"Bronchial artery delivery of viral vectors for gene delivery in cystic fibrosis; superior to airway delivery?".
BACKGROUND
Attempts at gene therapy for the pulmonary manifestations of Cystic Fibrosis have relied mainly on airway delivery. However the efficiency of gene transfer and expression in the airway epithelia has not reached therapeutic levels. Access to epithelial cells is not homogenous for a number of reasons and the submucosal glands cannot be reached via the airways.


METHODS
We propose to inject gene delivery vectors directly into bronchial arteries combined with pre-delivery of vascular endothelial growth factor to increase vascular endothelial permeability and post-delivery flow reduction by balloon occlusion. Thus it may be possible to reach mucous secreting cells of the bronchial luminal epithelium and the submucosal glands in an increased and homogenous fashion.


METHODS
This combination of techniques to the best of our knowledge has not previously been investigated, and may enable us to overcome some of the current limitations to gene therapy for Cystic Fibrosis.
Bakhai
Ameet
A
Clinical Trials & Evaluation Unit, Royal Brompton & Harefield NHS Trust, Britten Wing, Sydney Street, SW3 6NP, London UK. a.bakhai@rbh.nthames.nhs.uk
Sheridan
Desmond J
DJ
Coutelle
Charles C
CC