ANGIOGENESIS IN CARDIOVASCULAR DISEASE: A REVIEW

Angiogenesis is process of new blood vessel formation that occurs under both normal and pathological conditions. In the normal state, two distinct processes can be seen. One utilizes endothelial progenitor cells (EPC) and the second utilizes existing vasculature to generate new vessels. The healthy body controls angiogenesis through a series of “on” (angiogenesis-stimulating growth factors) and “off” (angiogenesis inhibitors) switches. However, the structures formed are often functionally abnormal; possibly due to an imbalance in the angiogenic process Angiogenesis represents an excellent therapeutic target for the treatment of cardiovascular disease. The healing of damaged tissues urgently required the rapid formation of new vessels which is brought about by various growth factors: VEGF, FGF, PDGF, Angiopoitins and Ephrins. Therapeutic angiogenesis is the clinical use of methods to enhance or promote the development of collateral blood vessels in ischemic, thrombotic, atherosclerotic tissue. This new form of treatment is an alternative to high risk percutaneous coronary intervention or coronary artery bypass surgery. There are three major ways to promote angiogenesis: protein therapy (by growth factor proteins including VEGF, bFGF), gene therapy (sustained production of angiogenic factors, the ability for local delivery and so less systemic exposure) and cellular therapy (monocytes, EPC and marrow stromal cells).