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Gene therapy for inherited immunodeficiency.
[wiskott-aldrich syndrome]
During
the
last
decade
,
gene
therapy
has
emerged
as
a
convincing
therapy
for
primary
immunodeficiencies
(
PIDs
)
.
Ex
vivo
gene
transfer
into
autologous
hematopoietic
stem
cells
(
HSCs
)
via
viral
vectors
permits
sustained
correction
of
T
cell
immunodeficiency
in
two
forms
of
severe
combined
immunodeficiency
:
X-
linked
SCID
(
SCID
-X
1
)
(
γ
chain
[
γc
]
deficiency
)
and
adenosine
deaminase
deficiency
.
However
,
this
success
has
been
balanced
by
the
occurrence
of
genotoxicity
generated
by
the
integration
of
first
-generation
retroviral
vectors
.
Recently
,
the
development
of
safer
self-inactivating
vectors
has
led
to
the
initiation
of
new
studies
with
the
hope
of
equivalent
efficacy
and
a
better
safety
profile
.
This
review
article
focuses
on
the
updated
results
of
gene
therapy
trials
for
PIDs
-
from
early
studies
to
ongoing
clinical
trials
.
We
detail
the
major
advances
made
in
gene
transfer
and
repair
technologies
,
and
discuss
the
many
ways
to
extend
our
present
experience
.
With
optimization
in
terms
of
safety
and
efficacy
,
gene
therapy
by
lentiviral
transduction
could
become
a
compelling
alternative
to
allogeneic
HSC
transplantation
,
and
thus
may
take
center
stage
in
the
management
of
PIDs
in
coming
years
.
Diseases
Validation
Diseases presenting
"autologous hematopoietic stem cells"
symptom
adrenomyeloneuropathy
severe combined immunodeficiency
wiskott-aldrich syndrome
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