Gene therapy for common acquired diseases of the heart : the Sirens' song.

The prospect of using genes as therapeutic agents presents myriad opportunities. No physician could fail to appreciate the power of this approach: why not abandon the shackles of the limited pharmacological and device repertoire and focus instead on reengineering the culprit tissue by somatic gene transfer? The explosion of genomic information leaves us with an embarrassment of riches in terms of potential therapeutic agents. Why draw the line at nature’s own genes expressed in their usual settings? Genes can readily be tailored to exhibit special properties not found in nature, altering the function of their protein products for specific ends. Alternatively, wild-type genes can be expressed in tissues where they are normally silent.