Cardiovascular gene therapy for myocardial infarction

Abstract

Introduction: Cardiovascular gene therapy is the third most popular application for gene therapy, representing 8.4% of all gene therapy trials as reported in 2012 estimates. Gene therapy in cardiovascular disease is aiming to treat heart failure from ischemic and non-ischemic causes, peripheral artery disease, venous ulcer, pulmonary hypertension, atherosclerosis and monogenic diseases, such as Fabry disease.

Areas covered: In this review, we will focus on elucidating current molecular targets for the treatment of ventricular dysfunction following myocardial infarction (MI). In particular, we will focus on the treatment of i) the clinical consequences of it, such as heart failure and residual myocardial ischemia and ii) etiological causes of MI (coronary vessels atherosclerosis, bypass venous graft disease, in-stent restenosis).

Expert opinion: We summarise the scheme of the review and the molecular targets either already at the gene therapy clinical trial phase or in the pipeline. These targets will be discussed below. Following this, we will focus on what we believe are the 4 prerequisites of success of any gene target therapy: safety, expression, specificity and efficacy (SESE).

Keywords::

• efficacy
• gene therapy
• myocardial infarction
• safety

Declaration of interest

This work is supported by R37 HL061690, R01 HL085503, P01 HL091799, P01 HL108806, P01 HL075443 and F32 HL110675 to W. J. Koch M. C. Scimia holds Grants4Targets from Bayer HealthCare, Drug Discovery Initiative Grant from Moulder Center of Temple University and the Scientist Development Grant from the AHA. A. Gumpert holds American Heart Association Postdoctoral Award.

Notes

This box summarizes key points contained in the article.