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多囊肾病的基因治疗:前景光明。

Gene therapy in polycystic kidney disease: A promising future.

作者信息

Xue Cheng, Lv Jiayi, Yang Bo, Mei Shuqin, Xu Jing, Li Xinming, Zhang Liming, Mao Zhiguo

机构信息

Division of Nephrology, Shanghai Changzheng Hospital, Second Military Medical University (Naval Medical University), Shanghai 200003, China.

Internal Medicine III (Nephrology), Naval Medical Center of PLA, Naval Medical University, Shanghai 200433, China.

出版信息

J Transl Int Med. 2025 Jan 10;12(6):543-552. doi: 10.1515/jtim-2024-0021. eCollection 2024 Dec.

Abstract

Polycystic kidney disease (PKD) is a genetic disorder marked by numerous cysts in the kidneys, progressively impairing renal function. It is classified into autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD), with ADPKD being more common. Current treatments mainly focus on symptom relief and slowing disease progression, without offering a cure. Recent advancements in gene editing technologies, such as CRISPR-Cas9, have introduced new therapeutic possibilities for PKD. These approaches include miR-17 antisense oligonucleotides, adenovirus-mediated gene knockdown, Pkd1 gene or polycystin -1 C-terminal tail enhancement therapy, and 3-UTR miR-17 binding element by CRISPR-Cas9, which have shown potential in animal models and early clinical trials. Specifically for ARPKD, strategies like antisense oligonucleotide therapy targeting c-myc and CRISPR/ Cas9 knockdown of the P2rx7 gene have shown promise. Despite facing challenges such as technological limitations, ethical and legal issues, and high costs, gene therapy presents unprecedented hope for PKD treatment. Future interdisciplinary collaboration and international cooperation are essential for developing more effective treatment strategies for PKD patients.

摘要

多囊肾病(PKD)是一种遗传性疾病,其特征是肾脏中出现大量囊肿,逐渐损害肾功能。它分为常染色体显性多囊肾病(ADPKD)和常染色体隐性多囊肾病(ARPKD),其中ADPKD更为常见。目前的治疗主要集中在缓解症状和减缓疾病进展,无法治愈。基因编辑技术(如CRISPR-Cas9)的最新进展为PKD带来了新的治疗可能性。这些方法包括miR-17反义寡核苷酸、腺病毒介导的基因敲低、Pkd1基因或多囊蛋白-1 C末端尾巴增强疗法,以及通过CRISPR-Cas9作用的3'-UTR miR-17结合元件,这些在动物模型和早期临床试验中已显示出潜力。特别是对于ARPKD,靶向c-myc的反义寡核苷酸疗法和CRISPR/Cas9敲低P2rx7基因等策略已显示出前景。尽管面临技术限制、伦理和法律问题以及高成本等挑战,但基因治疗为PKD治疗带来了前所未有的希望。未来的跨学科合作和国际合作对于为PKD患者开发更有效的治疗策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6515/11720931/1bbe6b5c192e/j_jtim-2024-0021_fig_001.jpg

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