Airway Epithelia

Cystic fibrosis (CF) is a common inherited disorder affecting a variety of epithelial tissues. The disease is caused by mutations in the cystic fibrosis transmembrane conductance regulator gene (CFTR) that lead to abnormal secretions, recurrent infection and inflammation, bronchiectasis, and premature death. Because airways disease is the major cause of morbidity and mortality in cystic fibrosis, gene therapy efforts have focused on luminal delivery of vector to the airways of CF patients. Retroviruses are attractive as a gene transfer vector system since integration of the wild-type CFTR cDNA into the host genome may lead to long-term expression and perhaps, a cure. However, simple retroviruses are limited as vectors for airway gene transfer by the low rates of epithelial cell proliferation in human airways (∼0.1–0.2%) combined with the traditionally low titers. Advances in vector design and production have improved titers, and the development of human and animal lentiviruses may help overcome the requirement for cell proliferation. These developments have raised hopes for retroviral approaches for treatment of CF lung disease.