title: Gene therapy for ischemic heart disease: review of clinical trials.
abstract: Severe ischemic heart disease with refractory angina, occurs in increasing incidence. Alternative forms of treatment, in an attempt to reduce myocardial ischemia and relief of symptoms has been studied. In this context, gene therapy is an option, for the possibility of inducing angiogenesis, establish collateral circulation and reperfuse ischemic myocardium. Several clinical trials have been conducted and, except for specific cases of adverse effects, there is indication of safety, feasibility and potential effectiveness of therapy. The clinical benefit, however, is not yet well established. In this article we review the clinical trials of gene therapy for patients with ischemic heart disease. The approach includes: (1) myocardial ischemia and angiogenesis on the pathophysiological aspects involved, (2) growth factors, dealing with specific aspects and justifying the use in cardiac patients with no option for conventional therapy, (3) controlled clinical trials, where a summary of the main studies involving gene therapy for severe ischemic heart disease is presented, (4) our experience, especially on preliminary results of the first gene therapy clinical trial in Brazil and (5) future prospects.
authors.affiliation: Programa de Pós-Graduação, Instituto de Cardiologia do Rio Grande do Sul, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brasil.
authors.forename: Bruna
authors.initials: B
authors.lastname: Eibel
authors.forename: Clarissa G
authors.initials: CG
authors.lastname: Rodrigues
authors.forename: Imarilde I
authors.initials: II
authors.lastname: Giusti
authors.forename: Ivo A
authors.initials: IA
authors.lastname: Nesralla
authors.forename: Paulo R L
authors.initials: PR
authors.lastname: Prates
authors.forename: Roberto T
authors.initials: RT
authors.lastname: Sant'Anna
authors.forename: Nance B
authors.initials: NB
authors.lastname: Nardi
authors.forename: Renato A K
authors.initials: RA
authors.lastname: Kalil
mesh_terms: D001938:Brazil; D002986:Clinical Trials as Topic; D015316:Genetic Therapy; D006801:Humans; D017202:Myocardial Ischemia / Q000628:therapy*; D042442:Vascular Endothelial Growth Factors / Q000502:physiology
chemical_list: D042442:Vascular Endothelial Growth Factors