Xia Emily, Munegowda Manjunatha Ankathatti, Cao Huibi, Hu Jim
Physiology & Experimental Medicine Program, Hospital for Sick Children, University of Toronto, Toronto, Ontario M5G 0A4, Canada ; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario M5G 0A4, Canada.
Genes Dis. 2014 Sep;1(1):40-52. doi: 10.1016/j.gendis.2014.06.001.
Gene therapy has been considered as the most ideal medical intervention for genetic diseases because it is intended to target the cause of diseases instead of disease symptoms. Availability of techniques for identification of genetic mutations and for manipulation of genes makes it practical and attractive. After the initial hype in 1990s and later disappointments in clinical trials for more than a decade, light has finally come into the tunnel in recent years, especially in the field of eye gene therapy where it has taken big strides. Clinical trials in gene therapy for retinal degenerative diseases such as Leber's congenital amaurosis (LCA) and choroideremia demonstrated clear therapeutic efficacies without apparent side effects. Although these successful examples are still rare and sporadic in the field, they provide the proof of concept for harnessing the power of gene therapy to treat genetic diseases and to modernize our medication. In addition, those success stories illuminate the path for the development of gene therapy treating other genetic diseases. Because of the differences in target organs and cells, distinct barriers to gene delivery exist in gene therapy for each genetic disease. It is not feasible for authors to review the current development in the entire field. Thus, in this article, we will focus on what we can learn from the current success in gene therapy for retinal degenerative diseases to speed up the gene therapy development for lung diseases, such as cystic fibrosis.
基因治疗一直被视为治疗遗传疾病最理想的医学干预手段,因为它旨在针对疾病的病因而非症状。识别基因突变和操纵基因的技术的出现使其具有实际可行性且颇具吸引力。在经历了20世纪90年代初期的炒作以及随后十多年临床试验的失望之后,近年来终于曙光初现,尤其是在眼部基因治疗领域取得了重大进展。针对视网膜退行性疾病如莱伯先天性黑矇(LCA)和脉络膜视网膜炎的基因治疗临床试验显示出明确的治疗效果且无明显副作用。尽管这些成功案例在该领域仍然罕见且零散,但它们为利用基因治疗的力量治疗遗传疾病并使我们的药物治疗现代化提供了概念验证。此外,这些成功案例为治疗其他遗传疾病的基因治疗发展指明了道路。由于靶器官和细胞的差异,每种遗传疾病的基因治疗中存在不同的基因递送障碍。作者对整个领域的当前发展进行综述是不可行的。因此,在本文中,我们将专注于从当前视网膜退行性疾病基因治疗的成功中可以学到什么,以加速针对肺部疾病如囊性纤维化的基因治疗发展。