Naso Gaetano, Petrova Anastasia
Molecular and Cellular Immunology Section, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, U.K.
Emerg Top Life Sci. 2019 May 31;3(3):313-326. doi: 10.1042/ETLS20180148.
Genodermatoses constitute a clinically heterogeneous group of devastating genetic skin disorders. Currently, therapy options are largely limited to symptomatic treatments and although significant advances have been made in ex vivo gene therapy strategies, various limitations remain. However, the recent technical transformation of the genome editing field promises to overcome the hurdles associated with conventional gene addition approaches. In this review, we discuss the need for developing novel treatments and describe the current status of gene editing for genodermatoses, focusing on a severe blistering disease called epidermolysis bullosa (EB), for which significant progress has been made. Initial research utilized engineered nucleases such as transcription activator-like effector nucleases and meganucleases. However, over the last few years, clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) have upstaged older generation gene editing tools. We examine different strategies for CRISPR/Cas9 application that can be employed depending on the type and position of the mutation as well as the mode of its inheritance. Promising developments in the field of base editing opens new avenues for precise correction of single base substitutions, common in EB and other genodermatoses. We also address the potential limitations and challenges such as safety concerns and delivery efficiency. This review gives an insight into the future of gene editing technologies for genodermatoses.
遗传性皮肤病是一组临床异质性的、具有破坏性的遗传性皮肤疾病。目前,治疗选择主要限于对症治疗,尽管在体外基因治疗策略方面取得了重大进展,但仍存在各种局限性。然而,基因组编辑领域最近的技术变革有望克服与传统基因添加方法相关的障碍。在这篇综述中,我们讨论了开发新疗法的必要性,并描述了遗传性皮肤病基因编辑的现状,重点关注一种名为大疱性表皮松解症(EB)的严重水疱性疾病,在该疾病的治疗上已取得了重大进展。最初的研究使用了工程核酸酶,如转录激活样效应核酸酶和巨核酸酶。然而,在过去几年中,成簇规律间隔短回文重复序列/CRISPR相关蛋白9(CRISPR/Cas9)已经超越了老一代基因编辑工具。我们研究了CRISPR/Cas9应用的不同策略,这些策略可根据突变的类型和位置及其遗传模式来采用。碱基编辑领域的有前景的进展为精确纠正单碱基替换开辟了新途径,单碱基替换在EB和其他遗传性皮肤病中很常见。我们还讨论了潜在的局限性和挑战,如安全问题和递送效率。这篇综述深入探讨了遗传性皮肤病基因编辑技术的未来。