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遗传性视网膜变性的基因治疗。

Gene Therapy for Inherited Retinal Degeneration.

机构信息

Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California.

出版信息

J Ocul Pharmacol Ther. 2019 Mar;35(2):79-97. doi: 10.1089/jop.2018.0087. Epub 2019 Jan 28.

Abstract

Inherited retinal degeneration (IRD), a group of rare retinal diseases that primarily lead to the progressive loss of retinal photoreceptor cells, can be inherited in all modes of inheritance: autosomal dominant (AD), autosomal recessive (AR), X-linked (XL), and mitochondrial. Based on the pattern of inheritance of the dystrophy, retinal gene therapy has 2 main strategies. AR, XL, and AD IRDs with haploinsufficiency can be treated by inserting a functional copy of the gene using either viral or nonviral vectors (gene augmentation). Different types of viral vectors and nonviral vectors are used to transfer plasmid DNA both in vitro and in vivo. AD IRDs with gain-of-function mutations or dominant-negative mutations can be treated by disrupting the mutant allele with (and occasionally without) gene augmentation. This review article aims to provide an overview of ocular gene therapy for treating IRDs using gene augmentation with viral or nonviral vectors or gene disruption through different gene-editing tools, especially with the clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated (Cas) system.

摘要

遗传性视网膜变性(IRD)是一组罕见的视网膜疾病,主要导致视网膜光感受器细胞进行性丧失,可通过常染色体显性(AD)、常染色体隐性(AR)、X 连锁(XL)和线粒体遗传等多种方式遗传。根据营养不良的遗传模式,视网膜基因治疗有 2 种主要策略。使用病毒或非病毒载体(基因增强)插入功能拷贝基因,可以治疗具有单倍体不足的 AR、XL 和 AD IRD。不同类型的病毒载体和非病毒载体用于在体外和体内转移质粒 DNA。对于具有功能获得性突变或显性负性突变的 AD IRD,可以通过(偶尔不通过)基因增强来破坏突变等位基因进行治疗。本文旨在通过使用病毒或非病毒载体进行基因增强或通过不同的基因编辑工具进行基因破坏(尤其是使用成簇规律间隔短回文重复序列(CRISPR)/CRISPR 相关(Cas)系统),为使用基因增强治疗 IRD 的眼部基因治疗提供概述。

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