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血液系统疾病的基因治疗:当前的挑战。

Gene therapy of hematological disorders: current challenges.

机构信息

Department of Biomedical Research, Research Center, King Fahad Specialist Hospital, Building 100, Room 27, Dammam, 31444, Saudi Arabia.

出版信息

Gene Ther. 2019 Aug;26(7-8):296-307. doi: 10.1038/s41434-019-0093-4. Epub 2019 Jul 12.

Abstract

Recent advances in genetic engineering technology and stem cell biology have spurred great interest in developing gene therapies for hereditary, as well as acquired hematological disorders. Currently, hematopoietic stem cell transplantation is used to cure disorders such as hemoglobinopathies and primary immunodeficiencies; however, this method is limited by the availability of immune-matched donors. Using autologous cells coupled with genome editing bypasses this limitation and therefore became the focus of many research groups aiming to develop efficient and safe genomic modification. Hence, gene therapy research has witnessed a noticeable growth in recent years with numerous successful achievements; however, several challenges have to be overcome before gene therapy becomes widely available for patients. In this review, I discuss tools used in gene therapy for hematological disorders, choices of target cells, and delivery vehicles with emphasis on current hurdles and attempts to solve them, and present examples of successful clinical trials to give a glimpse of current progress.

摘要

近年来,基因工程技术和干细胞生物学的进展激发了人们开发遗传性和获得性血液系统疾病基因治疗方法的极大兴趣。目前,造血干细胞移植被用于治疗血红蛋白病和原发性免疫缺陷等疾病;然而,这种方法受到免疫匹配供体可用性的限制。使用自体细胞结合基因组编辑可以绕过这一限制,因此成为许多旨在开发高效和安全基因组修饰的研究小组的关注焦点。因此,近年来,基因治疗研究取得了显著进展,取得了许多成功,但在基因治疗广泛应用于患者之前,还需要克服一些挑战。在这篇综述中,我讨论了用于血液系统疾病的基因治疗工具、靶细胞的选择和载体,重点介绍了当前的障碍和解决这些障碍的尝试,并介绍了成功的临床试验实例,以了解当前的进展。

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