Cardiologists label gene-therapy claim a gimmick

NEW DELHI, December 27: A noida doctor's claim that he has successfully used gene therapy for treating five terminally ill heart patients...

NEW DELHI, December 27: A noida doctor8217;s claim that he has successfully used gene therapy for treating five terminally ill heart patients has been labelled by prominent cardiologists as a gimmick. They argued that the research work for the therapy was still in its preliminary stages. The five patients, between 48 and 70 of age, had symptoms of angina and could not undergo bypass surgery. According to Dr Purshottam Lal, who worked on the project with cardiologists in Medical College of Wisconsin, his patients are the first in the world to have been successfully treated by the use of gene therapy.

The therapy, according to former Apollo surgeon Dr Lal, involves injection of a synthetic gene through the drug delivery catheter into blocked coronary arteries. The gene protein, called Vascular Endothelial Growth Factor or VGEF, is akin to ischemic heart muscle which lacks blood supply in patients because of blocked coronary arteries. When VGEF is injected, it settles down only in that part of the heart which lacks blood supply. It then works like a seed that makes new blood vessels grow and helps resume the blocked blood supply.

8220;The treatment is at present suitable only for those patients who cannot be treated through bypass surgery or angioplasty,8221; Dr Lal said.

Of the five patients who received the therapy between March and June, three of them were over 70 years old and the other two were 48 and 60 years. Two had undergone bypass surgery and could not undergo another surgery. They had stopped responding to aggressive medical treatment.

H.L. Khanna, 70, who was administered the VGEF dose in June, says he felt some relief for two months but he was back to square one after that. He said that the doctor was planning another dose of VGEF in January. He paid Rs 30,000 for the first dose. And a second dose would mean twice that fee, which should bring to naught Dr Lal8217;s claim that it is a poor man8217;s therapy. He says that the ultimate aim of researchers in this area is to make VGEF a substitute for bypass surgery and angioplasty. A bypass costs roughly between Rs 1.1 lakh to Rs 1.5 lakh.

Dr Lal says Khanna was an exception as his condition was worse than the rest. He added that a second dose was unlikely.

A prominent city cardiologist, who withheld his name, said gene therapy was still in an experimental stage and was not a reliable method of treatment. Dr Umesh Gupta of the MP Heart Centre here said that he knew from doctors in major cardiology centres like the Cleveland Clinic that the research in gene therapy was still in the primary stages and Dr Lal8217;s claims were difficult to believe.

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Dismissing these reactions as being prompted by envy, Dr Lal said the paper presented by him jointly with Dr Nicholas Kipshidb of the Medical College of Wisconsin at the American Heart Association was evidence of the authenticity of his work. Even as the validity of the use of gene therapy at this stage is under a cloud, Dr Lal is about to begin gene therapy on a fresh set of five patients. Gene therapy, according to him, was first tried on a diabetic patient8217;s leg in the Wisconsin Institute where because of blockage of leg artery it would have been cut. Later a doctor in the institute while doing bypass on 40 patients, gave a dose of VGEF to 20 of them and found that there was production of new blood vessels in those who received the dose.