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Non‐viral gene therapy for myocardial engineering
Author(s) -
Holladay Carolyn A.,
O'Brien Timothy,
Pandit Abhay
Publication year - 2010
Publication title -
wiley interdisciplinary reviews: nanomedicine and nanobiotechnology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.175
H-Index - 72
eISSN - 1939-0041
pISSN - 1939-5116
DOI - 10.1002/wnan.60
Subject(s) - genetic enhancement , gene delivery , paracrine signalling , viral vector , cell therapy , medicine , regeneration (biology) , myocardial infarction , transfection , vector (molecular biology) , clinical trial , stem cell therapy , stem cell , immunogenicity , bioinformatics , gene , biology , immunology , microbiology and biotechnology , pathology , surgery , cardiology , immune system , transplantation , genetics , recombinant dna , receptor
Abstract Despite significant advances in surgical and pharmacological techniques, myocardial infarction (MI) remains the main cause of morbidity in the developed world because no remedy has been found for the regeneration of infarcted myocardium. Once the blood supply to the area in question is interrupted, the inflammatory cascade, among other mechanisms, results in the damaged tissue becoming a scar. The goals of cardiac gene therapy are essentially to minimize damage, to promote regeneration, or some combination thereof. While the vector is, in theory, less important than the gene being delivered, the choice of vector can have a significant impact. Viral therapies can have very high transfection efficiencies, but disadvantages include immunogenicity, retroviral‐mediated insertional mutagenesis, and the expense and difficulty of manufacture. For these reasons, researchers have focused on non‐viral gene therapy as an alternative. In this review, naked plasmid delivery, or the delivery of complexed plasmids, and cell‐mediated gene delivery to the myocardium will be reviewed. Pre‐clinical and clinical trials in the cardiac tissue will form the core of the discussion. While unmodified stem cells are sometimes considered therapeutic vectors on the basis of paracrine mechanisms of action basic understanding is limited. Thus, only genetically modified cells will be discussed as cell‐mediated gene therapy. WIREs Nanomed Nanobiotechnol 2010 2 232–248 This article is categorized under: Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement