MODERN METHODS FOR ANGIOGENESIS ASSESSMENT IN CLINICAL PRACTICE

The concept of translational medicine implies early introduction of achievements of basic science into clinical practice for solving urgent problems of medicine. One area in which this concept finds its application is regenerative medicine including the gene and cell technologies. In recent years the growing interest was linked to the therapeutic angiogenesis – the method of stimulating the growth of blood vessels with the use of gene-cell approaches. However, despite the promising results in preclinical research, gene and cell drugs have shown limited effectiveness in clinical practice. This may be due to insufficient knowledge of the angiogenesis processes in humans. In the same time diverting results of clinical trials of gene-cell based drugs for treatment of peripheral arterial diseases and ischemic heart disease maybelin ked to in appropriate selection of diagnostic tools for therapeutic angiogenesis evaluation. The aim of the review is to describe advantages and disadvantages of the clinical methods to assess the formation of micro vascular bed – traditional and conventional (anklebrachial index assessment, segmental blood pressure measurement, duplex ultrasonography, angiography, transcutaneous oxygen pressure measurement), as well as innovative (angiography with indocyanine green, hyper spectral imaging, laser Doppler flowmetry, hyprid SPECT/MRI systems, molecular angiogenesis visualization methods) – for further analysis of the effectiveness of the applied angiogenic (anti-angiogenesis) therapy. Implementation of novel non-invasive methods for monitoring of molecular processes in ischemic tissues including effects of proangiogenic therapy into clinical practice allows early diagnostics and outcome prognostics of cardiovascular diseases and to find new therapeutic approaches for their healing.