Primary immunodeficiency: meeting the challenges.

There are many challenges to those who specialize in the research, education, and clinical care of patients with primary immunodeficiency. The first of these difficult challenges is just keeping up with this rapidly moving area of medicine, a task that is obvious to those who are engaged in the ongoing discoveries of genetic mutations causing previously unrecognized primary immunodeficiencies. The Journal has made special efforts in the last several years to assist subspecialty and general care physicians alike in staying current with new information on basic and clinical research of primary immunodeficiency diseases. Issues of the Journal that illuminated the topic of primary immunodeficiency more generally appeared in April 2004 and April 2006, whereas those that dealt with specialized topics of primary immunodeficiency were the issues on laboratory technology (August 2004), infection and immunity (August 2005), antibody therapy (October 2005), T-regulatory cells (November 2005), and host defenses versus hostile microbes (July 2007). The second challenge of primary immunodeficiency is the translation of genetic and molecular discoveries into effective new therapies for patients with immunodeficiency. Controversies exist in some of these treatments,