The Jared Grantham Kidney Institute.
Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, Kansas, USA.
Curr Opin Nephrol Hypertens. 2025 Jan 1;34(1):121-127. doi: 10.1097/MNH.0000000000001030. Epub 2024 Oct 3.
We aim to provide an updated perspective on the recent advancements in gene therapy for polycystic kidney disease (PKD), a genetic disorder with significant morbidity. Given the rapid evolution of gene therapy technologies and their potential for treating inherited diseases, this review explores the therapeutic prospects and challenges in applying these technologies to PKD.
Significant progress has been made in understanding the genetic underpinnings of PKD, making it a prime candidate for gene therapy. Re-expression of the PKD genes, treatment with the C-terminal tail of polycystin 1 protein and antagomir therapy against miR-17 have shown promise in reducing cyst formation and preserving kidney function. The rapid development of gene-editing tools, antisense oligonucleotide-based strategies, programmable RNA, and advanced gene delivery systems has opened new possibilities for PKD treatment. However, challenges such as off-target effects, delivery efficiency, and long-term safety remain significant barriers to clinical application.
Current research highlights the transformative potential of gene therapy for PKD. Ongoing studies are crucial to overcoming existing challenges and translating these findings into clinical practice. We highlight the need for multidisciplinary efforts to optimize gene-editing technologies and ensure their safety and efficacy in treating PKD.
目的综述:我们旨在提供对多囊肾病(PKD)基因治疗最新进展的更新视角,PKD 是一种具有重大发病率的遗传性疾病。鉴于基因治疗技术的快速发展及其治疗遗传性疾病的潜力,本综述探讨了将这些技术应用于 PKD 的治疗前景和挑战。
最新发现:人们对 PKD 的遗传基础有了更深入的了解,这使其成为基因治疗的主要候选疾病。PKD 基因的重新表达、对多囊蛋白 1 蛋白 C 端尾部的治疗以及针对 miR-17 的反义寡核苷酸治疗已显示出减少囊肿形成和保护肾功能的潜力。基因编辑工具、反义寡核苷酸策略、可编程 RNA 和先进的基因传递系统的快速发展为 PKD 的治疗开辟了新的可能性。然而,脱靶效应、传递效率和长期安全性等挑战仍然是临床应用的重大障碍。
总结:目前的研究强调了基因治疗对 PKD 的变革潜力。正在进行的研究对于克服现有挑战并将这些发现转化为临床实践至关重要。我们强调需要多学科努力来优化基因编辑技术,并确保其在治疗 PKD 中的安全性和有效性。