Effectiveness of cell and gene therapy in treatment of obliterating diseases of the arteries in the lower extremities: a review

Abstract

The lack of significant progress in improving the results of treatment for patients with chronic lower limb ischemia (CLLI) determines a necessity to search new approaches to solve this problem. One of the promising methods for treatment of patients with CLLI is therapeutic angiogenesis. Gene and cell therapy clinical trials for this pathology have been carried out in the world for more than 20 years and showed conflicting results. It is extremely difficult to produce a drug based on cellular material, therefore the development of gene-based therapies is more promising. In most of the analyzed studies, patients with critical limb ischemia, i.e with initially with a high risk for major amputation, were included. Since the process of neoangiogenesis takes several months, it seems more logical to use that option for treatment in the earlier stages of the disease. VEGF-165 is the most studied angiogenic agent. Only VEGF-165 is registered as a drug for treatment of patients with CLLI. There are publications on the effectiveness of treatment with a plasmid VEGF-165-gene therapy in patients with stages II and III of CLLI according to the FontaineA.V. Pokrovsky classification in a five-year follow-up study.