Gene Therapy for Coronary Restenosis: A Promising Strategy for the New Millennium?

Gene therapy is an attractive alternative for reducing restenosis after percutaneous coronary interventions. Several approaches, using genes encoding antiproliferative, antimigratory, cytostatic, or cytotoxic proteins have been successfully tested in relevant animal models. Antiproliferative, gene-based strategies also appear to be good candidates for the highly proliferative lesion responsible for in-stent restenosis. However, several key issues, including vector safety and delivery mechanisms, still have to be resolved before percutaneous gene therapy can be widely applied in the clinic. The amount of experimental research in this field indicates a medical evolution that can (and should) not be ignored by cardiologists.