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推进精准耳医学:利用动物模型获取疾病见解和实现治疗创新。

Advancing precision ear medicine: leveraging animal models for disease insights and therapeutic innovations.

作者信息

Vitry Sandrine, Mendia Clara, Maudoux Audrey, El-Amraoui Aziz

机构信息

Université Paris Cité, Institut Pasteur, AP-HP, INSERM, CNRS, Fondation Pour l'Audition, Institut de l'Audition, IHU reConnect, Progressive Sensory Disorders, Pathophysiology and Therapy, F-75012, Paris, France.

Unit Progressive Sensory Disorders, Pathophysiology and Therapy, Institut Pasteur, Institut de l'Audition, Paris, France.

出版信息

Mamm Genome. 2025 Apr 22. doi: 10.1007/s00335-025-10126-y.

Abstract

Gene therapy offers significant promise for treating inner ear disorders, but its clinical translation requires robust preclinical validation, often reliant on animal models. This review examines the role of these models in advancing gene therapeutics for inherited inner ear disorders, focusing on successes, challenges, and treatment solutions. By providing a precise understanding of disease mechanisms, these models offer a versatile preclinical platform that is essential for assessing and validating therapies. Successful gene supplementation and editing have shown potential in restoring hearing and balance functions and preventing their decline. However, challenges such as limitations in gene delivery methods, surgical access, immune responses, and discrepancies in disease manifestation between animal models and humans hinder clinical translation. Current efforts are dedicated to developing innovative strategies aimed at enhancing the efficiency of gene delivery, overcoming physical barriers such as the blood-labyrinth barrier, improving target specificity, and maximizing therapeutic efficacy while minimizing adverse immune responses. Diverse gene supplementation and editing strategies, along with evolving technologies, hold promise for maximizing therapeutic outcomes using disease relevant models. The future of inner ear gene therapeutics will hinge on personalized therapies and team science fueling interdisciplinary collaborations among researchers, clinicians, companies, and regulatory agencies to expedite the translation from bench to bedside and unlock the immense potential of precision medicine in the inner ear.

摘要

基因治疗为内耳疾病的治疗带来了巨大希望,但其临床转化需要强大的临床前验证,这通常依赖于动物模型。本综述探讨了这些模型在推进遗传性内耳疾病基因治疗方面的作用,重点关注成功案例、挑战和治疗方案。通过提供对疾病机制的精确理解,这些模型提供了一个多功能的临床前平台,这对于评估和验证治疗方法至关重要。成功的基因补充和编辑已显示出恢复听力和平衡功能以及防止其衰退的潜力。然而,诸如基因递送方法的局限性、手术通路、免疫反应以及动物模型与人类疾病表现的差异等挑战阻碍了临床转化。目前的努力致力于开发创新策略,旨在提高基因递送效率、克服诸如血迷路屏障等物理障碍、提高靶向特异性,并在最小化不良免疫反应的同时最大化治疗效果。多样的基因补充和编辑策略以及不断发展的技术,有望利用与疾病相关的模型实现最佳治疗效果。内耳基因治疗的未来将取决于个性化治疗以及团队科学,推动研究人员、临床医生、公司和监管机构之间的跨学科合作,以加速从 bench 到 bedside 的转化,并释放内耳精准医学的巨大潜力。

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