Division of Hematology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Prog Mol Biol Transl Sci. 2012;105:151-209. doi: 10.1016/B978-0-12-394596-9.00006-8.
The X-linked bleeding disorder hemophilia is caused by mutations in coagulation factor VIII (hemophilia A) or factor IX (hemophilia B). Unless prophylactic treatment is provided, patients with severe disease (less than 1% clotting activity) typically experience frequent spontaneous bleeds. Current treatment is largely based on intravenous infusion of recombinant or plasma-derived coagulation factor concentrate. More effective factor products are being developed. Moreover, gene therapies for sustained correction of hemophilia are showing much promise in preclinical studies and in clinical trials. These advances in molecular medicine heavily depend on availability of well-characterized small and large animal models of hemophilia, primarily hemophilia mice and dogs. Experiments in these animals represent important early and intermediate steps of translational research aimed at development of better and safer treatments for hemophilia, such a protein and gene therapies or immune tolerance protocols. While murine models are excellent for studies of large groups of animals using genetically defined strains, canine models are important for testing scale-up and for long-term follow-up as well as for studies that require larger blood volumes.
X 连锁出血性疾病血友病是由凝血因子 VIII(血友病 A)或因子 IX(血友病 B)突变引起的。除非进行预防性治疗,否则严重疾病(凝血活性低于 1%)的患者通常会频繁发生自发性出血。目前的治疗主要基于重组或血浆衍生的凝血因子浓缩物的静脉输注。正在开发更有效的因子产品。此外,用于持续纠正血友病的基因疗法在临床前研究和临床试验中显示出很大的希望。这些分子医学的进展在很大程度上依赖于具有良好特征的小型和大型动物血友病模型的可用性,主要是血友病小鼠和犬。这些动物实验代表了旨在开发更好和更安全的血友病治疗方法(如蛋白质和基因疗法或免疫耐受方案)的转化研究的重要早期和中期步骤。虽然鼠模型非常适合使用遗传定义品系对大量动物进行研究,但犬模型对于测试放大规模以及进行长期随访以及需要更大血液量的研究非常重要。