Byrne Barry J, Flanigan Kevin M, Matesanz Susan E, Finkel Richard S, Waldrop Megan A, D'Ambrosio Eleonora S, Johnson Nicholas E, Smith Barbara K, Bönnemann Carsten, Carrig Sean, Rossano Joseph W, Greenberg Barry, Lalaguna Laura, Lara-Pezzi Enrique, Subramony Sub, Corti Manuela, Mercado-Rodriguez Claudia, Leon-Astudillo Carmen, Ahrens-Nicklas Rebecca, Bharucha-Goebel Diana, Gao Guangping, Gessler Dominic J, Hwu Wuh-Liang, Chien Yin-Hsiu, Lee Ni-Chung, Boye Sanford L, Boye Shannon E, George Lindsey A
Powell Gene Therapy Center, University of Florida College of Medicine, Gainesville, FL, USA; Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, USA.
Center for Gene Therapy, Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatrics and Neurology, The Ohio State University, Columbus, OH, USA.
Mol Ther. 2025 Jun 4;33(6):2479-2516. doi: 10.1016/j.ymthe.2025.04.045. Epub 2025 May 5.
Currently, there are an estimated 8,000 genetic disorders that cumulatively affect approximately 10% of the population. Even among the 5% of patients with genetic disease that have treatment options, these therapeutics rarely address the underlying cause of disease but rather focus on managing or modifying symptoms and typically require recurrent, lifelong therapy. A therapeutic approach to genetic disease that in vivo delivers a functional copy of the aberrant gene is an intuitive solution that has thus far taken 3 decades to reduce to clinical practice, predominantly using adeno-associated viral (AAV) vectors. Among available viral and non-viral gene delivery approaches, AAV vectors remain the most efficient means for in vivo delivery of DNA to the nucleus. AAV vectors now constitute a bone fide novel therapeutic drug class composed of seven US Food and Drug Administration-approved products with over 10-fold more in clinical development for an expanding number of disease indications and an identified list of problems to overcome for widespread clinical application. Here, we review current progress in clinical AAV gene therapy, including for neuromuscular disorders, hemophilia, primary cardiovascular disorders, or disorders with cardiovascular manifestations, lysosomal storage disorders, mucopolysaccharide disorders, primary central nervous systemic disorders, and ocular disorders.
目前,据估计有8000种遗传疾病,累计影响约10%的人口。即使在有治疗选择的5%的遗传病患者中,这些疗法也很少针对疾病的根本原因,而是侧重于控制或改善症状,并且通常需要反复进行终身治疗。一种针对遗传疾病的治疗方法,即在体内递送异常基因的功能性拷贝,是一种直观的解决方案,到目前为止花了30年才转化为临床实践,主要使用腺相关病毒(AAV)载体。在现有的病毒和非病毒基因递送方法中,AAV载体仍然是将DNA体内递送至细胞核的最有效手段。AAV载体现在构成了一类真正的新型治疗药物,由美国食品药品监督管理局批准的7种产品组成,还有超过10种产品正在进行临床开发,用于越来越多的疾病适应症,并且为了广泛的临床应用还列出了一系列有待克服的问题。在这里,我们综述了AAV基因治疗的临床进展,包括用于神经肌肉疾病、血友病、原发性心血管疾病或有心血管表现的疾病、溶酶体贮积症、黏多糖病、原发性中枢神经系统疾病和眼部疾病的治疗进展。
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