Gene therapy in acute XXXX .

@entity1 @entity137 @entity295 @entity66 @entity1421 @entity3124 @entity3009 @entity4770 @entity647
The development of techniques for manipulating nucleic acids and strategies for delivering DNA to @entity1 has made gene therapy a reality. Although mostly focused on genetically based diseases so far, there is every reason to expand the concept to include @entity66 . @entity3124 may be a good target for gene therapy because of the high mortality and need for only transient treatment. Genes can be delivered in vivo using viral vectors (replication-deficient adenovirus and adeno-associated virus most often). Viral vectors have some negatives, mainly the triggering of an inflammatory and an immune response. Nonviral DNA delivery systems include liposomes (cationic or anionic), direct DNA injection, and polycation-DNA-glycoconjugates. Combining liposomes with viral components to deliver plasmids with a transgene may improve efficiency of delivery without causing @entity137 . In a model of @entity647 , in vivo delivery of a vector hyperexpressing the @entity3009 synthase gene using cationic liposomes resulted in increased production of @entity1421 and @entity4770 in the lungs, and protected the lungs from the effects of endotoxin. This end-result demonstrates the feasibility of this approach. A similar rationale for the treatment of @entity295 could be used. Other promising therapeutic genes would include those encoding antioxidant enzymes or antiproteases. The logistics for moving to initial studies of gene therapy in critically ill @entity1 have been worked out for other diseases; such steps should expedite the exploration of this new category of therapies.
