Heart 1997;78:426-428 ( November )
Editorial
Possible uses of gene therapy in reducing coronary restenosis
| The first 150 words of the full text of this article appear below. |
Gene transfer has been carried out in more than 700 patients as part of over 200 registered protocols in the United States and Europe since 1989. Although success rates vary and many efficacy and safety issues remain unsolved, the potential of this alternative therapeutic method is well accepted. The lack of success of many pharmaceutical agents in reducing restenosis rates after angioplasty shown in dozens of clinical trials has encouraged the development of gene therapy as a further treatment. The introduction of special catheters for local drug delivery allows high efficacy combined with maximum safety.
Pathophysiology of restenosisFour overlapping stages occur in the development of restenosis
as described in animal models. The inflammatory and thrombotic phases
begin at the time of injury and are maximal hours later. These are
followed by a proliferative phase, with the highest division activity
of smooth muscle cells about seven days after injury. Finally, there is
matrix
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