Somatic gene therapy in the cardiovascular system.
This review surveys a range of approaches using plasmid DNA encoding the 165-amino-acid isoform of vascular endothelial growth factor (phVEGF165) to therapeutically modulate micro- or macrovascular endothelial cells, focusing on strategies to augment postnatal collateral circulation in arterial insufficiency or to accelerate re-endothelialization after balloon angioplasty to prevent restenosis. We focus on intra-arterial and intramuscular/intramyocardial gene transfer of the VEGF165 gene, the options that have been most thoroughly studied to date in patients. We review developmental and postnatal significance of the endothelial-cell-specific mitogen VEGF that has stimulated these studies and present limitations of current knowledge as well as challenges for the future.
Baumgartner
I
I
Swiss Cardiovascular Center, Division Angiology, University Hospital, Bern, 3010 Switzerland. iris.baumgartner@insel.ch
Isner
J M
JM
D000818:Animals; D003327:Coronary Disease / Q000628:therapy*; D016228:Endothelial Growth Factors / Q000235:genetics*; D015316:Genetic Therapy; D006801:Humans; D008222:Lymphokines / Q000235:genetics*; D018919:Neovascularization, Physiologic / Q000235:genetics*; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D016228:Endothelial Growth Factors; D008222:Lymphokines; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors