Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, Australia; Military Institute of Medicine, Warsaw, Poland.
Molecular Neurobiology Research Laboratory, Kid's Research, Westmead, Australia; Military Institute of Medicine, Warsaw, Poland.
CRISPR J. 2022 Aug;5(4):490-499. doi: 10.1089/crispr.2022.0020. Epub 2022 Jul 26.
Rett syndrome (RTT) is a rare neurogenetic disorder caused by pathogenic variants of the Methyl CpG binding protein 2 () gene. The RTT is characterized by apparent normal early development followed by regression of communicative and fine motor skills. Comorbidities include epilepsy, severe cognitive impairment, and autonomic and motor dysfunction. Despite almost 60 clinical trials and the promise of a gene therapy, no cure has yet emerged with treatment remaining symptomatic. Advances in understanding RTT has provided insight into the complexity and exquisite control of expression, where loss of expression leads to RTT and overexpression leads to duplication syndrome. Therapy development requires regulated expression that matches the spatiotemporal endogenous expression of in the brain. Gene editing has revolutionized gene therapy and promises an exciting strategy for many incurable monogenic disorders, including RTT, by editing the native locus and retaining endogenous gene expression. Here, we review the literature on the currently available editing technologies and discuss their limitations and applicability to the treatment of RTT.
雷特综合征(RTT)是一种由甲基化CpG 结合蛋白 2()基因突变引起的罕见神经遗传疾病。RTT 的特征是早期发育明显正常,随后沟通和精细运动技能逐渐退化。合并症包括癫痫、严重认知障碍以及自主和运动功能障碍。尽管已经进行了近 60 项临床试验,并有望进行基因治疗,但目前尚无治愈方法,治疗仍以对症治疗为主。对 RTT 的深入了解为理解的表达的复杂性和精确性提供了线索,表达缺失会导致 RTT,而表达过度会导致重复综合征。治疗方法的开发需要进行调节表达,使其与大脑中内源性的时空表达相匹配。基因编辑技术已经彻底改变了基因治疗,并为许多无法治愈的单基因疾病提供了令人兴奋的治疗策略,包括 RTT,通过编辑天然基因座并保留内源性基因表达。在这里,我们回顾了目前可用的编辑技术的文献,并讨论了它们的局限性及其在 RTT 治疗中的适用性。