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Gene Therapy Approaches for the Prevention of Restenosis

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Experimental gene-therapeutic approaches for the prevention of restenosis after balloon angioplasty are the major source of our insight into pathways operative in the process of vascular renarrowing. We now understand that thrombosis and inflammation are the key mechanisms triggering vascular “healing” in response to injury and know a multitude of potential gene-therapeutic strategies to interfere with appositional thrombus formation, proliferation and migration of vascular smooth muscle cells, lesional recruitment of inflammatory cells or excess deposition of extracellular matrix. Thus far, the major limitation for clinical anti-restenotic gene therapy are concerns about the safety and efficacy of vector systems in use for the local overexpression of transgenes, which in turn is one of the most attractive advantages of gene therapy compared to systemic drug therapy. Here, we review the molecular mechanisms operative in postangioplasty restenosis by highlighting their respective gene therapeutic approaches and the current viral and non-viral vector systems.
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Keywords: adenovirus; balloon angioplasty; gene therapy; inflammation; restenosis; smooth muscle cell proliferation

Document Type: Review Article

Affiliations: Institute of Vascular Biology and Thrombosis Research, University of Vienna, Brunnerstr. 59, A-1235 Vienna, Austria.

Publication date: 2004-04-01

More about this publication?
  • Vascular disease is the commonest cause of death in Westernized countries and its incidence is on the increase in developing countries. It follows that considerable research is directed at establishing effective treatment for acute vascular events. Long-term treatment has also received considerable attention (e.g. for symptomatic relief). Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials.

    Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved. The latter include cardiology, vascular and cardio thoracic surgery, general medicine, radiology, clinical pharmacology and neurology (stroke units). Current Vascular Pharmacology will publish reviews to update all those concerned with the treatment of vascular disease. For example, reviews commenting on recently published trials or new drugs will be included. In addition to clinically relevant topics we will consider 'research-based' reviews dealing with future developments and potential drug targets. Therefore, another function of Current Vascular Pharmacology is to bridge the gap between clinical practice and ongoing research.

    Debates will also be encouraged in the correspondence section of this journal.
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