Fibroblast growth factor 4 gene therapy for chronic ischemic heart disease

Therapeutic myocardial angiogenesis and arteriogenesis represent a novel treatment strategy for patients with angina refractory to traditional medical and surgical therapies. The fibroblast growth factors are a family of proteins that are known mediators of angio-/arteriogenesis. Based on promising preclinical animal data, a series of four randomized placebo-controlled clinical trials have been conducted to determine the safety and efficacy of local delivery of fibroblast growth factor 4 with the use of adenovirus-vector-mediated gene transfer to induce myocardial angio-/arteriogenesis in patients with stable angina. This review describes the scientific rationale underlying these clinical trials, provides an overview of their results, and discusses the implications for future studies.