Document Detail


Gene therapy for the prevention of vein graft disease.
MedLine Citation:
PMID:  23274305     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ischemic cardiovascular disease remains the leading cause of death worldwide. Despite advances in the medical management of atherosclerosis over the past several decades, many patients require arterial revascularization to reduce mortality and alleviate ischemic symptoms. Technological advancements have led to dramatic increases in the use of percutaneous and endovascular approaches, yet surgical revascularization (bypass surgery) with autologous vein grafts remains a mainstay of therapy for both coronary and peripheral artery disease. Although bypass surgery is highly efficacious in the short term, long-term outcomes are limited by relatively high failure rates as a result of intimal hyperplasia, which is a common feature of vein graft disease. The supply of native veins is limited, and many individuals require multiple grafts and repeat procedures. The need to prevent vein graft failure has led to great interest in gene therapy approaches to this problem. Bypass grafting presents an ideal opportunity for gene therapy, as surgically harvested vein grafts can be treated with gene delivery vectors ex vivo, thereby maximizing gene delivery while minimizing the potential for systemic toxicity and targeting the pathogenesis of vein graft disease at its onset. Here we will review the pathogenesis of vein graft disease and discuss vector delivery strategies and potential molecular targets for its prevention. We will summarize the preclinical and clinical literature on gene therapy in vein grafting and discuss additional considerations for future therapies to prevent vein graft disease.
Authors:
Kevin W Southerland; Sarah B Frazier; Dawn E Bowles; Carmelo A Milano; Christopher D Kontos
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review     Date:  2012-12-27
Journal Detail:
Title:  Translational research : the journal of laboratory and clinical medicine     Volume:  161     ISSN:  1878-1810     ISO Abbreviation:  Transl Res     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-18     Completed Date:  2013-05-08     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  101280339     Medline TA:  Transl Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  321-38     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Blood Vessel Prosthesis / adverse effects*
Clinical Trials as Topic
Gene Transfer Techniques
Genetic Therapy*
Genetic Vectors / genetics
Humans
Veins / transplantation*
Grant Support
ID/Acronym/Agency:
R01 HL083385/HL/NHLBI NIH HHS; R01-HL083385/HL/NHLBI NIH HHS; R21 HL095795/HL/NHLBI NIH HHS; R21-HL095795/HL/NHLBI NIH HHS; T32 GM007171/GM/NIGMS NIH HHS; T32-GM007171/GM/NIGMS NIH HHS; UL1 RR024128/RR/NCRR NIH HHS; UL1-RR024128-04S1/RR/NCRR NIH HHS
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