Restenosis and gene therapy.
Atherosclerosis is one of the main causes of mortality and morbidity in westernised countries. Treatment of symptomatic atherosclerosis by angioplasty involves major vascular responses such as neointima formation and constrictive vascular remodelling leading to restenosis. Stent placement prevents vasoconstriction but is associated with in-stent neointima formation. Therefore, stent placement requires adjunctive therapy. In this review we discuss the potential of local gene therapy for restenosis. More particularly, we focus on strategies to inhibit smooth muscle cell (SMC) proliferation and migration, prevent thrombosis, decrease oxidative stress in the arterial wall and enhance re-endothelialisation associated with adaptive remodelling. The potential of different vector systems and devices for local gene transfer in the arterial wall is discussed.
Quarck
R
R
Department of Experimental Surgery and Anaesthesiology, University of Leuven, Campus Gasthuisberg O&N, Herestraat 49, B-3000 Leuven, Belgium.
Holvoet
P
P
D000818:Animals; D000975:Antioxidants / Q000494:pharmacology / Q000627:therapeutic use; D002455:Cell Division; D002465:Cell Movement; D023903:Coronary Restenosis / Q000628:therapy*; D004730:Endothelium, Vascular / Q000166:cytology / Q000378:metabolism; D015316:Genetic Therapy / Q000379:methods*; D005822:Genetic Vectors; D006801:Humans; D008954:Models, Biological; D016376:Oligonucleotides, Antisense / Q000627:therapeutic use; D010957:Plasmids / Q000378:metabolism; D014780:Viruses / Q000235:genetics
D000975:Antioxidants; D016376:Oligonucleotides, Antisense