Cardiovascular disease is the leading cause of death in the Western world, and gene
therapy approaches to several cardiovascular disorders have been proposed. One of
the major stumbling blocks to be overcome before widespread clinical use of this technology
is how to deliver DNA efficiently and safely to cells in vivo. While delivery of DNA
alone is inefficient, use of viral vectors may overcome this problem. Adenoviral vectors
are most commonly used in cardiovascular gene delivery, but toxicity related to these
vectors remains a concern. In addition, duration of gene expression with use of these
vectors is limited, which may be advantageous in settings in which transient expression
is satisfactory to obtain a therapeutic effect. Gene therapy has been suggested as
an approach to multiple conditions, including restenosis after angioplasty, therapeutic
neovascularization, and bypass graft restenosis. Phase 1 clinical trials were recently
reported. While proof of principle has been established in preclinical animal models,
convincing efficacy data in humans do not yet exist. Improvements in vector technology
and methods of catheter . mediated vascular gene delivery are needed before widespread
clinical application of this therapy.
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Article info
Footnotes
This work was supported by grant HL58080 from the National Heart, Lung, and Blood Institute (T.O.), a Juvenile Diabetes Foundation International Career Development Award (T.O.), and support from the Bruce and Ruth Rappaport Program in Vascular Biology.
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© 2000 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
