UC Doctors Test Protein in Heart Patients
Published December 2003
Physicians from UC have performed the first growth
factor protein injection in a heart patient to aid in the growth of new
coronary vessels. The protein, FGF1, was injected directly into the
heart muscle of a patient on November 3 at The University Hospital.
This cutting-edge procedure is part of a phase I
clinical trial testing the efficacy of using FGF1 for angiogenesis, the
growth of new blood vessels in patients with angina due to coronary
artery disease. The trial is sponsored by CardioVascular Genetic
Engineering of Tustin, California, and is expected to enroll 32
Walter H. Merrill, MD, chief of cardiothoracic surgery
at UC, performed the protein injection. He was assisted by Thomas
Stegmann, MD, professor and chief of cardiovascular surgery at Fulda
Medical Center in Fulda, Germany. Dr. Stegmann worked on the discovery
and development of this growth factor, and performed the first
procedure of this kind in the world.
During the procedure, patients receive up to two
injections of the growth factor protein during minimally-invasive,
beating-heart surgery. Supplementing the heart with the growth factor
protein can result in the growth of new blood vessels, which in turn
provides alternate routes for oxygenated blood to reach the heart
muscle. FGF1 has the potential to provide an additional treatment
option for those whose coronary artery disease cannot be adequately
treated by the most common methods, such as bypass surgery, angioplasty
Lynne Wagoner, MD, associate professor, UC Department
of Internal Medicine/Division of Cardiology, is the director of Cardiac
Services at The University Hospital. Dr. Wagoner is the director of
clinical trials at the new UC Heart and Vascular Center, and is the
principal investigator for this trial.
"Some people have such severe coronary artery disease
that conventional treatments such as stents or bypass surgery aren't an
option for them," said Dr. Wagoner. "Angiogenesis represents a very
promising treatment for the future."
"This is an exciting new therapeutic option for
patients who cannot be improved by any other means," said Dr. Merrill.
"Angiogenesis holds great potential to benefit patients in the future.
Monday's procedure is representative of important collaborations
between medical and surgical specialties that results in a spectrum of
extraordinary care for patients with advanced heart disease."
Angiogenesis occurs in an orderly series of complex
events: diseased or injured tissues produce and release proteins called
angiogenic growth factors, which bind to specific receptors located on
the cells of nearby blood vessels. The cells begin to produce new
molecules including enzymes, then divide and migrate outward, forming
new blood vessels. Individual blood vessel tubes connect to form a
network for circulation, and specialized muscle cells provide
structural support to these newly formed vessels to facilitate blood
flow throughout the body.
The healthy body controls angiogenesis by balancing
growth proteins with angiogenic inhibitors; the interaction between the
two serves as an "on" and "off" switch for new growth. When growth
factor proteins are produced in excess of inhibitors, blood vessel
growth is more likely.