Applications for Transient Gene Therapy

The technical innovations described above are at best laboratory proofs that will require extensive animal studies before clinical testing. However, the clinical data to date suggests that success with currently available Ad vectors is possible in applications where transient expression might be sufficient. For example, studies of therapeutic angiogenesis for coronary artery disease described above are a prototype of this type of application. Medical indications such as cancer, infectious disease, tissue remodeling (angiogenesis, recovery from surgery, stroke, or injury) are areas where development might be most appropriate. In contrast, metabolic and genetic disease, autoimmune disease, and other chronic conditions would seem to need substantial advances in adenoviral vector design or more likely some kind of hybrid vector before they become treatable on a persistent basis. Importantly, the knowledge of the cellular and host response to Ad infection in humans is still quite rudimentary and will need to be described in much greater detail before more rational approaches to prolonging expression can be devised.

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