Table Of ContentApplications of Biotechnology
in Cardiovascular Therapeutics
Applications
of Biotechnology
in Cardiovascular
Therapeutics
Kewal K. Jain MD, FRACS, FFPM
Jain PharmaBiotech, Basel, Switzerland
Kewal K. Jain
Jain PharmaBiotech
Blaesiring 7
Basel 4057
Switzerland
[email protected]
ISBN 978-1-61779-239-7 e-ISBN 978-1-61779-240-3
DOI 10.1007/978-1-61779-240-3
Springer New York Dordrecht Heidelberg London
Library of Congress Control Number: 2011931532
© Springer Science+Business Media, LLC 2011
All rights reserved. This work may not be translated or copied in whole or in part without the written
permission of the publisher (Humana Press, c/o Springer Science+Business Media, LLC, 233 Spring
Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly
analysis. Use in connection with any form of information storage and retrieval, electronic adaptation,
computer software, or by similar or dissimilar methodology now known or hereafter developed is
forbidden.
The use in this publication of trade names, trademarks, service marks, and similar terms, even if they
are not identified as such, is not to be taken as an expression of opinion as to whether or not they are
subject to proprietary rights.
Printed on acid-free paper
Humana press is part of Springer Science+Business Media (www.springer.com)
This book is dedicated to
Prof. Dr. Friedrich S. Eckstein,
Chief of Cardiac Surgery, Heart Center,
University Hospital Basel, who performed
the life-saving coronary artery bypass open
heart surgery with smooth recovery to enable
me to write this book. My thanks are due to
PD Dr. Michael Zellweger of the Cardiology
Department for competently conducting
diagnostic investigations including coronary
angiography and arranging treatment.
Finally, Prof. Dr. Michael Tamm and
PD Dr. Werner Strobel of the Pulmonology
Department referred me for cardiac
investigations after I presented with
nonspecific dyspnea. Having visited some
of the best medical centers in the world,
I am happy to say that the treatment that
I received in Basel was optimal and second
to none. I learned a fair bit about modern
cardiology during my interaction with
physicians at the hospital.
Preface
This report puts together excerpts from the various writings by the author on the
biotechnology topics as they relate to cardiovascular disease. Very appropriately the
report was put together during the week that the author was recovering from open
heart bypass surgery at the University Hospital, Basel, Switzerland. It is meant for
physicians, surgeons, and scientists working on cardiovascular disorders. It will be
useful for those working in life sciences and pharmaceutical industries, and some
basics of cardiovascular diseases are included for nonmedical readers.
A major application of biotechnology is in therapeutic delivery to the cardiovas-
cular system. Routes of drug delivery and applications to various diseases are
described. Formulations for drug delivery to the cardiovascular system range from
controlled release preparations to delivery of proteins and peptides. Various methods
of improving systemic administration of drugs for cardiovascular disorders are
described including the use of nanotechnology.
Cell-selective-targeted drug delivery has emerged as one of the most significant
areas of biotechnology engineering research to optimize the therapeutic efficacy of
a drug by strictly localizing its pharmacological activity to a pathophysiologically
relevant tissue system. These concepts have been applied to targeted drug delivery
to the cardiovascular system. Finally, devices for drug delivery to the cardiovascular
system are described. A full chapter is devoted to drug-eluting stents used for treat-
ment of restenosis following stenting of coronary arteries. This is one of the biggest
segments of the cardiovascular drug delivery market with 15 companies involved in
developing and producing stents.
Cell and gene therapies, including antisense and RNA interference, are described
in full chapters as they are the most innovative methods of delivery of therapeutics.
New cell-based therapeutic strategies are being developed in response to the short-
comings of available treatments for heart disease. Potential repair by cell grafting or
mobilizing endogenous cells holds particular attraction in heart disease, where the
meager capacity for cardiomyocyte proliferation likely contributes to the irrevers-
ibility of heart failure. Cell therapy approaches include attempts to reinitiate cardio-
myocyte proliferation in the adult, conversion of fibroblasts to contractile myocytes,
vii
viii Preface
conversion of bone marrow stem cells into cardiomyocytes, and transplantation of
myocytes or other cells into injured myocardium.
Advances in molecular pathophysiology of cardiovascular diseases have brought
gene therapy within the realm of possibility as a novel approach to treatment of
these diseases. It is hoped that gene therapy will be less expensive and affordable
because the techniques involved are simpler than those involved in cardiac bypass
surgery, heart transplantation, and stent implantation. Gene therapy would be a
more physiologic approach to deliver vasoprotective molecules to the site of vascular
lesion. Gene therapy is not only a sophisticated method of drug delivery; it may
also need drug delivery devices such as catheters for transfer of genes to various
parts of the cardiovascular system.
Finally, a chapter on personalized cardiology is important for the era of person-
alized medicine. This concept is the best way of integrating new technologies in
cardiology to select the best treatment for an individual patient.
The bibliography includes selected references from recent literature on this
topic, which are appended to each chapter. The text is supplemented by 22 tables
and 13 figures.
Kewal K. Jain, MD
Basel, Switzerland
About This Book
This book contains excerpts from various biotechnology books and reports authored
by Prof. K. K. Jain that are relevant to cardiovascular disorders. The most important
contributions of biotechnology are to cardiovascular drug delivery. Advances in
cardiovascular surgery based on biomedical technology are beyond the scope of
this report. This is the draft of the expanded and updated document to be issued as
separate book.
ix
