Non-viral Gene Delivery with Stents for the Treatment of Restenosis

Scientists and engineers at Northeastern University and the University of Pittsburgh collaboratively designed and performed an animal trial to demonstrate how gene eluting stents can be made to alter the gene expression of the tissues they contact in order to treat or prevent restenosis of the artery. In this study, the researchers used liposome structures, adhered to the stent in a gelatine mixture, to deliver a gene coding for human endothelial nirtic oxide synthase to the tissue around the stent. Nitric oxide is useful in the treatment and prevention of restenosis because it both discourages smooth muscle growth, which is a cause of arteriosclerosis, and promotes healthy endothelial growth to cover the damaged areas of the artery. A gene that produces this enzyme that catalyses the production of nitric oxide provides an opportunity to help the body essentially heal itself. Another notable accomplishment of the study is that they were able to introduce the genes without the need for a virus vector, which can have a high cytotoxicity and is unlikely to be used in a clinical setting.

This study could have a huge impact upon future treatment of cardiovascular disease. Today, stenting is done routinely, and restenosis is a very common problem, sometimes requiring additional surgery and other therapies. As this problem has become obvious, drug eluting stents have become the weapon of choice against restenosis. Drug eluting stents, however, are imprecise (their drugs affect more than the immediate area), and the drugs they carry could be improved upon. Using a form of gene therapy to temporarily induce the cells in the damaged area to produce nitric oxide would be a very attractive therapy either alone or in tandem with other therapies to treat restenosis, especially if it could be done without a virus vector.

This article is highly interesting because of its implications in the treatment of one of the most common causes of death in the developed world: cardio vascular disease. It is interesting how the researchers were able to think a little bit outside the box in treating this common disease.

http://www.biomedical-engineering-online.com/content/9/1/56