Clinical applications of vascular gene therapy

Abstract

Despite significant advances in prevention, coronary artery disease remains the leading cause of death in the Western world. Surgical bypass and angioplasty are the primary interventional therapies but they are limited by the problems of restenosis and graft occlusions. Natural response to vascular occlusion involves the formation of collateral vessels that bypass obstructions, but they are often inefficient in relieving ischemia. Vascular gene transfer offers a promising new approach to solve these problems. Its potential has been shown in animal models and in first human trials using vascular endothelial growth factor, fibroblast growth factor, and E2F cell-cycle transcription factor decoy. However, further basic research on gene transfer vectors, gene delivery techniques, and identification of effective treatment genes is needed to improve the efficacy and safety of human vascular gene therapy.

Vascularization in tissue engineering

“…Several strategies for the delivery of both direct and indirect angiogenic factors have been developed. These include the addition of recombinant proteins [29] and genes [30] to biomaterials and the use of cell transplants that are genetically engineered to overexpress specific factors [31]. The addition of recombinant proteins to biomaterials is the easiest method and thus has been most widely studied.…”

Gene therapy for therapeutic angiogenesis in critically ischaemic lower limb – on the way to the clinic

“…In the recent years, postnatal growth of blood vessels has become a new possibility for treating ischaemic disorders [7–9]. Classically vascular growth is divided into vasculogenesis, angiogenesis and arteriogenesis.…”