Eye Hospital, School of Ophthalmology & Optometry, Wenzhou Medical College, China.
Curr Mol Med. 2012 Mar;12(3):316-30. doi: 10.2174/156652412799218877.
In recent years, more and more mutant genes that cause retinal diseases have been detected. At the same time, many naturally occurring mouse models of retinal degeneration have also been found, which show similar changes to human retinal diseases. These, together with improved viral vector quality allow more and more traditionally incurable inherited retinal disorders to become potential candidates for gene therapy. Currently, the most common vehicle to deliver the therapeutic gene into target retinal cells is the adenoassociated viral vector (AAV). Following delivery to the immuno-privileged subretinal space, AAV-vectors can efficiently target both retinal pigment epithelium and photoreceptor cells, the origin of most retinal degenerations. This review focuses on the AAV-based gene therapy in mouse models of recessive retinal degenerations, especially those in which delivery of the correct copy of the wild-type gene has led to significant beneficial effects on visual function, as determined by morphological, biochemical, electroretinographic and behavioral analysis. The past studies in animal models and ongoing successful LCA2 clinical trials, predict a bright future for AAV gene replacement treatment for inherited recessive retinal diseases.
近年来,越来越多导致视网膜疾病的突变基因被检测到。同时,也发现了许多自然发生的视网膜变性的小鼠模型,它们与人类视网膜疾病表现出相似的变化。这些,加上改进的病毒载体质量,使得越来越多传统上无法治愈的遗传性视网膜疾病成为基因治疗的潜在候选者。目前,将治疗基因递送至靶视网膜细胞最常用的载体是腺相关病毒载体(AAV)。递送至免疫特惠的视网膜下腔后,AAV 载体可以有效地靶向视网膜色素上皮细胞和光感受器细胞,这是大多数视网膜变性的起源。本综述重点介绍了基于 AAV 的基因治疗在隐性视网膜变性的小鼠模型中的应用,特别是在那些通过形态学、生物化学、视网膜电图和行为分析确定正确的野生型基因副本的传递导致视觉功能显著改善的模型中。过去在动物模型中的研究和正在进行的成功的 LCA2 临床试验,预示着 AAV 基因替代治疗遗传性隐性视网膜疾病的光明未来。