X 连锁性视网膜炎劈裂
X-Linked Retinoschisis.
机构信息
Department of Ophthalmology & Vision Science, University of California Davis, Sacramento, California 95817, USA.
National Institutes of Health, National Institute of Allergy and Infectious Diseases, NIH Office of Biodefense, Research Resources and Translational Research/Vaccine Section, Bethesda, Maryland 20892, USA.
出版信息
Cold Spring Harb Perspect Med. 2023 Sep 1;13(9):a041288. doi: 10.1101/cshperspect.a041288.
X-linked retinoschisis (XLRS) is an inherited vitreoretinal dystrophy causing visual impairment in males starting at a young age with an estimated prevalence of 1:5000 to 1:25,000. The condition was first observed in two affected brothers by Josef Haas in 1898 and is clinically diagnosed by characteristic intraretinal cysts arranged in a petaloid "spoke-wheel" pattern centered in the macula. When clinical electroretinogram (ERG) testing began in the 1960s, XLRS was noted to have a characteristic reduction of the dark-adapted b-wave amplitude despite normal or usually nearly normal a-wave amplitudes, which became known as the "electronegative ERG response" of XLRS disease. The causative gene, , was identified on the X-chromosome in 1997 and led to understanding the molecular and cellular basis of the condition, discerning the structure and function of the retinoschisin protein, and generating XLRS murine models. Along with parallel development of gene delivery vectors suitable for targeting retinal diseases, successful gene augmentation therapy was demonstrated by rescuing the XLRS phenotype in mouse. Two human phase I/II therapeutic XLRS gene augmentation studies were initiated; and although these did not yield definitive improvement in visual function, they gave significant new knowledge and experience, which positions the field for further near-term clinical testing with enhanced, next-generation gene therapy for XLRS patients.
X 连锁性视锥-视杆营养不良(XLRS)是一种遗传性的玻璃体视网膜疾病,会导致男性在年轻时出现视力损害,其患病率估计为每 5000 至 25000 人中就有 1 例。这种疾病最初是由 Josef Haas 在 1898 年观察到的两名受影响的兄弟中发现的,其临床诊断特征是在黄斑中心呈花瓣状“辐轮”样排列的视网膜内囊肿。当 20 世纪 60 年代开始进行临床视网膜电图(ERG)检测时,XLRS 被发现具有特征性的暗适应 b 波振幅降低,尽管 a 波振幅正常或通常几乎正常,这种现象被称为 XLRS 疾病的“负电性 ERG 反应”。1997 年,该致病基因, ,在 X 染色体上被鉴定出来,这使得人们对该疾病的分子和细胞基础有了更深的理解,也有助于了解视锥-视杆营养不良蛋白的结构和功能,并生成了 XLRS 小鼠模型。随着适用于靶向视网膜疾病的基因传递载体的平行发展,成功的基因增强治疗通过挽救小鼠的 XLRS 表型得到了证实。两项针对人类 I/II 期的 XLRS 基因增强治疗研究已经启动;尽管这些研究没有在视觉功能方面取得明确的改善,但它们提供了新的重要知识和经验,为进一步进行更接近临床的、针对 XLRS 患者的下一代基因治疗提供了可能。