Efficacy of therapeutic angiogenesis in patients with chronic lower limb ischemia
- Authors: Talitsky, KA1, Bulkina, OS1, Arefeva, TI1, Vorobyeva, ON1, Levitsky, IV1, Fedorovich, AA1, Makarevich, PI1, Parfyenova, EV1, Karpov Y.A1
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Affiliations:
- Russian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, Moscow
- Issue: Vol 6, No 3 (2011)
- Pages: 89-98
- Section: Articles
- URL: https://genescells.ru/2313-1829/article/view/121562
- DOI: https://doi.org/10.23868/gc121562
- ID: 121562
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Abstract
modality in patients with chronic lower limb ischemia, for
whom revascularization is not indicated. A number of studies
demonstrated satisfactory therapeutic effects of gene and
cell-based therapy targeted to stimulate angiogenesis. At the
same time the factors affecting the efficacy of angiogenesis
stimulation in clinical settings are under-investigated.
In the given study 30 patients, aged 49-78 years with
chronic lower limb ischemia of atherosclerotic origin (Fontaine
IIb-IV) were randomized into groups of gene therapy (GT) or
the control group (C). Plasmid DNA containing an encoding
part of the vascular endothelial growth factor (VEGF-165)
gene was inserted into ischemic limb muscles of the GT
patients. All the patients had sessions of treadmill training
walking. Besides clinical findings, angiography, scintigraphy,
transcutaneous oxymetry, laser Doppler examination, duplex
ultrasonography, treadmill test were carried out to evaluate
the invention efficacy. Also circulating progenitor cell count
was assessed by flow cytometry, ELISA was used to evaluate
angiogenic growth factors. In 3 months limb perfusion
rate, painless walking distance, collateral circulation indices
increased. In 50% of patients the therapeutic effect was
assessed as moderate (Rutherford +2), in 30% as minimal
(Rutherford +1), 20% of patients showed no dynamics.
Clinical laboratory tests had no significant dynamics in the
group of standard therapy. No serious complications were
noted. In a correlation test the efficacy of angiogenic therapy
was associated with a patent ileac segment, shorter smoking
history and higher ankle-brachial index.
About the authors
K A Talitsky,
Russian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, MoscowRussian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, Moscow
O S Bulkina,
Russian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, MoscowRussian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, Moscow
T I Arefeva,
Russian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, MoscowRussian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, Moscow
O N Vorobyeva,
Russian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, MoscowRussian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, Moscow
I V Levitsky,
Russian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, MoscowRussian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, Moscow
A A Fedorovich,
Russian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, MoscowRussian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, Moscow
P I Makarevich,
Russian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, MoscowRussian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, Moscow
E V Parfyenova,
Russian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, MoscowRussian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, Moscow
Yu A Karpov
Russian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, MoscowRussian Cardiology Research-and-Production Complex of the RF Ministry of Public Health, Moscow
References
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