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用于治疗罕见遗传病的个性化体内基因编辑

Patient-Specific In Vivo Gene Editing to Treat a Rare Genetic Disease.

作者信息

Musunuru Kiran, Grandinette Sarah A, Wang Xiao, Hudson Taylor R, Briseno Kevin, Berry Anne Marie, Hacker Julia L, Hsu Alvin, Silverstein Rachel A, Hille Logan T, Ogul Aysel N, Robinson-Garvin Nancy A, Small Juliana C, McCague Sarah, Burke Samantha M, Wright Christina M, Bick Sarah, Indurthi Venkata, Sharma Shweta, Jepperson Michael, Vakulskas Christopher A, Collingwood Michael, Keogh Katie, Jacobi Ashley, Sturgeon Morgan, Brommel Christian, Schmaljohn Ellen, Kurgan Gavin, Osborne Thomas, Zhang He, Kinney Kyle, Rettig Garrett, Barbosa Christopher J, Semple Sean C, Tam Ying K, Lutz Cathleen, George Lindsey A, Kleinstiver Benjamin P, Liu David R, Ng Kim, Kassim Sadik H, Giannikopoulos Petros, Alameh Mohamad-Gabriel, Urnov Fyodor D, Ahrens-Nicklas Rebecca C

机构信息

Children's Hospital of Philadelphia, Philadelphia.

Perelman School of Medicine at the University of Pennsylvania, Philadelphia.

出版信息

N Engl J Med. 2025 Jun 12;392(22):2235-2243. doi: 10.1056/NEJMoa2504747. Epub 2025 May 15.


DOI:10.1056/NEJMoa2504747
PMID:40373211
Abstract

Base editors can correct disease-causing genetic variants. After a neonate had received a diagnosis of severe carbamoyl-phosphate synthetase 1 deficiency, a disease with an estimated 50% mortality in early infancy, we immediately began to develop a customized lipid nanoparticle-delivered base-editing therapy. After regulatory approval had been obtained for the therapy, the patient received two infusions at approximately 7 and 8 months of age. In the 7 weeks after the initial infusion, the patient was able to receive an increased amount of dietary protein and a reduced dose of a nitrogen-scavenger medication to half the starting dose, without unacceptable adverse events and despite viral illnesses. No serious adverse events occurred. Longer follow-up is warranted to assess safety and efficacy. (Funded by the National Institutes of Health and others.).

摘要

碱基编辑器可以纠正致病的基因变异。一名新生儿被诊断出患有严重的氨甲酰磷酸合成酶1缺乏症,这种疾病在婴儿早期的死亡率估计为50%,我们立即开始研发一种通过定制脂质纳米颗粒递送的碱基编辑疗法。在该疗法获得监管批准后,该患者在大约7个月和8个月大时接受了两次输注。在首次输注后的7周内,患者能够增加膳食蛋白质的摄入量,并将一种氮清除药物的剂量减半至起始剂量的一半,且未出现不可接受的不良事件,尽管期间患了病毒性疾病。未发生严重不良事件。需要进行更长时间的随访以评估安全性和疗效。(由美国国立卫生研究院等资助。)

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引用本文的文献

[1]
An integrated enzymatic and computational pipeline for quantifying off-target base-editing.

bioRxiv. 2025-8-26

[2]
Advancing gene editing therapeutics: Clinical trials and innovative delivery systems across diverse diseases.

Mol Ther Nucleic Acids. 2025-8-5

[3]
Cytosine base editor-DNA binding domain fusions for editing window modulation in the RNP format.

BMC Biotechnol. 2025-8-29

[4]
Engineering Targeted Gene Delivery Systems for Primary Hereditary Skeletal Myopathies: Current Strategies and Future Perspectives.

Biomedicines. 2025-8-16

[5]
Transforming Spinal Muscular Atrophy: From Pivotal Trials to Real-World Evidence and Future Therapeutic Frontiers in Types 1 and 2.

Biomedicines. 2025-8-8

[6]
Prenatal Management of Spinal Muscular Atrophy in the Era of Genetic Screening and Emerging Opportunities in In Utero Therapy.

Biomedicines. 2025-7-22

[7]
A baby benefits from personalized gene editing in the clinic.

Nature. 2025-8

[8]
Delivering the Message: Translating mRNA Therapy for Liver Inherited Metabolic Diseases.

J Inherit Metab Dis. 2025-9

[9]
Brain editing now 'closer to reality': the gene-altering tools tackling deadly disorders.

Nature. 2025-8

[10]
Understanding the Molecular Basis of Miller-Dieker Syndrome.

Int J Mol Sci. 2025-7-30

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