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Cardiovascular Research 1997 35(3):391-404; doi:10.1016/S0008-6363(97)00148-X
© 1997 by European Society of Cardiology
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Copyright © 1997, European Society of Cardiology

Optimal techniques for arterial gene transfer

Laurent J Feldman* and Gabriel Steg

Cardiology Department and U460 INSERM, Faculté Xavier Bichat, Hôpital Bichat, 46, Rue H. Huchard, 75877 Paris, Cedex, France

* Corresponding author. Tel.: +33 1 40256601; Fax: +33 1 40258865; E-mail: laurent.feldman@bch.ap-hop-paris.fr

Cardiovascular gene therapy is becoming a clinical reality due to improved vectors, delivery systems and careful experimental validation studies. Nearly all cardiovascular diseases are amenable to gene therapy, but the optimal combination of vector, delivery system and therapeutic gene is likely to be unique to each application. Currently, the most efficient vectors available are replication-defective adenoviral vectors, but transgene expression is limited in time due to a strong immune response. Conversely, non-viral vectors or plasmid DNA may be used safely but have very limited efficiency. Percutaneous, catheter-based delivery is feasible for most applications. The ultimate issues that will decide of the future of gene therapy are safety of the transfer and delivery techniques as well as cost/effectiveness comparisons with alternative therapies, including local delivery of drugs, proteins and/or mechanical devices.

KEYWORDS Gene therapy; Atherosclerosis; Adenovirus; Liposomes; Catheter; Restenosis; Angiogenesis; Plaque stabilization


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