Yang Ze-Feng, Jiang Xin-Chi, Gao Jian-Qing
State Key Laboratory of Advanced Drug Delivery and Release Systems, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China.
State Key Laboratory of Advanced Drug Delivery and Release Systems, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China..
Int J Pharm. 2025 Jan 25;669:125069. doi: 10.1016/j.ijpharm.2024.125069. Epub 2024 Dec 9.
Central nervous system (CNS) diseases, including Alzheimer's disease (AD), Parkinson's disease (PD), spinal cord injury (SCI), and ischemic strokes and certain rare diseases, such as amyotrophic lateral sclerosis (ALS) and ataxia, present significant obstacles to treatment using conventional molecular pharmaceuticals. Gene therapy, with its ability to target previously "undruggable" proteins with high specificity and safety, is increasingly utilized in both preclinical and clinical research for CNS ailments. As our comprehension of the pathophysiology of these conditions deepens, gene therapy stands out as a versatile and promising strategy with the potential to both prevent and treat these diseases. Despite the remarkable progress in refining and enhancing the structural design of gene therapy agents, substantial obstacles persist in their effective and safe delivery within living systems. To surmount these obstacles, a diverse array of gene delivery systems has been devised and continuously improved. Notably, Adeno-Associated Virus (AAVs)-based viral gene vectors and lipid-based nanocarriers have each advanced the in vivo delivery of gene therapies to various extents. This review aims to concisely summarize the pathophysiological foundations of CNS diseases and to shed light on the latest advancements in gene delivery vector technologies. It discusses the primary categories of these vectors, their respective advantages and limitations, and their specialized uses in the context of gene therapy delivery.
中枢神经系统(CNS)疾病,包括阿尔茨海默病(AD)、帕金森病(PD)、脊髓损伤(SCI)以及缺血性中风和某些罕见疾病,如肌萎缩侧索硬化症(ALS)和共济失调,给使用传统分子药物治疗带来了重大障碍。基因治疗能够以高特异性和安全性靶向先前“不可成药”的蛋白质,在中枢神经系统疾病的临床前和临床研究中越来越多地被采用。随着我们对这些疾病病理生理学的理解不断深入,基因治疗作为一种通用且有前景的策略脱颖而出,具有预防和治疗这些疾病的潜力。尽管在改进和增强基因治疗剂的结构设计方面取得了显著进展,但在其在生物系统中的有效和安全递送方面仍存在重大障碍。为克服这些障碍,已设计并不断改进了多种基因递送系统。值得注意的是,基于腺相关病毒(AAV)的病毒基因载体和基于脂质的纳米载体都在不同程度上推进了基因治疗的体内递送。本综述旨在简要总结中枢神经系统疾病的病理生理基础,并阐明基因递送载体技术的最新进展。它讨论了这些载体的主要类别、各自的优缺点以及它们在基因治疗递送背景下的特殊用途。