Chronic rejection: prospects for therapeutic intervention in fibroproliferative vascular disease

Vascular disease, manifesting as either transplant arteriopathy or native atherosclerosis, is currently the main obstacle to successful transplant outcome. In addition, vascular restenosis following balloon angioplasty or stenting continues to limit the long-term efficacy of these procedures. Neointimal hyperplasia is refractory to conventional immunosuppression although newer agents, such as rapamycin, have shown considerable promise in controlling it. By allowing large-scale study of gene expression during vascular remodelling, the emerging field of genomics is poised to revolutionise the drug discovery process. Here we summarise our initial experience using genomic methods to identify new targets for therapeutic intervention in vascular disease.