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(Circulation. 1995;91:2699-2702.)
© 1995 American Heart Association, Inc.

Articles

Growth Factor Therapies for Vascular Injury and Ischemia

Ward Casscells, MD

From the Cardiology Division, University of Texas Medical School at Houston; Hermann Hospital; and Texas Heart Institute (Houston).

Correspondence to Ward Casscells, MD, Texas Heart Institute, MC 2-255, PO Box 20345, Houston, TX 77225-0345.

	Introduction

 
In this issue of Circulation, Asahara et al¹ report that reendothelialization of the rat carotid artery after balloon denudation is accelerated by a local 30-minute incubation of 100 µg of vascular endothelial growth factor (VEGF 165). This treatment also may have increased the final extent of reendothelialization by 50%, although the 4-week end point is too early to be certain. Recently, Callow et al² reported equally dramatic effects using twice-weekly intravenous doses of 100 µg in the rabbit. Although no toxicity was described in the rabbit studies, the present report by Asahara and colleagues suggests that a single local administration is efficacious, eliminating concerns about other potential in vivo effects of VEGF, including vasorelaxation³ and increased vascular permeability.⁴

These outcomes were by no means guaranteed, since there was no previous evidence that VEGF played a role in this process. VEGF, a glycoprotein that is mitogenic for endothelial cells and angiogenic in vivo, is known to be expressed in ischemic and hypoxic myocytes^{5 6} and tumor cells (and indeed, the VEGF and erythropoietin genes have similar hypoxia-responsive regulatory regions⁷ ), but injured arteries are not hypoxic. VEGF is made by smooth muscle cells, and it may prove to be upregulated after balloon injury, since in other cells its expression is induced by protein kinase C and by tissue factor,⁸ which are activated after balloon injury.

These studies are also noteworthy for the magnitude of the effects, which contrast with reports that growth factors only marginally enhance dermal wound healing in normal . . . [Full Text of this Article]

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