Mochizuki Hideki
Department of Neurology, Research Institute for Diseases of Old Ages Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Brain Nerve. 2009 Apr;61(4):485-93.
Gene therapy is particularly appropriate for Parkinson disease (PD) since this condition exclusively affects the dopaminergic neurons projecting from the substantia nigra pars compacta (SNc) to the putamen. Currently, 4 ongoing phase I clinical trials are utilizing recombinant adeno-associated viral vectors (rAAv) or lentivirus vectors for the treatment of PD. In this article, we describe recent progress in the development of gene therapy methods for PD by reviewing clinical trials in this field. Parkin-associated PD is recessively inherited, that is, loss of function of parkin leads to the development of parkin -associated PD; hence, substrates for parkin (for its E3 function) are expected to accumulate in the brain. Therefore, the replacement of parkin function in such patients would decrease the toxicity of these substrates. We previously found that the transfer of parkin, encoding a familial PD-linked E3 ubiquitin ligase, in rats with PD could prevent the degeneration of nigral dopaminergic neurons. In addition, we recently reported the case report of a preclinical examination of rAAV vector-mediated retrograde delivery of parkin into nigrostriatal dopaminergic neurons in a non-human primate. In this article, we also review the potential of parkin gene therapy for the treatment of PD patients.
基因治疗特别适用于帕金森病(PD),因为这种疾病仅影响从黑质致密部(SNc)投射到壳核的多巴胺能神经元。目前,有4项正在进行的I期临床试验正在利用重组腺相关病毒载体(rAAv)或慢病毒载体来治疗PD。在本文中,我们通过回顾该领域的临床试验,描述了PD基因治疗方法开发的最新进展。帕金森病相关蛋白(Parkin)相关的PD是隐性遗传的,也就是说,Parkin功能丧失会导致Parkin相关PD的发展;因此,Parkin的底物(因其E3功能)预计会在大脑中积累。因此,在这类患者中恢复Parkin功能将降低这些底物的毒性。我们之前发现,在患有PD的大鼠中转移编码与家族性PD相关的E3泛素连接酶的Parkin,可以防止黑质多巴胺能神经元的退化。此外,我们最近报告了在非人类灵长类动物中对rAAV载体介导的Parkin逆行递送至黑质纹状体多巴胺能神经元进行临床前检查的病例报告。在本文中,我们还回顾了Parkin基因治疗对PD患者的治疗潜力。