Sonic boon: ultrasound enhances angiogenic cell therapy

This editorial refers to ‘Ultrasound stimulation restores impaired neovascularization-related capacities of human circulating angiogenic cells’ by Y. Toyama et a l., pp. 448–459, this issue. Peripheral vascular disease (PVD) affects ∼8 million people per year in the USA alone, and causes significant morbidity and mortality worldwide. Amputation remains the definitive treatment for severe PVD, despite the numerous negative effects the loss of a limb can have for a patient with PVD.1 Recent advances in molecular and cellular therapeutics offer the possibility that therapeutic angiogenesis may improve patient outcomes and improve the standard of care for patients with PVD.1,2 Gene therapy approaches have been developed to increase neovascularization in models of critical limb ischaemia (CLI) by expressing gene(s) associated with angiogenesis. These approaches have demonstrated much promise at the preclinical level, and have led to numerous efficacy and safety studies with a variety of therapeutic genes. Clinical gene therapy studies have been challenged by the relatively short duration of gene expression in some systems, as well as by the suboptimal distribution of gene expression, and have failed to demonstrate a significant benefit of gene therapy over placebo. …