Division of Stem Cell Transplant and Regenerative Medicine, Lucile Packard Children's Hospital, Stanford University, Palo Alto, California, USA.
Department of Microbiology, Immunology and Molecular Genetics, University of California Los Angeles, Los Angeles, California, USA.
Cytotherapy. 2019 Mar;21(3):358-366. doi: 10.1016/j.jcyt.2018.12.001. Epub 2019 Feb 8.
Gene modification of hematopoietic stem cells is increasingly becoming popular as a therapeutic approach, given the recent approvals and the number of new applications for clinical trials targeting monogenetic and immunodeficiency disorders. Technological advances in stem cell selection, culture, transduction and gene editing now allow for efficient ex vivo genetic manipulation of stem cells. Gene-addition techniques using viral vectors (mainly retrovirus- and lentivirus-based) and gene editing using various targeted nuclease platforms (e.g., Zinc finger, TALEN and Crispr/Cas9) are being applied to the treatment of multiple genetic and immunodeficiency disorders. Herein, the current state of the art in manufacturing and critical assays that are required for ex vivo manipulation of stem cells are addressed. Important quality control and safety assays that need to be planned early in the process development phase of these products for regulatory approval are also highlighted.
鉴于最近批准的针对单基因和免疫缺陷疾病的临床试验数量众多,对造血干细胞进行基因修饰作为一种治疗方法越来越受到关注。干细胞选择、培养、转导和基因编辑技术的进步现在允许对干细胞进行高效的体外基因操作。使用病毒载体(主要基于逆转录病毒和慢病毒)的基因添加技术和使用各种靶向核酸酶平台(例如锌指、TALEN 和 Crispr/Cas9)的基因编辑技术正被应用于多种遗传和免疫缺陷疾病的治疗。本文介绍了体外操作干细胞所需的制造技术和关键检测方法的最新进展。还强调了在这些产品的开发阶段早期就需要计划进行重要的质量控制和安全性检测,以获得监管批准。