Title:Nucleic Acid Drugs for Preventing Restenosis after Coronary Revascularization
Volume: 12
Issue: 15
Author(s): Takashi Miyake, Hironori Nakagami and Ryuichi Morishita
Affiliation:
Keywords:
Angioplasty, nucleic acid drug, restenosis, vein graft, ischemic heart disease, vascular bypass graft failure, heart failure, (ODN)-based therapy, siRNA- and miRNA-based strategies, ODN-based gene therapy
Abstract: Recent progress in molecular and cellular biology has resulted in the development of numerous effective drugs.
However, there are still a number of diseases for which no known effective therapy exists, such as ischemic heart disease,
vascular bypass graft failure and heart failure. Despite its limitations, oligodeoxynucleotide (ODN)-based therapy is
emerging as a potential strategy for the treatment of patients with cardiovascular disease that is resistant to current therapeutic
approaches. Indeed, several nucleic acid drugs and delivery methods for heart disease have been developed and
their efficacy has been investigated in animal models. Among them, some agents have undergone clinical trials, such as cmyc
antisense ODN, E2F and NFκB decoy ODN. However, none of the large randomized placebo-controlled trials has
shown conclusive evidence of clinical benefit. Recent experimental studies suggested that siRNA- and miRNA-based
strategies have potential as a potent therapeutic approach for the treatment of restenosis. In addition, simultaneous regulation
of multiple intracellular signaling pathways is expected to enhance the therapeutic effects. This review focuses on the
potential of recent ODN-based gene therapy for the treatment of heart disease, especially restenosis after revascularization.