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Gene therapy can be classified into ex vivo and in vivo based on the gene delivery strategy. Ex vivo involves removing cells, introducing normal genes in culture, and reintroducing them into the patient. In vivo therapy introduces normal functional genes directly into the target cells or tissues.
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Based on the nature of target cells or tissues, gene therapy can be classified into somatic and germ-line. Somatic gene therapy introduces functional copies into the patient’s somatic cells, while germ-line gene therapy introduces genes into the germ cells, leading to heritable changes.
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There are three main functional strategies in gene therapy:
- Gene augmentation therapy (GAT): Adding a functional gene to the genome to replace a missing gene product.
- Gene inhibition therapy (GIT): Blocking the expression of dominant acting mutated genes using antisense RNA or other inhibition techniques.
- Gene targeting: Replacing a non-functional gene with a normal gene using homologous recombination.
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The possibility of correcting defective genes through these strategies is due to advancements in rDNA technology, gene transfer, and gene editing mechanisms.
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The target gene (desired DNA sequence) can be delivered using either viral (direct gene transfer) or non-viral (indirect gene transfer) methods, as studied in previous chapters.