Ruzycki Conor A, Montoya Derek, Irshad Hammad, Cox Jason, Zhou Yue, McDonald Jacob D, Kuehl Philip J
Lovelace Biomedical Research Institute, Albuquerque, NM, USA.
Expert Opin Drug Deliv. 2023 Jul-Dec;20(8):1097-1113. doi: 10.1080/17425247.2023.2261369. Epub 2023 Oct 16.
Inhaled gene therapy programs targeting diseases of the lung have seen increasing interest in recent years, though as of yet no product has successfully entered the market. Preclinical research to support such programs is critically important in maximizing the chances of developing successful candidates.
Aspects of inhalation delivery of gene therapies are reviewed, with a focus on preclinical research in animal models. Various barriers to inhalation delivery of gene therapies are discussed, including aerosolization stresses, aerosol behavior in the respiratory tract, and disposition processes post-deposition. Important aspects of animal models are considered, including determinations of biologically relevant determinations of dose and issues related to translatability.
Development of clinically-efficacious inhaled gene therapies has proven difficult owing to numerous challenges. Fit-for-purpose experimental and analytical methods are necessary for determinations of biologically relevant doses in preclinical animal models. Further developments in disease-specific animal models may aid in improving the translatability of results in future work, and we expect to see accelerated interests in inhalation gene therapies for various diseases. Sponsors, researchers, and regulators are encouraged to engage in early and frequent discussion regarding candidate therapies, and additional dissemination of preclinical methodologies would be of immense value in avoiding common pitfalls.
近年来,针对肺部疾病的吸入式基因治疗方案越来越受到关注,尽管目前尚无产品成功进入市场。支持此类方案的临床前研究对于最大化开发成功候选产品的机会至关重要。
本文综述了基因治疗吸入给药的各个方面,重点是动物模型的临床前研究。讨论了基因治疗吸入给药的各种障碍,包括雾化压力、呼吸道中的气溶胶行为以及沉积后的处置过程。考虑了动物模型的重要方面,包括生物学相关剂量的确定以及与可转化性相关的问题。
由于众多挑战,开发临床有效的吸入式基因治疗已被证明很困难。在临床前动物模型中确定生物学相关剂量需要适用的实验和分析方法。针对特定疾病的动物模型的进一步发展可能有助于在未来的工作中提高结果的可转化性,并且我们预计对各种疾病的吸入式基因治疗的兴趣将加速增长。鼓励赞助商、研究人员和监管机构就候选疗法进行早期和频繁的讨论,并且更多地传播临床前方法对于避免常见陷阱将具有巨大价值。