The latest modality in the treatment of coronary artery disease is to induce hearts to regenerate blood vessels to bypass clogged arteries and damaged tissue. // Unfortunately, clinical trials, which were carried out for two important blood vessel growth factors, fibroblast growth factor- 2 (FGF2) and vascular endothelial growth factor (VEGF), have not yielded sterling outcomes.

Now researchers at Washington University School of Medicine in St. Louis have investigated a third signaling molecule -- called Sonic hedgehog -- that could overcome problems associated with FGF2 and VEGF therapy.

In a report appearing in the June 15 issue of Genes and Development, the team showed that activating hedgehog signals in adult mouse hearts led to an increase in the density of blood vessels in the heart.

Their findings suggest that a drug treatment that turned on or increased hedgehog signals could provide substantial benefit to patients suffering from ischemic heart disease and myocardial infarctions and offer an alternative to invasive procedures like surgery or angioplasty.

About 12 percent of heart patients are not eligible for bypass surgery, which redirects blood around clogged arteries, or for other procedures routinely used to open clogged vessels. That means each year in the United States, 100,000 to 200,000 patients could benefit from having another option for improving blood flow in the heart, according to the study's authors.

'Our study is the first to identify that hedgehog signaling pathways are operational in the developing and mature heart,' says senior author David Ornitz, M.D., Ph.D., the Alumni Endowed Professor of Molecular Biology and Pharmacology.

The hedgehog gene was discovered in fruit flies and named for the spiky appearance of fruit fly embryos with mutations of the gene.

'Hedgehog signaling is a good potential target for growing new vessels in the heart,' says first author Kory
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