Perspectives

The therapeutic benefit which would arise from gene therapy in treatment of cancers or immune disorders depends on both technical improvement and evolution in immunological concepts. Transduction efficiency and long-term expression of the transgene have already been emphasized as key problems in gene therapy procedures. Development of new vector strategies, targeting of cells to be transduced and control of expression of the transgene, using tissue specific promoters or inducible constructs, are now under investigation in order to overcome some aspects of these problems. In addition, full characterization of the cytokine network and cytokine functions in the human system would help to better define possible therapeutic utilities of some molecules in cancer therapy, and develop more therapeutically efficient combinations between the disease to be treated and the transgene used. In addition, even though most of the treatments to date have been performed by ex vivo genetic modification of the target cells, important efforts are under development to deliver new genetic information in vivo, thus emphasizing the need for cellular and molecular targeting in order to induce new functions restricted to the target cells.

See also: Acquired immune deficiency syndrome (AIDS); Adenovirus, infection and immunity; Antigen-presenting cells; Autoimmune disease, induced experimental models; Autoimmune diseases; Chronic granulomatous disease; Graft-versus-host reaction; Human immunodeficiency viruses; Immunotherapy of tumors; Liposomes; Retroviral vectors; Tumors, immune response to; Tumors, immunological escape of; Vaccination, methods of administration.

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