The lung represents an important target for gene therapy: for correction of genetic abnormalities such as cystic fibrosis, for lung cancer therapy, and for vaccination. Genes in the form of expression plasmids can be delivered both by the intravenous route and via the airways. So-called "naked" DNA can be delivered by both of these methods, but gene expression is low. Successful delivery is usually accomplished by complexing the DNA with cationic lipids or with polycations. This review will discuss the efficacy of delivery for particular purposes by various methods and complexing agents, as well as issues of biodistribution, inflammatory reactions, and improvements in formulations. Non-viral gene delivery to the lung has a long history of development, and it is now poised to represent a significant addition to the medical arsenal.
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