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[Therapeutic angiogenesis through intramuscular injection of the gene for vascular endothelial growth factor (VEGF)].

Therapeutic angiogenesis by injection of growth factors or genes encoding for these appears a promising strategy for treatment of critical limb ischaemia but is currently still in an experimental phase. Among the cytokines that promote angiogenesis, i.e. the postnatal growth of blood vessels due to activation and proliferation of endothelial cells, vascular endothelial growth factor (VEGF) takes a special position. VEGF has proven to be a powerful angiogenic factor in vivo that specifically promotes migration and replication of endothelial cells. The specificity of VEGF for endothelial cells, compared with the more widespread effects of other factors such as fibroblast growth factor (FGF), may provide a broader therapeutic potential. The recombinant form of the human VEGF gene can be injected intramuscularly as a plasmid (phVEGF). The angiogenic effect of phVEGF can be explained in several ways: by direct stimulation of proliferation and migration of endothelial cells in vivo; by recruitment of previously existing collaterals; and by improving vasomotor function of vessels in ischaemic tissue.