Rank of gene therapy in cardiovascular diseases

Vascular gene transfer potentially offers new treatments for cardiovascular diseases. It may be used to overexpress therapeutically important proteins and correct genetic defects, and to Lest experimentally the effects of var ious genes in a local vascular compartment. Vascular endothelial growth fac tor (VEGF) and fibroblast growth factor (FGF) gene transfers have improved blood flow and collateral development in ischemic limb and myocardium. Prom ising therapeutic effects have been obtained in animal models of restenosis or vein-graft thickening with the transfer of genes coding for VEGF, nitri c-oxide synthase, thymidine kinase, retinoblastoma, growth arrest homoeobox , tissue inhibitor of metalloproteinases, cyclin or cyclin-dependent kinase inhibitors, fas ligand and hirudin, and antisense oligonucleotides against transcription factors or cell-cycle regulatory proteins. First experiences of VEGF gene transfer and decoy oligonucleotides in human beings have been reported. However, further developments in gene transfer vectors, gene del ivery techniques and identification of effective treatment genes will be re quired before the full therapeutic potential of gene therapy in cardiovascu lar disease can be assessed.