b'Different vectors and their potential impact beyond the delivery of the gene into the host are being investigated. There are a number of viral vectors being used currently, in addition to non-viral vectors, such as oligonucleotides (see number 5inthislist,below),nakedDNA,andlipoplexesandpolyplexes.Technologies forsomaticgenemodification(replacingorinactivatingdefectivegenes),are advancing in sophistication and applicability, with CRISPR being the most recent. 2The FDA approved the first gene therapy in May 2019, for spinal muscular atrophy, and is keeping a watchful eye on additional clinical trials.3.Microbiome-Based TherapeuticsThemicrobiomeskeyroleindifferentgastrointestinalandnongastrointestinal diseases has led to it becoming an attractive target for potential therapeutics. One of the main challenges is determining cause-effect relationships and designing microbiome-basedtherapiesthathavepredictable,reproducibleeffectson themicrobialcommunity,andonhosthealth.Mostcurrentmicrobiome-based therapeuticsareeitherpre-orprobiotics.Probioticsexogenouslivemicrobes target the prokaryotic arm of the microbiome, and attempt to alter the microbial composition of the gut. Prebiotics are compounds that are consumed with the intention ofaffectingmicrobiome composition orfunctioninabeneficial way. Prebiotics,likeprobiotics,arearelativelyunspecificapproachtomicrobiome-based therapeutics, and further study is ongoing to fully understand their effects on different bacterial species. 3Onesuccessfulmicrobiome-basedinterventionapprovedbytheFDAisfecal microbiota transplantation (FMT). FMT involves the transfer of an entire microbial community from a healthy donor to a diseased recipient, to replace the disease-associated microbiome. FMT has shown efficacy in treating Clostridium difficile infection and the use of FMT in other conditions is currently being evaluated. There are some definite risks to FMT, including the possibility of transplanting pathobionts andnegativeinteractionswiththerecipientsexistingmicrobialcommunity. 4As research and knowledge advance, there are many potential opportunities for therapeutic interventions in areas from gastrointestinal, metabolic and psychiatric disorderstoneurologicaldisordersandweightloss,thatarebasedonanew mechanistic understanding of the microbiomes involvement in human health.'