In the history of medicine there can have been nothing which has stimulated so much interest or emotion as attempts to manipulate the genetic control of the human organism. The Royal College of Obstetricians and Gynaecologists established a Study Group to address specific medical aspects of and technical developments in diagnosis, screening and therapy using genetically based procedures, particularly as they relate to obstetrics and gynaecology.
This volume examines the role of genetic defects and genetic manipulation in benign gynaecological disorders and fertility, introducing the potentially important concept of trantransinfection by uterine gene therapy. Angiogenesis in both benign and malignant disease and vascular endothelial growth factor (VEGF) is considered in detail, along with the role of gene identification for inherited disorders such as cystic fibrosis, haemoglobinopathies and fragile X. The complex issues related to genital tract cancers, including oncogenic mechanisms and the biology of cancer susceptibility are discussed in detail, in addition to gene therapy strategies for gynaecological cancer. The potential and limitations of such approaches are outlined and one significant conclusion drawn is that we do not yet have the molecular techniques available such that a single gene therapy alone will "cure" a specific tumour, so that multiple strategies are still necessary.
The group has distilled a number of recommendations for clinical practice, future research, health education and health policy.
This volume provides a sound source of information on the current status of gene therapy, diagnosis and manipulation and will be of interest to clinicians and researchers involved in screening in relation to pregnancy, the management of benign gynaecological disease, developments in fertility and the screening and diagnosis and genetic manipulation of gynaecological cancer.
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