Терапевтический ангиогенез при заболеваниях внутренних органов возможности и перспективы

VEGF). Для повышения эффективности терапевтического Aнг используются новые плазмидные конструкции, наноан-титила, методы клонирования, передовые малоинвазивные вмешательства. Перспективно комбинирование генной и клеточной терапии с использованием факторов роста, клеток жировой ткани, прогениторных и стволовых клеток с фармакологическими препаратами, фотодинамическим воздействием. Определенные надежды ученые связывают с операциями механического туннелирования органов и тканей (хирургический Анг).Relevance of the impact on the process of neovascularization is associated with the fact that more than 500 million people worldwide suffer from rheumatic and cancer diseases, which has the following factors inhibit the pathological angiogenesis (Ang). Also, the same number of patients with peripheral arterial disease, after cardiovascular events or stroke, on the contrary, requires the stimulation of natural, but insufficient mechanisms of the vascularization. Ang universal process of the capillary network formation in response to injury, hypoxia. Ang is the leading element of internal diseases (ID) coronary heart disease (CHD), critical limb ischemia (CLI), metabolic syndrome (MS), hypertension, obesity, chronic glomerulonephritis (CGN), diabetic macular degeneration of the retina, neoplastic processes, rheumatoid arthritis (RA), psoriasis, hepatitis, cirrhosis, Crohn's disease, pulmonary and portal hypertension, preeclampsia. One of the Ang key factors is the vascular endothelial growth factor (VEGF). The study of the Ang molecular mechanisms is allowed to applicate vector systems, cell and gene technology, different variants of targeted therapy in clinical practice. The modern spectrum of antiangiogenic agents includes growth factors (GF), interferons, interleukins, chemokines, pharmacological agents, anti-VEGF monoclonal antibody. The evidence base for using of anti-VEGF therapy in patients with cardiovascular pathology, which can not be made a radical intervention was accumulated by the end of the first decade of the XXI century (VIVA, FIRST, GM-CSF AGENT, KAT, REVASC, EUROINJECT; TRAFFIC, RAVE studies). In the treatment of CHD such drugs, as «Heartcellgram», «Gematsel», «Neovaskulogen», shock-wave therapy, platelet rich plasma, combined cell-gene therapy were using to improve the Ang process. Anti-VEGF therapy make better condition of individuals with LCA, according to VISION, MARINA, ANCHOR, FOCUS studies. However, the therapy is accompanied by serious side effects (hypertension, proteinuria, gastrointestinal bleeding). Study Ang in CGN allows you to define prognosis and treatment strategy of patients. Perspective of therapy with anti-angiogenic agents. Activation of VEGF the most important manifestation of cancers of various locations. The greatest prospects oncologists associated with the use of sorafenib multi-kinase inhibitor that suppresses cell proliferation and Ang (TARGET study). The Ang other factors, not only VEGF, such as angiopoietin 1 and 2, are involved in the pathogenesis of pulmonary hypertension (PH), and directly related to the parameters of cardiacpulmonary remodeling. These agents are independent predictors of death and the response to treatment in patients with PH. There is evidence of the positive dynamics of change in serum levels of FGF in patients with chronic pulmonary heart after ACE inhibitor treatment. You can correct the effects of ischemic stroke by activating neuroangiogenesis the introduction of stem cells (SC) with angiogenic GF. Most scientists associate therapeutic Ang setbacks with endothelial dysfunction that persisting after the intervention. To increase the effectiveness of therapeutic Ang new plasmid constructs are introduced, nanoantibody, cloning techniques are used for a more complete VEGF blockade, advanced the minimally invasive interventions are implemented. The development of quantitative estimation of efficiency methods of therapeutic Ang is important. New Ang direction in therapeutic use of such agents is as hypoxia inducible factor, matrix metal-loproteinasis, their inhibitors, urokinase, transcription factors, cyclin dependent kinases. A promising combination of gene and cell therapy using GF, fat cells, progenitor and SC with pharmacological agents, photodynamic effect. Some hopes associated with the activation of neoangiogenesis during operations mechanical tunneling of organs and tissues (surgical Ang).