Mandel Ronald J
University of Florida, College of Medicine, Department of Neuroscience, PO Box 100244, Gainesville, FL 32610, USA.
Curr Opin Mol Ther. 2010 Apr;12(2):240-7.
To date, only five drugs have been approved for the treatment of Alzheimer's disease (AD); however, these agents impact the symptoms rather than the progression of the disease. It is well established that nerve growth factor (NGF) enhances the function and survival of basal forebrain cholinergic neurons that are vulnerable in AD. However, NGF does not cross the blood-brain barrier, and intraventricular NGF injections in animals and humans were associated with significant side effects. Adeno-associated virus (AAV)-based gene delivery is a novel technology being developed for administration of NGF to the brain to treat AD symptoms and progression. Indeed, the efficacy of ex vivo gene delivery was demonstrated in patients with AD who experienced improvements in cerebral metabolism and cognition compared with pre-operative function without adverse events. CERE-110 (AAV2-NGF), under development by Ceregene Inc, is an AAV serotype 2-based vector expressing human NGF delivered to the nucleus basalis of Meynert by stereotactic injection for the treatment of AD. Animal studies have established the preclinical efficacy of CERE-110, revealing an excellent safety profile. CERE-110 has passed phase I clinical testing and a multicenter phase II clinical trial has commenced. CERE-110 is a promising candidate for the treatment of AD.
迄今为止,仅有五种药物被批准用于治疗阿尔茨海默病(AD);然而,这些药物只能缓解症状,无法延缓疾病进展。众所周知,神经生长因子(NGF)可增强基底前脑胆碱能神经元的功能并延长其存活时间,而这些神经元在AD中易受损伤。然而,NGF无法穿过血脑屏障,在动物和人体中进行脑室内注射NGF会产生显著的副作用。基于腺相关病毒(AAV)的基因传递技术是一项正在研发的新技术,用于将NGF导入大脑以治疗AD的症状并延缓疾病进展。事实上,在AD患者中已证实了离体基因传递的疗效,与术前功能相比,患者的脑代谢和认知功能均有所改善,且未出现不良事件。Ceregene公司正在研发的CERE-110(AAV2-NGF)是一种基于AAV血清型2的载体,通过立体定向注射将表达人NGF的载体递送至Meynert基底核,用于治疗AD。动物研究已证实了CERE-110的临床前疗效,并显示出良好的安全性。CERE-110已通过I期临床试验,一项多中心II期临床试验已经启动。CERE-110是治疗AD的一个有前景的候选药物。