Aravalli Rajagopal N, Steer Clifford J
a Department of Radiology , University of Minnesota Medical School , Minneapolis , MN , USA.
b Departments of Medicine , University of Minnesota Medical School , Minneapolis , MN , USA.
Expert Opin Biol Ther. 2016;16(5):595-608. doi: 10.1517/14712598.2016.1158808. Epub 2016 Mar 21.
More than 100 liver-related disorders are caused by mutations in a single gene. These include both inherited and acquired genetic disorders. The development of nucleic acid-based therapies for liver diseases has been severely restricted due to many undesirable side effects and methodological limitations.
In recent years, however, efforts have been intensified to address these issues, and to develop liver-targeted approaches using novel gene editing technologies, including ZFN, TALEN, CRISPR/Cas and PITCh. While each of these methods utilizes a distinct mechanism of gene modification at the genomic level, they all are dependent on an efficient delivery system to the target site within the host cell. This review will provide an overview on current and emerging therapeutic strategies for the treatment of liver diseases.
Clinical trials for liver gene therapy have entered an exciting stage and are already showing promise with the development of novel technologies and delivery options. A deeper understanding of off-target effects produced by gene editing approaches and immune responses generated in host cells by gene carriers is needed to fully realize their potential.
超过100种肝脏相关疾病是由单个基因突变引起的。这些疾病包括遗传性和获得性遗传疾病。由于许多不良副作用和方法学上的局限性,基于核酸的肝脏疾病治疗方法的发展受到了严重限制。
然而,近年来,人们加大了努力来解决这些问题,并利用包括锌指核酸酶(ZFN)、转录激活因子样效应物核酸酶(TALEN)、规律成簇间隔短回文重复序列/CRISPR相关蛋白(CRISPR/Cas)和精准整合靶向染色体编辑(PITCh)在内的新型基因编辑技术开发肝脏靶向方法。虽然这些方法中的每一种在基因组水平上都利用了独特的基因修饰机制,但它们都依赖于一种有效的递送系统将其递送至宿主细胞内的靶位点。本综述将概述当前和新兴的肝脏疾病治疗策略。
肝脏基因治疗的临床试验已进入一个令人兴奋的阶段,并且随着新技术和递送方法的发展已经展现出前景。为了充分实现其潜力,需要更深入地了解基因编辑方法产生的脱靶效应以及基因载体在宿主细胞中引发的免疫反应。