Piotrowski-Daspit Alexandra S, Glaze Peter M, Saltzman W Mark
Department of Biomedical Engineering, Yale University, New Haven, CT 06511.
Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT 06510.
Curr Opin Biomed Eng. 2018 Sep;7:24-32. doi: 10.1016/j.cobme.2018.08.002. Epub 2018 Aug 21.
Efforts to precisely correct genomic mutations that underlie hereditary diseases for therapeutic benefit have advanced alongside the emergence and improvement of genome engineering technologies. These methods can be divided into two main classes: active nucleasebased platforms including the popular CRISPR/Cas9 system and oligo/polynucleotide strategies including triplex-forming oligonucleotides (TFOs), such as peptide nucleic acids (PNAs). These technologies have been successful in cell culture and in animals, but important challenges remain before these tools can be translated into the clinic; they must be effectively delivered to and taken up by specific cell types of interest, achieve correction levels in target cells that significantly ameliorate the disease phenotype, and demonstrate minimal off-target and toxicity effects. Here we review and compare the current strategies and non-viral delivery methods, mainly lipid and polymeric vehicles, proposed for genome editing of inherited disorders with a focus on delivery and efficacy. While the path to a safe and effective medical treatment may be arduous, the future outlook of therapeutic genome editing remains promising as long as precise technologies can be combined with efficient delivery.
为了实现治疗益处而精确纠正导致遗传性疾病的基因突变的努力,随着基因组工程技术的出现和改进而取得了进展。这些方法可主要分为两类:基于活性核酸酶的平台,包括广为人知的CRISPR/Cas9系统;以及寡核苷酸/多核苷酸策略,包括三链形成寡核苷酸(TFO),如肽核酸(PNA)。这些技术在细胞培养和动物实验中已取得成功,但在这些工具能够转化到临床应用之前,仍存在重大挑战;它们必须有效地递送至特定的目标细胞类型并被其摄取,在靶细胞中达到能够显著改善疾病表型的校正水平,并表现出最小的脱靶效应和毒性作用。在此,我们综述并比较了目前针对遗传性疾病基因组编辑所提出的策略和非病毒递送方法,主要是脂质和聚合物载体,重点关注递送和效果。虽然通往安全有效医疗治疗的道路可能艰巨,但只要精确技术能够与高效递送相结合,治疗性基因组编辑的未来前景依然广阔。