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基因编辑细胞:用于大疱性表皮松解症的新型异基因基因/细胞疗法。

Gene-edited cells: novel allogeneic gene/cell therapy for epidermolysis bullosa.

作者信息

Gila Fatemeh, Alamdari-Palangi Vahab, Rafiee Maedeh, Jokar Arezoo, Ehtiaty Sajad, Dianatinasab Aria, Khatami Seyyed Hossein, Taheri-Anganeh Mortaza, Movahedpour Ahmad, Fallahi Jafar

机构信息

Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Molecular Medicine, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

J Appl Genet. 2024 Dec;65(4):705-726. doi: 10.1007/s13353-024-00839-2. Epub 2024 Mar 9.

Abstract

Epidermolysis bullosa (EB) is a group of rare genetic skin fragility disorders, which are hereditary. These disorders are associated with mutations in at least 16 genes that encode components of the epidermal adhesion complex. Currently, there are no effective treatments for this disorder. All current treatment approaches focus on topical treatments to prevent complications and infections. In recent years, significant progress has been achieved in the treatment of the severe genetic skin blistering condition known as EB through preclinical and clinical advancements. Promising developments have emerged in the areas of protein and cell therapies, such as allogeneic stem cell transplantation; in addition, RNA-based therapies and gene therapy approaches have also become a reality. Stem cells obtained from embryonic or adult tissues, including the skin, are undifferentiated cells with the ability to generate, maintain, and replace fully developed cells and tissues. Recent advancements in preclinical and clinical research have significantly enhanced stem cell therapy, presenting a promising treatment option for various diseases that are not effectively addressed by current medical treatments. Different types of stem cells such as primarily hematopoietic and mesenchymal, obtained from the patient or from a donor, have been utilized to treat severe forms of diseases, each with some beneficial effects. In addition, extensive research has shown that gene transfer methods targeting allogeneic and autologous epidermal stem cells to replace or correct the defective gene are promising. These methods can regenerate and restore the adhesion of primary keratinocytes in EB patients. The long-term treatment of skin lesions in a small number of patients has shown promising results through the transplantation of skin grafts produced from gene-corrected autologous epidermal stem cells. This article attempts to summarize the current situation, potential development prospects, and some of the challenges related to the cell therapy approach for EB treatment.

摘要

大疱性表皮松解症(EB)是一组罕见的遗传性皮肤脆性疾病。这些疾病与至少16个编码表皮黏附复合体成分的基因突变有关。目前,这种疾病尚无有效的治疗方法。所有当前的治疗方法都集中在局部治疗以预防并发症和感染。近年来,通过临床前和临床进展,在治疗被称为EB的严重遗传性皮肤水疱病方面取得了重大进展。在蛋白质和细胞疗法领域出现了有前景的发展,例如异基因干细胞移植;此外,基于RNA的疗法和基因治疗方法也已成为现实。从胚胎或成人组织(包括皮肤)中获得的干细胞是未分化的细胞,具有生成、维持和替换完全发育的细胞和组织的能力。临床前和临床研究的最新进展显著增强了干细胞疗法,为当前医学治疗无法有效解决的各种疾病提供了一种有前景的治疗选择。从患者或供体获得的不同类型的干细胞,如主要是造血干细胞和间充质干细胞,已被用于治疗严重形式的疾病,每种都有一些有益效果。此外,广泛的研究表明,针对异基因和自体表皮干细胞以替代或纠正缺陷基因的基因转移方法很有前景。这些方法可以使EB患者的原代表皮细胞再生并恢复黏附。通过移植由基因校正的自体表皮干细胞产生的皮肤移植物,对少数患者的皮肤病变进行长期治疗已显示出有前景的结果。本文试图总结当前情况、潜在的发展前景以及与用于EB治疗的细胞疗法相关的一些挑战。

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