Division of Cardiology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.
College of Medicine, Kyung Hee University, Seoul, Korea.
Yonsei Med J. 2024 Oct;65(10):557-571. doi: 10.3349/ymj.2024.0127.
Cardiovascular disease (CVD) stands as one of the leading causes of death in the United States, with its prevalence steadily on the rise. Traditional therapeutic approaches, such as pharmacological treatment, cardiovascular intervention, and surgery, have inherent limitations. In response to these challenges, cardiac gene therapy has emerged as a promising alternative for treating CVD patients. However, several obstacles persist, including the low efficiency of gene transduction, immune reactions to vectors or transduced cells, and the occurrence of off-target effects. While preclinical research has demonstrated significant success in various CVD model in both small and large animals, the translation of these findings to clinical applications has, for the most part, yielded disappointing results, except for some early, albeit small, trials. This review aims to provide a comprehensive summary of recent preclinical and clinical studies on gene therapy for various CVDs. Additionally, we discuss the existing limitations and challenges that hinder the widespread clinical application of cardiac gene therapy.
心血管疾病(CVD)是美国主要的死亡原因之一,其患病率稳步上升。传统的治疗方法,如药物治疗、心血管介入治疗和手术,存在固有局限性。为应对这些挑战,心脏基因治疗已成为治疗 CVD 患者的一种有前途的替代方法。然而,仍存在一些障碍,包括基因转导效率低、载体或转导细胞的免疫反应以及脱靶效应的发生。尽管临床前研究在小型和大型动物的各种 CVD 模型中取得了显著成功,但这些发现转化为临床应用的大部分结果令人失望,除了一些早期的、尽管规模较小的试验。本综述旨在对各种 CVD 的基因治疗的临床前和临床研究进行全面总结。此外,我们还讨论了阻碍心脏基因治疗广泛临床应用的现有局限性和挑战。