International Journal of Molecular Medical Science, 2024, Vol.14, No.2, 48-55 http://medscipublisher.com/index.php/ijmms 51 Inflammation and immune regulation play important roles in the development and progression of cardiovascular diseases (Li and Yang, 2020). Gene therapy has also shown potential in regulating inflammation and immune responses, providing new directions for the treatment of cardiovascular diseases. Inflammation and immune response often manifest as vascular wall inflammation and elevated levels of inflammatory markers such as C-reactive protein and tumor necrosis factor in cardiovascular diseases. Gene therapy strategies can suppress the degree of inflammation and inflammation related damage by regulating the expression of genes related to inflammation and immune response, thereby improving the prognosis of cardiovascular diseases. A common gene therapy method is to inhibit the inflammatory response by transducing anti-inflammatory factor genes. For example, Transduction of genes that inhibit tumor necrosis factor or chemokine expression inhibitors can reduce inflammation of vascular wall and the release of inflammatory mediators, thereby reducing the occurrence and progression of atherosclerosis. Another strategy is to regulate immune responses by transducing genes of immune regulatory factors. For example, genes that transduce the surface molecules of antigen presenting cells can enhance the specificity and function of antigen presenting cells, thus regulating the occurrence and degree of immune response and inhibiting the development of cardiovascular diseases such as atherosclerosis. In addition, some studies have explored gene therapy for immune cells, such as transducing T cell surface receptor genes to enhance their anti-inflammatory function, or transducing stem cells into immunosuppressive cells to regulate immune responses and alleviate inflammatory responses. Although gene therapy related to inflammation and immune regulation has shown potential in laboratory and animal models, there are still some challenges in clinical application. For example, further research and optimization are needed on issues such as appropriate genome selection, delivery system selection, and gene regulation. In addition, evaluating the long-term efficacy and safety of gene therapy is also a challenging issue. 2 Clinical Practice and Translation of Gene Therapy 2.1 Overview of clinical trials of gene therapy in cardiovascular diseases The core idea of gene therapy is to repair or regulate abnormal gene functions in patients by introducing exogenous genetic materials. In the field of cardiovascular disease, clinical practice and translation of gene therapy are constantly evolving, and have already involved multiple clinical trials. Some clinical trials of gene therapy related to cardiovascular diseases have been conducted or are currently underway. At present, some experiments have been conducted on myocardial ischemia and myocardial infarction, such as gene therapy using angiogenic factors (such as VEGF and FGF) to promote new blood vessel growth and myocardial protection (Deng et al., 2020). Other experiments involve using stem cells to transduce specific genes to promote myocardial repair and regeneration. In the aspect of atherosclerosis, some experiments are under way to inhibit inflammation of arterial wall, promote plaque stability and enhance the function of vascular smooth muscle cells through gene therapy. For example, in trials, genes that inhibit inflammatory factors or stabilize plaque are used to treat atherosclerosis. In addition, some clinical trials have been conducted to investigate the use of gene therapy to correct genetic mutations associated with congenital heart disease. For example, gene repair techniques targeting specific mutated genes are used to treat some congenital heart diseases. In the treatment of heart failure, some gene therapies in trials aim to enhance myocardial contractility and metabolic function. For example, in the experiment, carriers were used to deliver specific genes to enhance the contractile proteins of myocardial cells. Clinical trials of gene therapy in cardiovascular diseases have made progress, but still face some challenges. This includes the selection of delivery systems, regulation of gene expression, and evaluation of the persistence and safety of treatment. In addition, the high cost and large-scale production of gene therapy are also one of the factors that restrict its transformation. Nevertheless, clinical trials of gene therapy in the field of cardiovascular disease continue, and it may provide more promising therapies for the treatment of cardiovascular disease in the future.
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