Indresh K. Srivastava, PhD; Margaret A. Liu, MD
Acknowledgment: The authors thank Nelle Cronen for editorial assistance.
Potential Financial Conflicts of Interest:Employment: I. Srivistava (Chiron Corp.), M.A. Liu (Bill & Melinda Gates Foundation, Transgene, Chiron Corp., Merck & Co., Inc.); Consultancies: M.A. Liu; Honoraria: M.A. Liu (Bill & Melinda Gates Foundation); Stock ownership or options (other than mutual funds): I. Srivistava (Chiron Corp.), M.A. Liu (Merck & Co., Inc., Chiron Corp.); Grants received: I. Srivistava (Chiron Corp.); Patents received and pending: M.A. Liu (Merck & Co., Inc., Chiron Corp.).
Requests for Single Reprints: Margaret A. Liu, MD, Transgene, 11 rue de Molsheim, 67082 Strasbourg, France; e-mail, email@example.com.
Current Author Addresses: Dr. Srivastava: Chiron Corporation, 4560 Horton Street, MS 4.3, Emeryville, CA 94608.
Dr. Liu: Transgene, 11 rue de Molsheim, 67082 Strasbourg, France.
Srivastava IK, Liu MA. Gene Vaccines[dhelix]. Ann Intern Med. 2003;138:550-559. doi: 10.7326/0003-4819-138-7-200304010-00011
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Published: Ann Intern Med. 2003;138(7):550-559.
Gene vaccines are a new approach to immunization and immunotherapy in which, rather than a live or inactivated organism (or a subunit thereof), one or more genes that encode proteins of the pathogen are delivered. The goal of this approach is to generate immunity against diseases for which traditional vaccines and treatments have not worked, to improve vaccines, and to treat chronic diseases. Gene vaccines make use of advances in immunology and molecular biology to more specifically tailor immune responses (cellular or humoral, or both) against selected antigens. They are still under development in research and clinical trials.
The mechanisms for inducing cellular (as opposed to humoral) responses against a particular antigen have been elucidated. Gene vaccines provide a means to generate specific cellular responses while still generating antibodies, if desired. In addition, by delivering only the genes that encode the particular proteins against which a protective or therapeutic immune response is desired, the potential limitations and risks of certain other approaches can be avoided.
This article describes the rationale for, immunologic mechanisms involved in, and design of gene vaccines under development. Preclinical and clinical studies of these vaccines are discussed for various clinical applications, focusing on infectious diseases.
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Infectious Disease, Vaccines/Immunization, Prevention/Screening.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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