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Granulocyte colony-stimulating factor (G-CSF) as a new therapeutic approach to myocardial infarction.
DailyUpdates
15th
March 2004. Thrombolytic, antithrombotic and anticoagulant treatments represent the major acute therapeutic options for the treatment of myocardial infarction. However, in the days and weeks following myocardial damage, strategies to prevent further ischemic cell death or to promote the recovery of damaged tissue may be of greater advantage. Japanese researchers have now demonstrated the therapeutic potential of granulocyte colony-stimulating factor (G-CSF) when administered after the onset of myocardial infarction.
According to IMS MIDAS data, global sales of cardiovascular and antithrombotic drugs including those used as cardiac therapies, reached $72.6bn in 2002 (for an analysis of this field click here). Thrombolytic, antithrombotic and anticoagulant treatments represent the major acute therapeutic options for the treatment of myocardial infarction. However, in the days and weeks following myocardial damage, strategies to prevent further ischemic cell death or to promote the recovery of damaged tissue may be of greater advantage. Pharmacologic agents with the ability to promote angiogenesis (new blood vessel formation) may offer considerable hope with respect to tissue remodeling and salvage. In search of novel therapies for the treatment of cardiovascular diseases, especially myocardial infarction, much work has recently appeared focusing on the use of stem cell. Collectively, the value of markets for cell therapy technologies in 2002 was approximately $20.2 billion and is estimated to increase to $35.7 billion by the year 2007 and $81.3 billion by the year 2012 (for an analysis of this field click here). As an alternative to the use of cell therapeutics the drug discovery sector is also engaged in the identification of growth factors including various cytokines that stimulate the growth of stem cells. Growth factors are gene products that play important roles in the regulation of cell division and tissue proliferation. Generally, the binding of a growth factor to its receptor initiates or, in some cases, blocks the ability of cells to divide and multiply. Pretreatment with a combination of granulocyte colony-stimulating factor (G-CSF) and stem cell factor (SCF) has been reported to attenuate left ventricular remodelling after acute myocardial infarction. Now Japanese researchers have reported that cytokine treatment started after myocardial infarction also has beneficial effects. In their FASEB Journal publication, Ohtsuka et al report that the administration of G-CSF alone or together with SCF for 5 days after myocardial infarction reduced left ventricular remodelling and improved cardiac function and survival rate after myocardial infarction. The number of capillaries was increased suggestive of enhanced neovascularization and the number of apoptotic cells was decreased in the border area. Improved thrombolytic strategies for the acute treatment of myocardial infarction should reduce cardiovascular death rates considerably. Further improvements in longer term treatment of patients are also required and this data suggests that the use of G-CSF represents a strategy extending past the window during which thrombolytic therapies may be of use.
(source DailyUpdates 15th
March; for a full abstract of the original paper see FASEB
J. 2004 Mar 4 [Epub ahead of print])
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