PubMed · 9634764
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C P Hodgson. 1995. The vector void in gene therapy.. https://doi.org/10.1038/nbt0395-222
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The recent discovery that RNA can act as a catalyst, apart from carrying genetic information, has given a new dimension to the field of gene therapy and has come to act synergistically with antisense technology. Ribozymes can be used to down-regulate (by RNA cleavage) or repair (by RNA trans-splicing) unwanted gene expression involved in disease. Hammerhead ribozymes have been used extensively to down-regulate gene expression in many diseases such as viral infections and cancer. Group I intron ribozymes on the other hand, have only been tried to repair inherited mutations but hold great promise for the future. Peptide nucleic acids (PNAs) technology is another new technology, which is currently been tried to block gene or RNA function. Gene therapy protocols need significant improvements in order to be used routinely in patients and hopefully, these new players should prove valuable to identifying new therapies for several untreated diseases.
Gene therapy for the treatment of cancer was initiated with high levels of optimism and enthusiasm. Recently, this perception has had to be tempered by the realisation that efficiency and accuracy of gene delivery remain the most significant barriers to its success. So far, there has been a disappointing inability to reach target cells with sufficient efficacy to generate high enough levels of direct killing and this has necessitated the invocation of bystander effects in order for any potential strategy to be convincing. At least in the foreseeable future, clinical advance will come from co-operation with other more established disciplines - such as chemotherapy, radiotherapy and immunotherapy. This is inevitable - and necessary - in order to prove that gene therapy can have efficacy as part of a combinatorial therapy, before hoping to move clinical mountains alone. In addition, there will have to be a thorough understanding of the clinical situations in which gene therapy will be used in order both to understand its own limitations, and to exploit its full potential. This will enable it to find the appropriate clinical niche in which its abilities will be optimally useful. Finally, anyone wishing to practise clinical cancer gene therapy will rapidly have to learn the ways of the free market and be able to juggle commercial necessities with ideological purity. Gene Therapy (2000) 7, 2-8.