Cardiovascular Gene Therapy: Past, Present, and Future

Mol Ther. 2017 May 3;25(5):1095-1106. doi: 10.1016/j.ymthe.2017.03.027. Epub 2017 Apr 4.

Abstract

Cardiovascular diseases remain a large global health problem. Although several conventional small-molecule treatments are available for common cardiovascular problems, gene therapy is a potential treatment option for acquired and inherited cardiovascular diseases that remain with unmet clinical needs. Among potential targets for gene therapy are severe cardiac and peripheral ischemia, heart failure, vein graft failure, and some forms of dyslipidemias. The first approved gene therapy in the Western world was indicated for lipoprotein lipase deficiency, which causes high plasma triglyceride levels. With improved gene delivery methods and more efficient vectors, together with interventional transgene strategies aligned for a better understanding of the pathophysiology of these diseases, new approaches are currently tested for safety and efficacy in clinical trials. In this article, we integrate a historical perspective with recent advances that will likely affect clinical development in this research area.

Keywords: cardiovascular gene therapy; clinical trials; endpoints; heart failure; hyperlipidemias; ischemia; trial design.

Publication types

  • Historical Article
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoviruses, Human / genetics
  • Adenoviruses, Human / metabolism
  • Animals
  • Cardiovascular Diseases / genetics
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / pathology
  • Cardiovascular Diseases / therapy*
  • Clinical Trials as Topic
  • Disease Models, Animal
  • Drug Approval
  • Fibroblast Growth Factor 4 / genetics*
  • Fibroblast Growth Factor 4 / metabolism
  • Gene Expression
  • Genetic Therapy / history
  • Genetic Therapy / methods
  • Genetic Therapy / trends*
  • Genetic Vectors / administration & dosage*
  • Genetic Vectors / chemistry
  • Genetic Vectors / metabolism
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Injections, Intramuscular
  • Sarcoplasmic Reticulum Calcium-Transporting ATPases / genetics*
  • Sarcoplasmic Reticulum Calcium-Transporting ATPases / metabolism
  • Vascular Endothelial Growth Factor A / genetics*
  • Vascular Endothelial Growth Factor A / metabolism

Substances

  • FGF4 protein, human
  • Fibroblast Growth Factor 4
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Sarcoplasmic Reticulum Calcium-Transporting ATPases