Rawle Fiona E M, Lillicrap David
Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada.
Semin Thromb Hemost. 2004 Apr;30(2):205-13. doi: 10.1055/s-2004-825634.
Hemophilia A and B are excellent candidate disorders for the application of somatic cell gene therapy. One of the major advantages in the preclinical development of hemophilia gene therapy strategies has been the availability of several animal models for both hemophilia A and B. These models recapitulate many of the phenotypic aspects of human hemophilia and have proven to be very informative in exploring the efficacy and safety of gene therapy. Considerable progress has been made in the design of gene therapy protocols, and over the last 5 years it has been shown that long-term phenotypic correction, with sustained therapeutic levels of factor VIII (FVIII) and factor IX (FIX), can be attained in FVIII- and FIX-deficient mice and dogs using various viral vector-mediated gene therapy approaches. These animal models also have elucidated potential complications of gene therapy protocols, including acute vector-associated toxicities and the induction of neutralizing antibodies to the FVIII and FIX transgene products. Nevertheless, although the preclinical paradigm of hemophilic mouse followed by hemophilic dog studies has proven to be extremely helpful in evaluating the efficacy and safety of potential clinical gene therapy protocols, several limitations to these animal models still exist. This review presents a summary of the animal models available for hemophilia gene therapy, and highlights the various strengths and weaknesses of these models.
甲型和乙型血友病是体细胞基因治疗应用的理想候选疾病。血友病基因治疗策略临床前开发的主要优势之一是有多种甲型和乙型血友病动物模型。这些模型概括了人类血友病的许多表型特征,并且已证明在探索基因治疗的疗效和安全性方面非常有用。基因治疗方案的设计取得了相当大的进展,在过去5年中,已表明使用各种病毒载体介导的基因治疗方法,在缺乏FVIII和FIX的小鼠和犬中可实现长期表型纠正,并维持治疗水平的凝血因子VIII(FVIII)和凝血因子IX(FIX)。这些动物模型还阐明了基因治疗方案的潜在并发症,包括急性载体相关毒性以及对FVIII和FIX转基因产物的中和抗体的诱导。然而,尽管先进行血友病小鼠研究再进行血友病犬研究的临床前模式已被证明在评估潜在临床基因治疗方案的疗效和安全性方面非常有帮助,但这些动物模型仍存在一些局限性。本综述总结了可用于血友病基因治疗的动物模型,并强调了这些模型的各种优缺点。
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