Current status of catheter- and stent-based gene therapy

Abstract

Significant progress has been made in the field of cardiovascular gene therapy over the past decade. Animal models of human disease have helped in identifying potential therapeutic genes and have also assisted in the evaluation of an ideal vector. A number of percutaneous catheter systems have been used in animal models with limited success. Stents represent an attractive alternative for localized gene delivery, as they provide a platform for prolonged gene elution and efficient transduction of opposed arterial walls. This gene delivery strategy has the potential to decrease the systemic spread of the viral vectors and hence a reduced host immune response. Both synthetic and naturally occurring stent coatings have shown potential to allow prolonged gene elution with no significant adverse reaction. However, further animal studies are required to evaluate the compatibility of stent coatings, vector solutions, and the arterial wall as well as assessment of the feasibility of this approach to achieve the full potential of gene therapy.

Ultrasonically targeted delivery into endothelial and smooth muscle cells in ex vivo arteries

“…In addition, targeted drug and gene delivery to the endothelium is being used to treat cancerous tumors by anti-vascular therapy [5] and myocardial and peripheral ischemia by promoting angiogenesis [6]. Many drug and gene delivery systems are being developed to increase targeting to vascular cells, such as drug-eluting stents [7], catheter-based systems [8], viral vectors [9,10], and targeted liposomes [11] and microbubbles [12]. However, most current techniques lack either the effectiveness or specificity to adequately treat these disorders while safely administering the therapeutic and avoiding toxic systemic effects or require significantly invasive intervention.…”

Interleukin 10: a new risk marker for the development of restenosis after percutaneous coronary intervention

“…[3][4][5] Several inflammatory genes have already been reported to be associated with the development of restenosis. 6,7 However, little is known about the involvement of anti-inflammatory cytokines, although they seem logic candidate genes in the process of restenosis.…”

Anchoring of self-assembled plasmid DNA/ anti-DNA antibody/cationic lipid micelles on bisphosphonate-modified stent for cardiovascular gene delivery

“…[1][2][3][4] The use of the stent itself as a platform for gene delivery is attractive because it is site specific, potentially helping to avoid distal spread of therapeutic DNA and viral vectors. For example, a wide range of therapeutic DNA and viruses were delivered from the stent surface to reduce the extent of restenosis.…”