Angina Heart Pain Target of New Gene Therapy Trial

When supply and demand don’t match up in business, there can be economic trouble.

When blood supply is inadequate and doesn’t match the demand from your heart, there can be heart trouble – chest pain called angina.

Blood supply is often not up to par because of coronary artery disease, the build-up of plaque inside blood vessels that can restrict blood flow to areas of the heart. For those with refractory angina – people who have exhausted their treatment options, such as medication, stents and bypass surgery – there may be hope in the form of a new gene therapy.

Lehigh Valley Heart and Vascular Institute is part of a trial by XyloCor Therapeutics to determine how well that gene therapy works. It’s one of just 16 sites chosen for the study.

“This trial represents one of the most innovative types of research ongoing in cardiac care today,” says Ronald Freudenberger, MD, Physician in Chief at Lehigh Valley Heart and Vascular Institute. “Being involved on the ground floor of developing these types of novel therapies is part of our mission and I think the fact that we’ve been asked to participate recognizes our excellence in research and clinical care.”

The science behind the study is beyond what most of us probably retained from our high school biology class days, so here’s a basic rundown.

The gene therapy looks to prompt heart muscle cells to produce more of a naturally occurring protein called human vascular endothelial growth factor, or VEGF. According to XyloCor, the increased VEGF is designed to lead to the formation of new blood vessels in the heart that would bypass diseased blood vessels and increase blood flow to the heart.

Think of it as your heart creating new pathways for blood and oxygen to reach your heart muscle allowing the supply to meet the demand from exertion.

In the trial, a heart surgeon injects the investigational gene therapy product directly into the heart muscle. It’s done by using an altered adenovirus that includes the VEGF gene. The altered adenovirus, also called a vector, doesn’t reproduce and isn’t harmful. The same adenovirus delivery method is used in other ways, including some vaccines.

“The hope is that the patient’s own heart cells will create more VEGF in a process called gene transfer. It would be an incredible advance if we can show that it works,” says Freudenberger.