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Richard M. Engelman
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Ann Thorac Surg 1999;68:1929-1933
© 1999 The Society of Thoracic Surgeons

I. Pathophysiology of Ischemic Reperfusion Injury

Molecular targets of gene therapy

Dipak K. Das, PhDa, Richard M. Engelman, MDb, Nilanjana Maulik, PhDa, John A. Rousou, MDb, Joseph E. Flack, III, MDb, David W. Deaton, MDb

a Department of Surgery, University of Connecticut School of Medicine, Farmington, Connecticut, USA
b Department of Surgery, Baystate Medical Center, Springfield, Massachusetts, USA

Address reprint requests to Dr Das, Department of Surgery, University of Connecticut School of Medicine, Farmington, CT 06030-1110
e-mail: ddas{at}neuron.uchc.edu

Presented at the International Symposium on Myocardial Protection From Surgical Ischemic-Reperfusion Injury, Asheville, NC, Sep 21–24, 1997.

Abstract

Ischemic reperfused heart represents a potential target for gene therapy because gene transfer can represent an alternate pharmacological approach to protect the heart from cellular injury. Gene therapy may be particularly useful to deal with previously unapproachable problems. For myocardial preservation, gene therapy could replace those pharmacological interventions when drugs are delivered locally by sustained release with the help of mechanical device, eg, implants. In this review, attempts are made to define the molecular targets for gene therapy primarily applicable to myocardial preservation associated with ischemia and reperfusion. It has been emphasized that for successful gene transfer, not only characterization of proper targets and elimination of undesirable side effects are necessary, but also the therapy must be proven superior compared to other pharmacological interventions including surgery.






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