Optimizing the host substrate environment for cardiac angiogenesis, arteriogenesis, and myogenesis

Expert Opin Biol Ther. 2017 Apr;17(4):435-447. doi: 10.1080/14712598.2017.1293038. Epub 2017 Feb 17.

Abstract

The diseased host milieu, such as endothelial dysfunction (ED), decreased NO bioavailability, and ischemic/inflammatory post-MI environment, hamper the clinical success of existing cardiac regenerative therapies. Area covered: In this article, current strategies including pharmacological and nonpharmacological approaches for improving the diseased host milieu are reviewed. Specifically, the authors provide focus on: i) the mechanism of ED in patients with cardiovascular diseases, ii) the current results of ED improving strategies in pre-clinical and clinical studies, and iii) the use of biomaterials as a novel modulator in damaged post-MI environment. Expert opinion: Adjunct therapies which improve host endothelial function have demonstrated promising outcomes, potentially overcoming disappointing results of cell therapy in human studies. In the future, elucidation of the interactions between the host tissue and therapeutic agents, as well as downstream signaling pathways, will be the next challenges in enhancing regenerative therapy. More careful investigations are also required to establish these agents' safety and efficacy for wide usage in humans.

Keywords: Angiogenesis; arteriogenesis; cardiovascular disease; cell therapy; endothelial dysfunction; myogenesis; tissue engineering.

Publication types

  • Review

MeSH terms

  • Animals
  • Arteries / drug effects
  • Arteries / physiology*
  • Biocompatible Materials / pharmacology
  • Cell- and Tissue-Based Therapy / methods
  • Heart / drug effects
  • Heart / physiology
  • Humans
  • Muscle Development / drug effects
  • Muscle Development / physiology*
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / drug therapy
  • Neovascularization, Physiologic / drug effects
  • Neovascularization, Physiologic / physiology*
  • Regeneration / drug effects
  • Regeneration / physiology*
  • Vascular Diseases / diagnosis
  • Vascular Diseases / drug therapy

Substances

  • Biocompatible Materials

Grants and funding