T, Tamura K, Sasame A, Naito Y, Nagai Y, Ibukiyama C
Second Department of Internal Medicine, Tokyo Medical College, Japan.
Jpn Circ J. 1998 Dec;62(12):933-9. doi: 10.1253/jcj.62.933.
Basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) have shown strong angiogenetic effects in ischemic animals; however, whether such a beneficial effect could be achieved using low doses remains to be determined. The effects of identical low-level doses of these substances on the creation of collateral circulation in canine acute hind limb insufficiency were evaluated. Anesthetized dogs that had undergone left femoral artery occlusion received 20 microg (2 microg/kg) intravenous boluses of either bFGF or VEGF 3 times at 2-day intervals for the first week only, animals on vehicle saline injection served as controls. All groups, control (n=8), bFGF-treated (n=8), and VEGF-treated (n=6) underwent angiography, blood flow measurement (in ml/min) on the day of ligation (day 0), and at 7, 14 and 28 days, then underwent ischemic limb muscle biopsy at 28 days. Angiogenic-treated groups showed remarkable enhanced collateral circulation at 7 days, which was maintained up to 28 days, and the main collateral source artery of the angiogenic-treated groups dilated by 14 days. Many neovascularized arterioles in specimens of the angiogenic groups were recognized without any tissue edema or necrosis. Even low doses of bFGF or VEGF were enough to augment collateral circulation with no side-effects, and short treatment after acute ischemia was effective. Low-dose bFGF or VEGF may be therapeutical effective options in patients with acute lower limb vascular disease.
碱性成纤维细胞生长因子(bFGF)和血管内皮生长因子(VEGF)在缺血动物中已显示出强大的血管生成作用;然而,使用低剂量是否能达到这种有益效果仍有待确定。评估了相同低剂量的这些物质对犬急性后肢缺血时侧支循环形成的影响。仅在第一周,每隔2天对接受左股动脉闭塞的麻醉犬静脉推注20微克(2微克/千克)的bFGF或VEGF 3次,以注射生理盐水的动物作为对照。所有组,即对照组(n = 8)、bFGF治疗组(n = 8)和VEGF治疗组(n = 6),在结扎当天(第0天)以及第7、14和28天进行血管造影和血流测量(毫升/分钟),然后在第28天进行缺血肢体肌肉活检。血管生成治疗组在第7天显示出明显增强的侧支循环,这种情况一直维持到第28天,并且血管生成治疗组的主要侧支源动脉在第14天时扩张。血管生成组标本中有许多新生血管化的小动脉,未发现任何组织水肿或坏死。即使是低剂量的bFGF或VEGF也足以增加侧支循环且无副作用,急性缺血后进行短期治疗是有效的。低剂量的bFGF或VEGF可能是急性下肢血管疾病患者的有效治疗选择。