Gene therapy for pulmonary disease, a field still in the experimental stage, has nonetheless
progressed considerably in the past decade. There have been significant advances in
pre-clinical studies, as well as important developments resulting from multiple early-phase
human clinical trials for a variety of respiratory disorders. Although there are several
ways of delivering therapeutic genes to the lungs, the primary delivery modality remains
flexible bronchoscopy. The flexible bronchoscope, because of its unique access to
both large and small airways, serves as an ideal instrument to deliver therapeutic
genes to the tracheobronchial tree, even to small airways and alveoli that are beyond
the reach of the bronchoscope. In addition, bronchoscopic gene delivery has the capacity
to treat pulmonary vascular disorders because delivery of marker and therapeutic genes
via the airways has been demonstrated to successfully transduce the pulmonary vascular
endothelium. This article describes the various methods and disease targets of bronchoscopically
mediated gene therapy, focusing in particular on the results of clinical studies and
providing a glimpse into the future of the field.
KEYWORDS
Gene therapy - vector - transgene - transduction - bronchoscopy
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Daniel H StermanM.D.
833 West Gates Bldg., Hospital of the University of Pennsylvania
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Email: sterman@mail.med.upenn.edu