St John's Institute of Dermatology, King's College London, London SE1 9RT, UK.
Red Cell Hematology Lab, Comprehensive Cancer Center, School of Cancer & Pharmaceutical Sciences, King's College London, United Kingdom.
Blood Rev. 2024 May;65:101185. doi: 10.1016/j.blre.2024.101185. Epub 2024 Mar 7.
Recent advancements in gene editing illuminate new potential therapeutic approaches for Sickle Cell Disease (SCD), a debilitating monogenic disorder caused by a point mutation in the β-globin gene. Despite the availability of several FDA-approved medications for symptomatic relief, allogeneic hematopoietic stem cell transplantation (HSCT) remains the sole curative option, underscoring a persistent need for novel treatments. This review delves into the growing field of gene editing, particularly the extensive research focused on curing haemoglobinopathies like SCD. We examine the use of techniques such as CRISPR-Cas9 and homology-directed repair, base editing, and prime editing to either correct the pathogenic variant into a non-pathogenic or wild-type one or augment fetal haemoglobin (HbF) production. The article elucidates ways to optimize these tools for efficacious gene editing with minimal off-target effects and offers insights into their effective delivery into cells. Furthermore, we explore clinical trials involving alternative SCD treatment strategies, such as LentiGlobin therapy and autologous HSCT, distilling the current findings. This review consolidates vital information for the clinical translation of gene editing for SCD, providing strategic insights for investigators eager to further the development of gene editing for SCD.
近年来,基因编辑技术的进步为镰状细胞病(Sickle Cell Disease,SCD)带来了新的潜在治疗方法。SCD 是一种由β-珠蛋白基因突变引起的严重单基因疾病。尽管有几种获得 FDA 批准的药物可用于缓解症状,但异基因造血干细胞移植(Hematopoietic Stem Cell Transplantation,HSCT)仍然是唯一的治愈方法,这突显了对新型治疗方法的持续需求。本文深入探讨了基因编辑领域的最新进展,特别是针对治疗 SCD 等血红蛋白病的广泛研究。我们研究了 CRISPR-Cas9 和同源定向修复、碱基编辑和先导编辑等技术的应用,以将致病变体纠正为非致病或野生型变体,或增加胎儿血红蛋白(Fetal Hemoglobin,HbF)的产生。本文阐述了如何优化这些工具以实现高效的基因编辑,同时最大限度地减少脱靶效应,并提供了有关将其有效递送至细胞内的见解。此外,我们还探讨了涉及替代 SCD 治疗策略的临床试验,如 LentiGlobin 疗法和自体 HSCT,提炼了当前的研究结果。本文为 SCD 的基因编辑临床转化提供了重要信息,为渴望进一步推进 SCD 基因编辑发展的研究人员提供了战略见解。