Somatic gene therapy in the cardiovascular system

This review surveys a range of approaches using plasmid DNA encoding the 16 5-amino-acid isoform of vascular endothelial growth factor (phVEGF(165)) to therapeutically modulate micro- or macrovascular endothelial cells, focusi ng on strategies to augment postnatal collateral circulation in arterial in sufficiency or to accelerate re-endothelialization after balloon angioplast y to prevent restenosis. We focus on intra-arterial and intramuscular/intra myocardial gene transfer of the VEGF(165) gene, the options that have been most thoroughly studied to date in patients. We review developmental and po stnatal significance of the endothelial-cell-specific mitogen VEGF that has stimulated these studies and present limitations of current knowledge as w ell as challenges for the future.