Molecular targets of gene therapy

Ischemic reperfused heart represents a potential target for gene therapy be cause gene transfer can represent an alternate pharmacological approach to protect the heart from cellular injury. Gene therapy may be particularly us eful to deal with previously unapproachable problems. For myocardial preser vation, gene therapy could replace those pharmacological interventions when drugs are delivered locally by sustained release with the help of mechanic al device, eg, implants. In this review, attempts are made to define the mo lecular targets for gene therapy primarily applicable to myocardial preserv ation associated with ischemia and reperfusion. It has been emphasized that for successful gene transfer, not only characterization of proper targets and elimination of undesirable side effects are necessary, but also the the rapy must be proven superior compared to other pharmacological intervention s including surgery. (C) 1999 by The Society of Thoracic Surgeons.