During the last decade, an understanding of the causes of many human d
iseases has progressed rapidly, in large measure because of the develo
pment of technologies that allow us to identify the genes that are inv
olved. Identification of a gene that is suspected to play an important
role in a particular disease opens up a whole new dimension of resear
ch to understand the molecular events that underlie the cause of that
disorder. A crucial step in this process is often the development of a
n animal model of the disease. Again, the last decade has seen rapid a
dvances in our ability to create such models, particularly in mice. Te
chnologies that allow for the addition, alteration, of elimination of
individual genes from the genome to create a transgenic mouse are now
routine. The advantages of having a transgenic mouse model of a human
disease are many. These animals often provide the first unequivocal pr
oof that a particular gene is responsible for causing the pathological
changes that occur with disease. They also can provide a system to ca
refully dissect the successive events that lead to the disease state,
and can provide a custom-designed whole animal system to test potentia
l therapies to treat and eventually cure the disease. Most important,
new concepts relating to gene expression and gene function in disease
often emerge from such transgenic studies. This review will illustrate
several examples in which transgenic animals have contributed signifi
cantly to the evolution of concepts of the underlying mechanisms of hu
man disease.