Delivery approaches for angiogenic growth factors in the treatment of ischemic conditions

Introduction: Despite current medical treatments, cardiovascular disease resulting in local ischemia remains a significant clinical problem. Therapeutic angiogenesis, that is, the growth and remodeling of new blood vessels from pre-existing blood vessels to the ischemic area, is a promising solution to this problem. Areas covered: Therapeutic angiogenesis can be generated in vivo through the local release of various proangiogenic factors. This review describes the various formulation approaches that have been devised for this purpose, highlighting the advantages and disadvantages of each. Expert opinion: Formulations that release single proangiogenic growth factors have not yet been demonstrated to achieve functional therapeutic angiogenesis. Formulations capable of multiple growth factor delivery are needed; however, the complexity of the physiologic process requires the examination of appropriate growth factor doses, as well as release sequence, to guide effectively new formulation design. Furthermore, new formulation approaches need to be tested in vivo in appropriate animal models over extended time periods to assess clearly the potential of the delivery approach.