Voss S D, Kruskal J B
Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Radiographics. 1998 Nov-Dec;18(6):1343-72. doi: 10.1148/radiographics.18.6.9821189.
Gene therapy is one of the most rapidly evolving areas in medicine. Radiologists should have an understanding of basic techniques used to identify and clone a gene and insert it into a vector capable of directing expression in mammalian tissues. DNA delivery systems include retroviral vectors (RNA viruses), adenoviral vectors (DNA viruses), and cationic liposomes, along with strategies that involve ultrasound-directed gene transfer, computed tomography-guided gene transfer, and transcatheter gene delivery, in particular via the hepatic artery. Genes being evaluated in preclinical and clinical trials include oncogenes, antioncogenes (tumor suppressor genes), suicide genes, conventional antimetabolites, antiangiogenesis factors, secreted immunostimulatory cytokines such as interleukins and interferons, and immunomodulatory cell surface proteins, including foreign HLA proteins and costimulatory molecules. A foundation in molecular biology is needed for the practicing radiologist interested in but unfamiliar with current gene therapy terminology and experimental strategies. Such a foundation will encourage the dissemination of basic biologic, diagnostic imaging, and interventional oncoradiologic developments and should facilitate integration of the radiologist into the gene therapy team.
基因治疗是医学领域中发展最为迅速的领域之一。放射科医生应了解用于识别和克隆基因并将其插入能够在哺乳动物组织中指导表达的载体的基本技术。DNA递送系统包括逆转录病毒载体（RNA病毒）、腺病毒载体（DNA病毒）和阳离子脂质体，以及涉及超声引导基因转移、计算机断层扫描引导基因转移和经导管基因递送（特别是通过肝动脉）的策略。正在临床前和临床试验中评估的基因包括癌基因、抗癌基因（肿瘤抑制基因）、自杀基因、传统抗代谢物、抗血管生成因子、分泌的免疫刺激细胞因子（如白细胞介素和干扰素）以及免疫调节细胞表面蛋白，包括外来的HLA蛋白和共刺激分子。对于对当前基因治疗术语和实验策略感兴趣但不熟悉的执业放射科医生来说，需要有分子生物学基础。这样的基础将促进基础生物学、诊断成像和介入肿瘤放射学发展的传播，并应有助于放射科医生融入基因治疗团队。
