Bräuer Stefan, Falkenburger Björn
Klinik und Poliklinik für Neurologie, Universitätsklinikum an der TU Dresden, Dresden, Germany.
Fortschr Neurol Psychiatr. 2023 Apr;91(4):141-146. doi: 10.1055/a-2042-2338. Epub 2023 Apr 11.
Englisch: Being one of the most common genetic neurodegenerative disease, Huntington's disease has been a model disease - also for gene therapy. Among the various options, the development of antisense oligonucleotides is the most advanced. Further options at the RNA level include micro-RNAs and modulators of RNA processing (splicing), at the DNA level zinc finger proteins. Several products are in clinical trials. These differ in their mode of application and in the extent of systemic availability. Another important difference between therapeutic strategies could be whether all forms of the huntingtin protein are targeted in the same extent, or whether a therapy preferentially targets particular toxic forms such as the exon1 protein. The results of the recently terminated GENERATION HD1 trial were somewhat sobering, most likely due to the side effect-related hydrocephalus. Therefore they represent just one step towards the development of an effective gene therapy against Huntington's disease.
作为最常见的遗传性神经退行性疾病之一,亨廷顿舞蹈症一直是一种典型疾病——也是基因治疗方面的典型疾病。在各种治疗方案中,反义寡核苷酸的研发最为先进。在RNA水平上的其他治疗方案包括微小RNA和RNA加工(剪接)调节剂,在DNA水平上则有锌指蛋白。有几种产品正在进行临床试验。它们在应用方式和全身可利用程度方面存在差异。治疗策略之间的另一个重要区别可能在于,是否同等程度地针对亨廷顿蛋白的所有形式,或者一种疗法是否优先针对特定的毒性形式,如外显子1蛋白。最近结束的GENERATION HD1试验结果有些令人沮丧,很可能是由于与副作用相关的脑积水。因此,这些结果仅仅是朝着开发针对亨廷顿舞蹈症的有效基因疗法迈出的一步。