Gen Takagi
Division of Regenerative Medicine, Department of Internal Medicine Nippon Medical School Tokyo, Japan

Abstract:

Background: Therapeutic angiogeneisis is a clinically effective strategy for patients with peripheral artery disease (PAD). However it is still unknown the systemic effects of therapeutic angiogenesis. We examined the effect and mechanism of therapeutic angiogenesis to the systemic vascular function in patients with PAD. Methods: Gelatin hydrogel containing 600 μg of b-FGF, which is controlled release formula of b-FGF, was administered into the ischemic limbs in 12 PAD patients. Skin perfusion (transcutaneous oxygen tension,TcPO2), tissue blood flow (99mTc-tetrofosmin scintigraphy), and, endothelial function by brachial artery endothelial-dependent flow - mediated dilatation (FMD) were examined before and 4 weeks after treatment.

Results: b-FGF administration improved visual analog pain scale (72.9 ± 26 to 6.8 ± 12, P < 0.01) and TcPO2 (14.7 ± 14 to 47.3 ± 16 mmHg, P < 0.01). 99mTc-tetrofosmin scintigraphy score from healthy side (non-treated limbs) tend to be improved (0.64 ± 0.3 to 0.75 ± 0.3, P = 0.37), however it was not reached to the statistical significance. FMD was significantly improved (3.94 ± 1.4 to 7.83 ± 2.8 %, P < 0.01). Linear relation was confirmed between FMD and walking distance.

Conclusions: Therapeutic angiogenesis by controlled release b-FGF, restored systemic endothelium-dependent vasodilation in patients with PAD.

Keywords: Angiogenesis, Drug delivery system, Peripheral Artery Disease