Laboratory for General Biochemistry and Physical Pharmacy, Department of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
Leiden Academic Centre for Drug Research, Leiden University, 2333 CC Leiden, The Netherlands.
Chem Soc Rev. 2024 Jan 2;53(1):317-360. doi: 10.1039/d3cs00194f.
Gene therapy is on its way to revolutionize the treatment of both inherited and acquired diseases, by transferring nucleic acids to correct a disease-causing gene in the target cells of patients. In the fight against infectious diseases, mRNA-based therapeutics have proven to be a viable strategy in the recent Covid-19 pandemic. Although a growing number of gene therapies have been approved, the success rate is limited when compared to the large number of preclinical and clinical trials that have been/are being performed. In this review, we highlight some of the hurdles which gene therapies encounter after administration into the human body, with a focus on nucleic acid degradation by nucleases that are extremely abundant in mammalian organs, biological fluids as well as in subcellular compartments. We overview the available strategies to reduce the biodegradation of gene therapeutics after administration, including chemical modifications of the nucleic acids, encapsulation into vectors and co-administration with nuclease inhibitors and discuss which strategies are applied for clinically approved nucleic acid therapeutics. In the final part, we discuss the currently available methods and techniques to qualify and quantify the integrity of nucleic acids, with their own strengths and limitations.
基因治疗正通过将核酸转移到患者靶细胞中的致病基因,来彻底改变遗传性和获得性疾病的治疗方法。在与传染病的斗争中,mRNA 疗法已被证明是最近的 COVID-19 大流行中的一种可行策略。尽管越来越多的基因疗法获得批准,但与已经/正在进行的大量临床前和临床试验相比,成功率有限。在这篇综述中,我们重点介绍了基因疗法在进入人体后遇到的一些障碍,包括在哺乳动物器官、生物体液以及亚细胞区室中极其丰富的核酸酶对核酸的降解。我们概述了现有的降低基因治疗后生物降解的策略,包括核酸的化学修饰、封装到载体中以及与核酸酶抑制剂共同给药,并讨论了哪些策略适用于临床批准的核酸疗法。在最后一部分,我们讨论了目前可用于定性和定量核酸完整性的方法和技术,以及它们各自的优缺点。
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