Gene therapy for vascular proliferative disorders

Abstract

Despite major advances in interventional techniques in recent years, restenosis remains an important late complication of percutaneous revascularization procedures. Vascular smooth muscle cell proliferation after arterial injury plays an important role in the pathogenesis of restenosis. Major progress has been made recently in elucidating the cellular and molecular mechanisms underlying this proliferative response. This in turn has led to the development of novel, gene-based approaches for the treatment and prevention of restenosis as well as other vascular proliferative disorders. Included among these are somatic gene therapy the ability to introduce and express recombinant genes in non-germ-line cells of a recipient organism in vivo. This article reviews specific genetic approaches that have recently been developed for the treatment of vascular proliferative disorders such as restenosis, focusing on the use of adenovirus-mediated arterial gene transfer strategies designed to suppress the vascular smooth muscle cell proliferative response associated with these diseases.