Principles of gene therapy: potential applications in the treatment of cerebral ischaemia

In this review we explore gene therapy as a possible treatment for conditio ns causing cerebral ischaemia and briefly consider other neurological patho logies such as brain tumours. DNA transfer may be achieved using retrovirus , herpes simplex virus, adenovirus, and adeno-associated virus vectors or l iposomes. After cerebral ischaemia, these vectors are used to upregulate ge nes that increase survival and inhibit those that promote death in the inju red cells. In contrast, in brain tumours gene therapy aims to kill the targ et cells. Examples from studies using cell culture, animal models and patie nts are presented. We conclude that manipulation of gene expression has pot ential for the treatment of cerebral ischaemia and brain tumours, although, at present, there are formidable technical obstacles to be overcome before clinical applications become a reality.