ADVENTITIAL GENE-TRANSFER TO ARTERIAL-WALL

Vascular gene transfer offers a promising alternative for the treatmen t of cardiovascular diseases. Blood vessels are among the easiest targ ets for gene therapy and in most conditions only a temporary expressio n of the transfected gene will be required to achieve a beneficial bio logical effect. Adenoviruses lead to most efficient transgene expressi on in arterial wall. Depending on the treatment requirements, gene tra nsfer to the artery wall can be accomplished both from lumen and from adventitia. Promising therapeutic effects have been obtained in animal models of restenosis with the transfer of vascular endothelial growth factor (VEGF), nitric oxide synthase, thymidine kinase, retinoblastom a, growth arrest homeobox gene and antisense oligonucleotides against transcription factors or cell cycle regulatory proteins. First experie nces of VEGF gene transfer to human peripheral arteries have also been reported. However, further studies regarding gene transfer techniques , vectors and safety of the procedures are needed before a full therap eutic potential of gene therapy in vascular diseases can be evaluated. (C) 1998 The Italian Pharmacological Society.