用于治疗X连锁视网膜色素变性的基因疗法。

Gene therapy for the treatment of X-linked retinitis pigmentosa.

作者信息

Martinez-Fernandez De La Camara Cristina, Nanda Anika, Salvetti Anna Paola, Fischer M Dominik, MacLaren Robert E

机构信息

Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.

Oxford Eye Hospital, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK.

出版信息

Expert Opin Orphan Drugs. 2018 Feb 27;6(3):167-177. doi: 10.1080/21678707.2018.1444476.

Abstract

INTRODUCTION

X-linked retinitis pigmentosa caused by mutations in the () gene is the most common form of recessive RP. The phenotype is characterised by its severity and rapid disease progression. Gene therapy using adeno-associated viral vectors is currently the most promising therapeutic approach. However, the construction of a stable vector encoding the full-length RPGR transcript has previously proven to be a limiting step towards gene therapy clinical trials. Recently however, a codon optimised version of has been shown to increase the stability and fidelity of the sequence, conferring a therapeutic effect in murine and canine animal models.

AREAS COVERED

This manuscript reviews the natural history of X-linked retinitis pigmentosa and the research performed from the discovery of the causative gene, , to the preclinical testing of potential therapies that have led to the initiation of three clinical trials.

EXPERT OPINION

X-linked retinitis pigmentosa is an amenable disease to be treated by gene therapy. Codon optimisation has overcome the challenge of designing an vector without mutations, and with a therapeutic effect in different animal models. With the RPGR gene therapy clinical trials still in the early stages, the confirmation of the safety, tolerability and potency of the therapy is still ongoing.

摘要

引言

由()基因突变引起的X连锁视网膜色素变性是隐性视网膜色素变性最常见的形式。其表型的特征在于病情严重程度和疾病进展迅速。使用腺相关病毒载体的基因治疗是目前最有前景的治疗方法。然而,构建编码全长RPGR转录本的稳定载体先前已被证明是基因治疗临床试验的一个限制步骤。然而最近,已显示一种密码子优化的()版本可提高序列的稳定性和保真度,在小鼠和犬类动物模型中具有治疗效果。

涵盖领域

本手稿回顾了X连锁视网膜色素变性的自然病史以及从致病基因()的发现到导致三项临床试验启动的潜在疗法的临床前测试所进行的研究。

专家观点

X连锁视网膜色素变性是一种适合通过基因治疗的疾病。密码子优化克服了设计无突变且在不同动物模型中具有治疗效果的()载体的挑战。随着RPGR基因治疗临床试验仍处于早期阶段,对该疗法的安全性、耐受性和效力的确认仍在进行中。

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