Biomedical Engineering Reference
In-Depth Information
Physiological effects of ANP, including decreased systolic blood pressure, increased
urinary cGMP output, and decreases in heart weight as a percentage of body weight
were also under the control of Mfp. Given these capabilities, this vector represents
a paradigm for the gene therapy of hypertension.
Hepatocyte growth factor (HGF) has close relationships with hypertension, arte-
riosclerosis, and heart failure. HGF enhances renal regeneration and suppresses the
progression of hypertension. Intramuscular electroporation of the therapeutic gene
is a simple and economic method as a remedy for hypertension with low toxic
compared to systemic administration of the purified proteins or peptides (Komamura
et al.
2008
).
Genetic Factors for Myocardial Infarction
Mutations of the gene encoding angiotensin-converting enzyme (ACE) have been
associated with increased risk of myocardial infarction. The main function of ACE
is to convert angiotensin I into angiotensin II, which exerts its cellular actions
through the angiotensin II AT1 receptor subtype AGT1 R. Analysis of DNA from
patients with myocardial infarction shows a significant interaction between ACE
and AGT1 R gene polymorphism. The findings of this study suggest that those
carrying the ACE DD genotype and AGT1 R C allele are at higher risk for myocar-
dial infarction. These findings have clinical implications for the prevention and
treatment of coronary heart disease. Gene therapy could potentially cure these
patients by introduction of a dominant-negative mutation.
Gene Therapy for Acquired Cardiovascular Diseases
This category includes the most common heart diseases such as coronary artery
disease (CAD), angina pectoris, myocardial infarction (MI), and congestive heart
failure (CHF). Role of gene therapy in the treatment of these disorders will be dis-
cussed in this section. Gene therapy strategies could reduce the incidence of heart
disease by correcting the gene defects responsible for insulin-dependent diabetes
mellitus, hyperlipidemia, and hypertension.
Coronary Artery Disease with Angina Pectoris
The use of gene therapy has been explored in improving the management of vascu-
lar occlusive disease. Angiogenic gene therapy for stable angina is aimed at pro-
moting new blood vessel formation in the heart, thus providing enhanced cardiac
perfusion, symptom relief, increased exercise capacity, improved quality of life,
and reduced risk of coronary events.
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