New gene therapy for the treatment of burn wounds

Skin gene therapy is a relatively new approach with great potential because of the accessibility and the possibility to monitor the modified area. Gene therapy may facilitate the transfer of several growth factors. Among them, vascular endothelial growth factor (VEGF) plays a pivotal role in the skin repair process: For wound healing, the induction of controlled neo-angiogenesis is, in fact, a fundamental process. Dr. Galeano and colleagues designed a study, described in this issue of Critical Care Medicine, aimed at evaluating the efficacy of a gene therapy with VEGF for the treatment of burn wounds. For successful gene delivery, the selection of an appropriate vector has been shown to be paramount. Viruses, in particular adenoviruses, with their transfection capabilities, have been used as gene vectors. However, adenoviruses display infection-associated toxicity, immunologic compromise, and possible mutagenic effects that make this approach potentially dangerous . In their experiments of VEGF gene therapy, Dr. Galeano and colleagues used vectors based on the adeno-associated virus (AAV). These vectors, derived from a nonpathogenic Parvovirus, do not have any viral genes and therefore cause no inflammatory or immune reaction in the site of injection.