New Approaches to Correcting Immunologic Disorders n recent years many of the genes responsible for immunodeficiency diseases have been identified. It has been possible to correct some of these gene defects in cells in the laboratory and, rarely, in patients. In the near future, research will be directed toward developing the existing technology for gene transfer to make it more effective in correcting these gene defects in human patients. It is important also to continue the search for other defective genes; it is likely that with increasing knowledge of the human genome more will be found soon. A continuing challenge is finding ways to overcome graft rejection to make bone marrow and other transplants more acceptable. The challenge of treating cancer and of preventing rejection of essential transplants may be met, at least in part, by the development of gene transfer technology and by better understanding of the mechanisms of cellular immunological mechanisms.

The identification of immune system molecules, such as cytokines, and progress in understanding their functions will offer new means of treating autoimmune diseases. Research into understanding the regulation of immune responses will also help in controlling autoimmune and immunodeficiency disease, and it will permit development of improved vaccines.

A promising and challenging area is the development of human stem cell research. Stem cells have an almost unlimited capacity to divide, and some of them can differentiate into most of the tissues in the body. They could be used to generate cells for transplantation and to replace defective or injured tissues such as nerve tissue. They might also be used to test the effects of drugs on human cells, without the danger of testing on human beings. A major stumbling block is the fact that the stem cells come from fetal material, either from early stage embryos obtained from fertility treatments or from non-living fetuses from terminated pregnancies. Currently, controversy rages about legal and ethical guidelines for the use of these cells.

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