Aarhus Institute of Advanced Studies (AIAS), Aarhus University, DK-8000 Aarhus C., Denmark; Department of Biomedicine, Aarhus University, DK-8000 Aarhus C., Denmark.
Department of Pediatrics, Stanford University, Stanford, CA 94305, USA.
Trends Genet. 2018 Aug;34(8):600-611. doi: 10.1016/j.tig.2018.05.004. Epub 2018 Jun 13.
Smithies et al. (1985) and Jasin and colleagues (1994) provided proof of concept that homologous recombination (HR) could be applied to the treatment of human disease and that its efficiency could be improved by the induction of double-strand breaks (DSBs). A key advance was the discovery of engineered nucleases, such as zinc-finger nucleases (ZFNs) and transcription activator-like (TAL) effector nucleases (TALENs), that can generate site-specific DSBs. The democratization and widespread use of genome editing was enabled by the discovery of the clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 nuclease system. While genome editing using ZFNs and TALENs has already reached clinical trials, the pace at which genome editing enters human trials is bound to accelerate in the next several years with multiple promising preclinical studies heralding cures for monogenic diseases that are currently difficult to manage or even incurable. Here we review recent advances and current limitations and discuss the path forward using genome editing to understand, treat, and cure genetic diseases.
史密斯等人(1985 年)和贾辛及其同事(1994 年)提供了同源重组(HR)可应用于人类疾病治疗的概念验证,并且通过诱导双链断裂(DSB)可以提高其效率。一项关键进展是发现了工程化的核酸酶,例如锌指核酸酶(ZFNs)和转录激活因子样效应核酸酶(TALENs),它们可以产生特定位置的 DSB。CRISPR-Cas9 核酸酶系统的发现使基因组编辑的民主化和广泛应用成为可能。虽然使用 ZFNs 和 TALENs 的基因组编辑已经进入临床试验,但随着多项有前途的临床前研究预示着对目前难以治疗甚至无法治愈的单基因疾病的治疗方法,基因组编辑进入人体试验的步伐在未来几年肯定会加快。在这里,我们回顾了最近的进展和当前的局限性,并讨论了使用基因组编辑来理解、治疗和治愈遗传疾病的前进道路。