Reprogrammed Endothelial Cells Cell Therapy for Coronary Collateral Growth?

Myocardial infarction, ischemic stroke, and atherosclero-sis of arteries supplying the heart, brain, and lower extremities are leading causes of morbidity and mortality. The abundance of native preexisting collateral vessels in tissues, and their anatomic lumen enlargement induced by arterial obstruction (remodeling or arteriogenesis) are major determinants of the severity of ischemic tissue injury caused by these diseases. Unfortunately, findings in animal studies showing that both of these determinants vary significantly among individuals because of differences in genetic back-ground and environmental factors (eg, cardiovascular risk factors) are beginning to find corroboration in humans.1–6 Although efforts to increase collateral growth in ischemia using small molecules, proteins, and gene therapy have shown some effectiveness in experimental animals, patient trials for therapeutic angiogenesis have been largel