Wu Joseph C, Yla-Herttuala Seppo
Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Edwards Building, Room R354, Stanford, CA 94305-5344, USA.
Eur J Nucl Med Mol Imaging. 2005 Dec;32 Suppl 2:S346-57. doi: 10.1007/s00259-005-1897-6.
This review discusses the basics of cardiovascular gene therapy, the results of recent human clinical trials, and the rapid progress in imaging techniques in cardiology. Improved understanding of the molecular and genetic basis of coronary heart disease has made gene therapy a potential new alternative for the treatment of cardiovascular diseases. Experimental studies have established the proof-of-principle that gene transfer to the cardiovascular system can achieve therapeutic effects. First human clinical trials provided initial evidence of feasibility and safety of cardiovascular gene therapy. However, phase II/III clinical trials have so far been rather disappointing and one of the major problems in cardiovascular gene therapy has been the inability to verify gene expression in the target tissue. New imaging techniques could significantly contribute to the development of better gene therapeutic approaches. Although the exact choice of imaging modality will depend on the biological question asked, further improvement in image resolution and detection sensitivity will be needed for all modalities as we move from imaging of organs and tissues to imaging of cells and genes.
本综述讨论了心血管基因治疗的基础知识、近期人类临床试验的结果以及心脏病学成像技术的快速进展。对冠心病分子和遗传基础的深入了解使基因治疗成为心血管疾病治疗的一种潜在新选择。实验研究已证实将基因转移至心血管系统可实现治疗效果。首批人体临床试验提供了心血管基因治疗可行性和安全性的初步证据。然而，到目前为止，II/III期临床试验结果相当令人失望，心血管基因治疗的主要问题之一是无法在靶组织中验证基因表达。新的成像技术可显著推动更好的基因治疗方法的发展。尽管成像方式的确切选择将取决于所提出的生物学问题，但随着我们从器官和组织成像转向细胞和基因成像，所有成像方式都需要进一步提高图像分辨率和检测灵敏度。
