Introduction

Over the past decade, knowledge in two areas has been converging toward a new era in the treatment of acute cerebral injuries such as stroke. From one direction, there have been remarkable new insights into the basic mechanisms at the molecular, cellular and tissue levels that cause ischemic brain injury and the repair processes that follow the acute injury. From another area of science, there have been major advances in our ability to introduce foreign genes into cells and cause the expression of specific proteins that affect tissue function. Knowledge in these two areas will inevitably result in the use of gene therapy to treat strokes.

While clinical trials of gene therapy in stroke are not imminent at the time of writing, the ground work is being established through studies using experimental animals and through efforts to perfect gene delivery vehicles known collectively as vectors. The purpose of this report is to review the development of a particularly promising vector, the adenovirus, and to outline some of the logistical issues that must be addressed before adenoviral vectors can be used in humans to treat stroke.

The adenovirus

The use of viruses to deliver genes to cells in vivo has progressed to the point where numerous clinical trials have been approved and many are ongoing. The most commonly used viruses for gene therapy are retroviruses, herpes simplex viruses and adenoviruses.