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Progress and prospects: gene therapy for inherited immunodeficiencies

Abstract

Haematopoietic stem cell transplantation (HSCT) is now widely used to treat primary immunodeficiencies (PID). For patients with specific disorders (severe combined immunodeficiency (SCID)-X1, adenosine deaminase deficiency (ADA)–SCID, X-chronic granulomatous disease (CGD) and Wiskott–Aldrich Syndrome (WAS)) who lack a suitable human leukocyte antigen (HLA)-matched donor, gene therapy has offered an important alternative treatment option. The success of gene therapy can be attributed, in part, to the selective advantage offered to gene-corrected cells, the avoidance of graft-versus-host disease and to the use of pre-conditioning in patients with chemotherapy to facilitate engraftment of corrected cells. Adverse events have been encountered and this has led to detailed characterization of retroviral vector integration profiles. A new generation of self-inactivating retroviral and lentiviral vectors have been designed to address these safety concerns, and are at an advanced stage of preparation for the next phase of clinical testing.

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Correspondence to A J Thrasher.

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Qasim, W., Gaspar, H. & Thrasher, A. Progress and prospects: gene therapy for inherited immunodeficiencies. Gene Ther 16, 1285–1291 (2009). https://doi.org/10.1038/gt.2009.127

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