Shim Gayong, Kim Dongyoon, Park Gyu Thae, Jin Hyerim, Suh Soo-Kyung, Oh Yu-Kyoung
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Gwanak-gu, Seoul 08826, Republic of Korea.
Advanced Therapy Product Research Division, Ministry of Food and Drug Safety, Cheongju, Chungcheongbuk-do, Republic of Korea.
Acta Pharmacol Sin. 2017 Jun;38(6):738-753. doi: 10.1038/aps.2017.2. Epub 2017 Apr 10.
Gene-editing technology is an emerging therapeutic modality for manipulating the eukaryotic genome by using target-sequence-specific engineered nucleases. Because of the exceptional advantages that gene-editing technology offers in facilitating the accurate correction of sequences in a genome, gene editing-based therapy is being aggressively developed as a next-generation therapeutic approach to treat a wide range of diseases. However, strategies for precise engineering and delivery of gene-editing nucleases, including zinc finger nucleases, transcription activator-like effector nuclease, and CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats-associated nuclease Cas9), present major obstacles to the development of gene-editing therapies, as with other gene-targeting therapeutics. Currently, viral and non-viral vectors are being studied for the delivery of these nucleases into cells in the form of DNA, mRNA, or proteins. Clinical trials are already ongoing, and in vivo studies are actively investigating the applicability of CRISPR/Cas9 techniques. However, the concept of correcting the genome poses major concerns from a regulatory perspective, especially in terms of safety. This review addresses current research trends and delivery strategies for gene editing-based therapeutics in non-clinical and clinical settings and considers the associated regulatory issues.
基因编辑技术是一种新兴的治疗方式,通过使用靶向序列特异性工程核酸酶来操纵真核生物基因组。由于基因编辑技术在促进基因组序列精确校正方面具有突出优势,基于基因编辑的疗法正作为一种治疗多种疾病的下一代治疗方法而被积极开发。然而,与其他基因靶向治疗方法一样,包括锌指核酸酶、转录激活样效应核酸酶和CRISPR/Cas9(成簇规律间隔短回文重复序列相关核酸酶Cas9)在内的基因编辑核酸酶的精确工程和递送策略,是基因编辑疗法发展的主要障碍。目前,正在研究病毒和非病毒载体,以便将这些核酸酶以DNA、mRNA或蛋白质的形式递送至细胞中。临床试验已经在进行,体内研究也在积极探索CRISPR/Cas9技术的适用性。然而,从监管角度来看,校正基因组的概念引发了重大担忧,尤其是在安全性方面。本综述阐述了非临床和临床环境中基于基因编辑的治疗方法的当前研究趋势和递送策略,并探讨了相关的监管问题。