Gene therapy was conceived during the early and mid part of the 20th
century. At first, it was considered a revolutionary biomedical
procedure, which could potentially cure any disease for which the
molecular bases were understood. Since then, gene therapy has gone
through many stages and has evolved from a nearly unrealistic
perspective to a real life application. Clinical efficacy in humans was
demonstrated at the beginning of this century after its successful
application in small-scale clinical trials to cure severe
immunodeficiency in children. However, their successes were overshadowed
some time later by the occurrence of vector-related leukaemia in a
number of treated children. It is in this context that lentiviral
vectors have appeared, with improved efficiency and, possibly, increased
biosafety. Very recently, the first clinical trials with lentivectors
have been carried out with some success.
This Brief firstly defines gene therapy, and places lentivectors within
this fascinating therapeutic strategy. Then follows a comprehensive
description of the development of retroviral and lentiviral vectors and
how to specifically target distinct cell types and tissues. The authors
also discuss the application of lentivector gene therapy for the
treatment of cancer and autoimmune diseases, ending with the application
of lentivectors in human gene therapy clinical trials.