Chung Daniel C, Lee Vivian, Maguire Albert M
F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Curr Opin Ophthalmol. 2009 Sep;20(5):377-81. doi: 10.1097/ICU.0b013e32832f802a.
Ocular gene therapy has made significant advances due to improvements in viral vector delivery methods. Recent clinical trials for the treatment of Leber's congenital amaurosis have provided evidence for successful in-vivo gene therapy in humans.
Gene therapy for ocular disease has been under investigation just over 15 years. Recently, the first human gene therapy trials for retinal degeneration were undertaken with encouraging preliminary safety and efficacy findings. Building on previous success in reversing blindness in animal models of Leber's congenital amaurosis, several groups proceeded with adeno-associated virus-mediated gene replacement. Many of the humans demonstrated increases in light sensitivity and in visual acuity. Subjective improvements in vision were corroborated in some cases by objective tests such as pupillary light response and nystagmography. Although much of the work in ocular gene therapy has involved retinal applications, significant progress has been seen in other aspects of ophthalmology.
Ongoing human clinical trials support the safety and efficacy of adeno-associated virus-mediated gene therapy for retinal disease. These and other studies will establish the foundation for methodology to treat additional ocular diseases using gene therapy strategies.
由于病毒载体递送方法的改进,眼部基因治疗取得了重大进展。最近治疗莱伯先天性黑蒙的临床试验为人类体内基因治疗的成功提供了证据。
眼部疾病的基因治疗已研究了15年多。最近,首次针对视网膜变性的人类基因治疗试验取得了令人鼓舞的初步安全性和有效性结果。基于先前在莱伯先天性黑蒙动物模型中逆转失明的成功经验,多个研究小组开展了腺相关病毒介导的基因替代治疗。许多受试者的光敏感度和视力有所提高。在某些情况下,通过诸如瞳孔光反应和眼震电图等客观测试证实了视力的主观改善。尽管眼部基因治疗的大部分工作都涉及视网膜应用,但在眼科的其他方面也取得了显著进展。
正在进行的人类临床试验支持腺相关病毒介导的基因治疗对视网膜疾病的安全性和有效性。这些研究及其他研究将为使用基因治疗策略治疗其他眼部疾病的方法奠定基础。