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Ronald G. Crystal, MD

JAMA. 2001;285:612-618.

Lung diseases cause morbidity, mortality, and economic burden. Susceptibility to pathogenesis of most lung diseases result from a complex interaction of a relevant challenge from the environment, genetic background, and the nature of the host responses. Cutting-edge research in lung disease now centers on understanding the lung as a genetically determined biological organ that functions to mediate gas exchange and defend against a hostile environment. A major challenge is to determine the hierarchy of gene expression that integrates the function of multiple cell types in this complex anatomy. Emerging therapies that will play a major role in the future treatment of lung disease include the use of recombinant proteins, including monoclonal antibodies, cell therapy (including stem cells), and gene therapy. Future advances will include the cure of the major hereditary lung disorders by gene therapy, new treatment for asthma, chronic obstructive pulmonary disease, and interstitial lung disease; development of vaccines to protect the lung from major lung pathogens; and pathogen-specific "designer" therapies to eradicate chronic lung infections.

Author Affiliation: Institute of Genetic Medicine, Weill Medical College of Cornell University, New York, NY.

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