Department CIBIO, University of Trento, Trento, Italy; Institute of Biophysics, National Research Council, Trento, Italy.
Molecular Virology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Flanders, Belgium.
Prog Mol Biol Transl Sci. 2021;182:185-224. doi: 10.1016/bs.pmbts.2020.12.018. Epub 2021 Jan 28.
Cystic fibrosis (CF) is an autosomal recessive monogenic disease caused by mutations in the Cystic Fibrosis Transmembrane conductance Regulator (CFTR) gene. Although F508del is the most frequent mutation, there are in total 360 confirmed disease-causing CFTR mutations, impairing CFTR production, function and stability. Currently, the only causal treatments available are CFTR correctors and potentiators that directly target the mutant protein. While these pharmacological advances and better symptomatic care have improved life expectancy of people with CF, none of these treatments provides a cure. The discovery and development of programmable nucleases, in particular CRISPR nucleases and derived systems, rekindled the field of CF gene therapy, offering the possibility of a permanent correction of the CFTR gene. In this review we will discuss different strategies to restore CFTR function via gene editing correction of CFTR mutations or enhanced CFTR expression, and address how best to deliver these treatments to target cells.
囊性纤维化(CF)是一种常染色体隐性单基因疾病,由囊性纤维化跨膜电导调节因子(CFTR)基因突变引起。虽然 F508del 是最常见的突变,但总共有 360 种已确认的导致 CFTR 突变的疾病,这些突变会损害 CFTR 的产生、功能和稳定性。目前,唯一可用的因果治疗方法是直接针对突变蛋白的 CFTR 校正剂和增强剂。尽管这些药物学进展和更好的对症治疗提高了 CF 患者的预期寿命,但这些治疗方法都不能治愈疾病。可编程核酸酶的发现和发展,特别是 CRISPR 核酸酶及其衍生系统,重新点燃了 CF 基因治疗领域的希望,为 CFTR 基因的永久性校正提供了可能。在这篇综述中,我们将讨论通过基因编辑纠正 CFTR 突变或增强 CFTR 表达来恢复 CFTR 功能的不同策略,并探讨如何将这些治疗方法递送到靶细胞。