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Gene Therapy in Lung Disease: Lung Biology in Health and Disease; Volume 169 FREE TO VIEW

Charles F. Thomas, Jr, MD, FCCP
Chest. 2005;127(5):1872. doi:10.1378/chest.127.5.1872
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By Steven M. Albelda, ed. New York, NY: Marcel Dekker, 2002; 576 pp; $185

The use of natural products refined into pharmaceutical agents in order to treat patients suffering the effects of disease has been the traditional approach of medicine for generations. With the completed sequencing of the human genome, inherited or acquired genetic defects are increasingly recognized as a cause of many aliments. In this new era of medical genomics, researchers are investigating novel mechanistic approaches to cure specific diseases. Gene therapy is one of these approaches that has evolved from the concept of inserting a normal copy of a gene to restore the proper function of a damaged one. Initial excitement over gene therapy from the first clinical trials in 1990 has waned with the appreciation of numerous hurdles, present both at the bench and the bedside, which need to be overcome in order for gene therapy to benefit patients.

Gene Therapy in Lung Disease, edited by Steven M. Albelda, is the 169th volume in the Lung Biology in Health and Disease series from executive editor Claude Lenfant. This multiauthored book is a comprehensive and balanced review of the application and limitations of gene therapy to pulmonary disease. The book commences with a historical overview of the field of gene therapy and a discussion of the mechanisms of public oversight of human gene therapy trials by the National Institutes of Health and Food and Drug Administration, immediately drawing the attention of the reader to the regulatory hurdles physicians face in applying new technologies to patient care.

Many efforts in gene therapy have focused on finding the proper vector and delivery systems to introduce a corrected gene to the affected cell or tissue. Chapters 2 through 6 in the first section of the book, “Vectorology,” describe the advances that have been made in the development of gene delivery systems to the lungs. These chapters discuss adenoviral and adeno-associated viral vectors, cationic lipids or liposomal delivery, replicating vectors, and strategies used to improve the targeting and expression of transgenes in specific cell types.

The second part of the book, “Use of Gene Therapy to Study Lung Diseases,” discusses the great utility of gene therapy applied to researching the mechanisms of lung disorders. The research described in this section highlights the use of gene knockout and transgenic rodents to investigate such diverse processes as inflammation, infection, immunity, and fibrosis. The third and largest part of the book, “Use of Gene Therapy to Treat Lung Diseases,” provides readers with the current status of gene therapy for lung cancer and malignant mesothelioma, cystic fibrosis, pulmonary hypertension, α1-antitrypsin deficiency, acute lung injury, and lung transplantation.

Gene Therapy in Lung Disease is a well-written and comprehensive volume from recognized experts in this rapidly developing field. This book should be of interest to physicians caring for patients with lung diseases who desire insight into the state-of-the-art applications of gene therapy and the promising future of these techniques.




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