Prevention of coronary in-stent restenosis and vein graft failure: Does vascular gene therapy have a role?

Robertson, K.E., McDonald, R.A., Oldroyd, K.G., Nicklin, S.A. and Baker, A.H. (2012) Prevention of coronary in-stent restenosis and vein graft failure: Does vascular gene therapy have a role? Pharmacology and Therapeutics, 136(1), pp. 23-34. (doi:10.1016/j.pharmthera.2012.07.002)

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Abstract

Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), including stent insertion, are established therapies in both acute coronary syndromes (ACS) and symptomatic chronic coronary artery disease refractory to pharmacological therapy. These continually advancing treatments remain limited by failure of conduit grafts in CABG and by restenosis or thrombosis of stented vessel segments in PCI caused by neointimal hyperplasia, impaired endothelialisation and accelerated atherosclerosis. While pharmacological and technological advancements have improved patient outcomes following both procedures, when grafts or stents fail these result in significant health burdens. In this review we discuss the pathophysiology of vein graft disease and in-stent restenosis, gene therapy vector development and design, and translation from pre-clinical animal models through human clinical trials. We identify the key issues that are currently preventing vascular gene therapy from interfacing with clinical use and introduce the areas of research attempting to overcome these.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Robertson, Dr Keith and Nicklin, Professor Stuart and Baker, Professor Andrew and Oldroyd, Dr Keith and McDonald, Dr Robert
Authors: Robertson, K.E., McDonald, R.A., Oldroyd, K.G., Nicklin, S.A., and Baker, A.H.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Pharmacology and Therapeutics
Publisher:Elsevier
ISSN:0163-7258
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
477651Optimisation and analysis of integrating and non-integrating lentiviruses for vascular gene transfer in vivo - application to in-stent restenosis with delivery of Nogo-BAndrew BakerBritish Heart Foundation (BHF)FS/08/026/24762RI CARDIOVASCULAR & MEDICAL SCIENCES