Wang Liang, Shah Serena M, Mangwani-Mordani Simran, Gregori Ninel Z
University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
J Clin Med. 2023 Sep 27;12(19):6229. doi: 10.3390/jcm12196229.
Autosomal recessive Stargardt disease (STGD1) is an inherited retinal degenerative disease associated with a mutated ATP-binding cassette, subfamily A, member 4 () gene. STGD1 is the most common form of juvenile macular degeneration with onset in late childhood to early or middle adulthood and causes progressive, irreversible visual impairment and blindness. No effective treatment is currently available. In the present article, we review the most recent updates in clinical trials targeting the management of STGD1, including gene therapy, small molecule therapy, and stem cell therapy. In gene therapy, dual adeno-associated virus and non-viral vectors have been successful in delivering the human gene in preclinical studies. For pharmaceutical therapies ALK-001, deuterated vitamin A shows promise with preliminary data for phase 2 trial, demonstrating a decreased atrophy growth rate after two years. Stem cell therapy using human pluripotent stem cell-derived retinal pigment epithelium cells demonstrated long-term safety three years after implantation and visual acuity improvements in the first two years after initiation of therapy. Many other treatment options have ongoing investigations and clinical trials. While multiple potential interventions have shown promise in attenuating disease progression, further exploration is necessary to demonstrate treatment safety and efficacy.
常染色体隐性遗传性斯特格黄斑营养不良(STGD1)是一种遗传性视网膜退行性疾病,与ATP结合盒转运蛋白A亚家族成员4(ABCA4)基因突变有关。STGD1是青少年黄斑变性最常见的形式,发病于儿童晚期至成年早期或中期,会导致进行性、不可逆的视力损害和失明。目前尚无有效的治疗方法。在本文中,我们综述了针对STGD1治疗的临床试验的最新进展,包括基因治疗、小分子治疗和干细胞治疗。在基因治疗中,双腺相关病毒和非病毒载体在临床前研究中已成功递送人ABCA4基因。对于药物治疗,ALK - 001(氘代维生素A)在2期试验的初步数据中显示出前景,表明两年后萎缩生长速率降低。使用人多能干细胞衍生的视网膜色素上皮细胞进行的干细胞治疗在植入三年后显示出长期安全性,且在治疗开始后的头两年视力有所改善。许多其他治疗选择正在进行研究和临床试验。虽然多种潜在干预措施在减缓疾病进展方面已显示出前景,但仍需进一步探索以证明治疗的安全性和有效性。