Botto Catherine, Dalkara Deniz, El-Amraoui Aziz
Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France.
Unit Progressive Sensory Disorders, Pathophysiology and Therapy, Institut Pasteur, Institut de l'Audition, Université de Paris, INSERM-UMRS1120, Paris, France.
Front Genome Ed. 2021 Oct 28;3:737632. doi: 10.3389/fgeed.2021.737632. eCollection 2021.
Blindness and deafness are the most frequent sensory disorders in humans. Whatever their cause - genetic, environmental, or due to toxic agents, or aging - the deterioration of these senses is often linked to irreversible damage to the light-sensing photoreceptor cells (blindness) and/or the mechanosensitive hair cells (deafness). Efforts are increasingly focused on preventing disease progression by correcting or replacing the blindness and deafness-causal pathogenic alleles. In recent years, gene replacement therapies for rare monogenic disorders of the retina have given positive results, leading to the marketing of the first gene therapy product for a form of childhood hereditary blindness. Promising results, with a partial restoration of auditory function, have also been reported in preclinical models of human deafness. Silencing approaches, including antisense oligonucleotides, adeno-associated virus (AAV)-mediated microRNA delivery, and genome-editing approaches have also been applied to various genetic forms of blindness and deafness The discovery of new DNA- and RNA-based CRISPR/Cas nucleases, and the new generations of base, prime, and RNA editors offers new possibilities for directly repairing point mutations and therapeutically restoring gene function. Thanks to easy access and immune-privilege status of self-contained compartments, the eye and the ear continue to be at the forefront of developing therapies for genetic diseases. Here, we review the ongoing applications and achievements of this new class of emerging therapeutics in the sensory organs of vision and hearing, highlighting the challenges ahead and the solutions to be overcome for their successful therapeutic application .
失明和失聪是人类最常见的感觉障碍。无论其病因是遗传、环境、有毒物质还是衰老,这些感官的退化通常与感光光感受器细胞(失明)和/或机械敏感毛细胞(失聪)的不可逆损伤有关。人们越来越致力于通过纠正或替换导致失明和失聪的致病等位基因来预防疾病进展。近年来,针对罕见的视网膜单基因疾病的基因替代疗法取得了积极成果,首个用于某种儿童遗传性失明的基因治疗产品已上市。在人类失聪的临床前模型中也报告了有希望的结果,听觉功能得到了部分恢复。沉默方法,包括反义寡核苷酸、腺相关病毒(AAV)介导的微小RNA递送,以及基因组编辑方法也已应用于各种遗传形式的失明和失聪。新型基于DNA和RNA的CRISPR/Cas核酸酶以及新一代碱基编辑器、引导编辑器和RNA编辑器的发现为直接修复点突变和治疗性恢复基因功能提供了新的可能性。由于眼和耳易于进入且具有免疫豁免状态,它们在遗传性疾病治疗的发展中一直处于前沿。在此,我们综述了这类新兴疗法在视觉和听觉感觉器官中的当前应用和成果,强调了未来面临的挑战以及为实现其成功治疗应用需克服的解决方案。