溶酶体贮积症的基因治疗:当前临床试验前景
Gene therapy for lysosomal storage diseases: Current clinical trial prospects.
作者信息
Kido Jun, Sugawara Keishin, Nakamura Kimitoshi
机构信息
Department of Pediatrics, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Department of Pediatrics, Kumamoto University Hospital, Kumamoto, Japan.
出版信息
Front Genet. 2023 Jan 13;14:1064924. doi: 10.3389/fgene.2023.1064924. eCollection 2023.
Lysosomal storage diseases (LSDs) are a group of metabolic inborn errors caused by defective enzymes in the lysosome, resulting in the accumulation of undegraded substrates. LSDs are progressive diseases that exhibit variable rates of progression depending on the disease and the patient. The availability of effective treatment options, including substrate reduction therapy, pharmacological chaperone therapy, enzyme replacement therapy, and bone marrow transplantation, has increased survival time and improved the quality of life in many patients with LSDs. However, these therapies are not sufficiently effective, especially against central nerve system abnormalities and corresponding neurological and psychiatric symptoms because of the blood-brain barrier that prevents the entry of drugs into the brain or limiting features of specific treatments. Gene therapy is a promising tool for the treatment of neurological pathologies associated with LSDs. Here, we review the current state of gene therapy for several LSDs for which clinical trials have been conducted or are planned. Several clinical trials using gene therapy for LSDs are underway as phase 1/2 studies; no adverse events have not been reported in most of these studies. The administration of viral vectors has achieved good therapeutic outcomes in animal models of LSDs, and subsequent human clinical trials are expected to promote the practical application of gene therapy for LSDs.
溶酶体贮积症(LSDs)是一组由溶酶体中酶缺陷引起的先天性代谢错误,导致未降解底物的积累。LSDs是进行性疾病,其进展速度因疾病和患者而异。有效的治疗选择,包括底物减少疗法、药物伴侣疗法、酶替代疗法和骨髓移植,已经延长了许多LSDs患者的生存时间并改善了他们的生活质量。然而,这些疗法并不足够有效,尤其是针对中枢神经系统异常以及相应的神经和精神症状,这是因为血脑屏障会阻止药物进入大脑或特定治疗存在局限性。基因治疗是治疗与LSDs相关神经病理学的一种有前景的工具。在此,我们综述了针对几种已开展或计划开展临床试验的LSDs的基因治疗现状。几项针对LSDs的基因治疗临床试验正在作为1/2期研究进行;在大多数这些研究中尚未报告不良事件。病毒载体的给药在LSDs动物模型中取得了良好的治疗效果,后续的人体临床试验有望推动基因治疗在LSDs中的实际应用。
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