Retroviral vector gene therapy is a promising approach to treating HIV-1. However,\nintegrated vectors are mutagens with the potential to dysregulate nearby genes and cause severe\nadverse side effects. Leukemia has already been a documented severe adverse event in gene therapy\nclinical trials for the treatment of primary immunodeficiencies. These side effects will need to be\nreduced or avoided if retroviral vectors are to be used clinically for HIV-1 treatment. The addition\nof chromatin insulators to retroviral vectors is a potential strategy for reducing adverse side effects.\nInsulators have already been effectively used in retroviral vectors to reduce genotoxicity in pre-clinical\nstudies. Here, we will review how insulators function, genotoxicity in gene therapy clinical trials, the\ndesign of insulated retroviral vectors, promising results from insulated retroviral vector studies, and\nconsiderations for the development of insulated retroviral treatment vectors for HIV-1 gene therapy
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