非病毒性载体在肝脏疾病基因治疗中的研究进展

基因治疗肝脏疾病的新策略已引起高度关注,在肝病的基因治疗中,最关键的是如何将治疗基因特异性地导入肝细胞中并适当表达.在过去的二十多年里,受体介导的基因给药系统广泛用于肝靶向基因递送,但一些非病毒载体的基因传递效率不高.本文综述了目前最常用的非病毒载体,包括其理化性质、优点和局限性,基因递送作用机理以及修饰后在肝靶向基因治疗中的应用,并综述了在肝细胞基因传递中常用的电穿孔技术和流体力学注射法等物理方法以及如何实现其最优化的转染率.     

基因治疗及其临床应用研究进展

基因治疗可定义为在某一个体的细胞中引入新的遗传物质,从而使该个体的疾病得到治疗的方法．基因治疗主要研究免疫治疗、细胞素／药物传递基因、药物敏感基因、药物抗性基因和选择性抗性基因治疗等．基因治疗尚仅限于体细胞,生殖细胞的基因治疗由于技术难度更大,且涉及伦理学与社会学的问题．还不在考虑之列．目前基因治疗的对象主要以恶性肿瘤为重点,同时兼顾心血管及少数遗传病。基因治疗的基本内容包括;引起疾病的缺陷基因定位（基因诊断）;选择适当的载体及载体的加工、修饰与包装（基因载体）;外源基因导入人体靶细胞（基因转移）的临床研究．体外基因转移已广泛应用于各类基因病的临床治疗研究;而体内基因转移目前尚未走出实验室．继美国之后,世界上许多国家都已开始实施各自的基因治疗研究计划．人类的基因病有４０００多种,基因治疗前景广阔．     

基因治疗研究的国内外进展

引言基因治疗,(GeneTherapy),是指在基因水平对人类遗传疾病进行治疗。具体地说,基因治疗是利用基因转移或基因调控的手段,将正常基因转入疾病患者机体细胞中,取代突变基因,表达所缺乏的基因产物,或者通过关闭或降低 异常表达的基因等途径,达到治疗某些人类疾病的方法。目前的科学发展水平还只能在体细胞水平上对单基因遗传病进行基因治疗,随着科学的发展将会有越来越多的疾病能用此法进行根治。     

基因治疗及细胞治疗发展态势分析

<正>基因治疗是将目的基因导入患者的特定组织或细胞进行适当有调控的表达,以纠正或补偿因基因缺陷或异常而引起的疾病,从而达到治疗疾病的目的~([1-2])。基因治疗可以被用于治疗血友病等单基因遗传性疾病以及癌症、神经退行性疾病、眼科疾病和心血管疾病等多基因疾病。2017年,美国FDA批准了一种基因治疗产品Luxturna~(TM),该     

Somatix公司开发口服基因治疗法

Somatix Therapy Corp.公司已获得全球独家专利许可,通过口腔传递进行基因治疗。 公司声称,该技术基于腺病毒相关(AAV)载体,把DNA存放于分裂细胞和未分裂细胞中。AAV被认为是病毒基因传递的一种较为安全的手段,因为它们与任何疾病没有关联。公司希望利用这种AAV载体把基因导入消化道细胞内,以此产生治疗蛋白。     

医学分子遗传学第十讲基因治疗

基因治疗是人类征服遗传性疾病最有希望的手段。基因治疗是指通过遗传操作直接在基因水平上治疗由基因突变所引起的遗传性疾病。进行基因治疗有两个基本策略:(1)原位修复有缺陷的基因;(2)将有功能的正常基因转移到疾病细胞或个体基因组的某一部位上以替代缺陷基因发挥作用。目前条件下,后者是比较容易着手的一种基因治疗策略,也称为基因替代疗法。在早期进行基因治疗尝试时,最适合的对象应当是一些产物量无需精确调节,同时又经常开放的基因。首选对象有(1)次黄嘌呤-鸟嘌呤磷酸核糖转移酶(HPRT),由于这种酶的缺乏,在人类中可引起自毁容     

碳纳米管作为siRNA转运载体的研究进展

随着人们对RNA干扰分子机理的研究愈加深入,siRNA作为一种新的基因治疗药物极有可能为人类攻克癌症等难以治愈的疾病带来希望。然而,目前在RNA干扰应用中遇到的最大挑战就是如何有效地将siRNA导入靶细胞且不致引起严重的细胞毒性。碳纳米管在药物传递和基因传递等生物医学领域的潜在应用受到广泛关注;但要实现碳纳米管在基因治疗领域的应用,碳纳米管的功能化是关键,也是近几年来研究的重点。综述近年来碳纳米管作为siRNA转运载体在基因治疗领域的研究进展。     

基因治疗的应用研究进展

基因治疗 (ｇｅｎｅｔｈｅｒａｐｙ)是向靶细胞引入正常有功能的基因 ,以纠正或补偿致病基因所产生的缺陷 ,从而达到治疗疾病的目的 ,通常包括基因置换、基因修正、基因修饰、基因失活等。 80年代初 ,Ａｎｄｅｒｓｏｎ首先阐述了基因治疗的概况 ;1990年美国国立卫生研究院的Ｂｌｅａｓｅ等[1] 成功地进行了世界上首例临床基因治疗 ,即腺苷脱氨酶 (ａｄｅｎｏｓｉｎｅｄｅａｍｉｎａｓｅ ,ＡＤＡ)缺陷病的人体基因治疗 ;1991年我国首例基因治疗Ｂ型血友病也获得成功。近年来 ,这一领域的研究取得了重大进展 ,基因治疗作为一种全新的疾病治疗…     

磁性纳米技术在癌症基因治疗中的应用

癌症基因组的最新进展使直接针对癌症基因进行治疗具有极大的可能性。然而,需要新的基因传递方法使这种潜力向临床应用转化,为治疗病人服务。磁性纳米技术是通过外部磁场选择性地高效传递治疗基因,还能同时用影像监测体内的传递过程。相比传统的基因传递方法,这种技术能明显提高人类移植肿瘤和不同的内脏器官如肝、肾及中枢神经系统的基因传递效率。因此,磁性纳米技术使活体内癌症的基因治疗进入到新的前沿领域。     

2023年基因治疗发展态势分析

基因治疗是指通过在基因水平上操纵或修饰细胞内基因的表达来治疗疾病的一种生物医学手段。近年来,基因治疗技术逐渐成熟,产业化加速,不断有重磅产品获批,已成为生物医药领域继小分子、大分子之后的一条新热门赛道。本文从基础研究、临床研究和产品获批等方面对2023年基因治疗的态势进行了分析,结果发现治疗及递送新技术的不断涌现及疾病生物学研究的深入,推动基因治疗发展进入快车道,适应证范围不断拓展,临床潜力不断获得验证,产品加速上市。2023年,基因替代治疗、基因编辑治疗和RNA治疗等基因疗法先后迎来多款突破性新产品上市,递送技术的开发和优化取得重要进展,同时基因治疗领域潜在的安全风险和有效性仍需进一步的长期跟踪研究;基因治疗的可及性也有待多渠道来进一步提高。最后,本文也对基因治疗领域的未来发展进行了展望。     

基因治疗在临床应用中的研究进展

20世纪60年代,科学家首次提出利用基因治疗治愈遗传疾病的概念。这一全新的概念性策略旨在通过将外源性遗传物质引入患者体内来获得长期的治疗效果。五十年的风雨沉浮,21世纪取得的里程碑式突破为基因治疗开启了新的篇章。文中回顾和总结了基因治疗的发展历程和重大突破,包括一些重要的临床试验和已批准上市的基因疗法,以及新兴的基因编辑技术。相对于传统疗法的独特优势,基因疗法将会成为治疗遗传疾病的重要手段,必将造福全人类。     

Is cystic fibrosis genetic medicine's canary?

In 1989 the gene that causes cystic fibrosis (CF) was identified in a search accompanied by intense anticipation that the gene, once discovered, would lead rapidly to gene therapy. Many hoped that the disease would effectively disappear. Those affected were going to inhale vectors packed with functioning genes, which would go immediately to work in the lungs. It was a bewitching image, repeatedly invoked in both scientific and popular texts. Gene therapy clinical trials were carried out with a range of strategies and occasionally success seemed close, but by 1996 the idea that gene therapy for CF would quickly provide a cure was being abandoned by the communities engaged with treatment and research. While conventional wisdom holds that the death of Jesse Gelsinger in an unrelated gene therapy trial in 1999 produced new skepticism about gene therapy, the CF story suggests a different trajectory, and some different lessons. This article considers the rise and fall of gene therapy for CF and suggests that CF may provide a particularly compelling case study of a failed genomic technology, perhaps even of a medical "canary." The story of CF might be a kind of warning to us that genetic medicine may create as many problems as it solves, and that moving forward constructively with these techniques and practices requires many kinds of right information, not just about biology, but also about values, priorities, market forces, uncertainty, and consumer choice.     

Gene therapy in The Netherlands: highlights from the Low Countries

Gene therapy is an active research area in The Netherlands and Dutch scientists involved in fundamental and clinical gene therapy research significantly contribute to the progresses made in this field. This ranges from the establishment of the 293, 911 and PER.C6 cell lines, which are used worldwide for the production of replication-defective adenoviral vectors, to the development of targeted viral vectors and T lymphocytes as well as of non-viral vectors. Several milestones have been achieved in Dutch clinical gene therapy trials, including the first treatment worldwide of patients with adenosine deaminase deficiency with genetically corrected hematopoietic stem cells in collaboration with French and British scientists. Until now, about 230 patients with various diseases have been treated with viral and non-viral gene therapy in this country. Ongoing and upcoming Dutch clinical trials focus on the translation of new developments in gene therapy research, including the restoration of genetic defects other than SCID, and the use of oncolytic adenoviruses and targeted T cells for the treatment of cancer. The growing commercial interest in Dutch clinical gene therapy is reflected by the involvement of two Dutch companies in ongoing trials as well as the participation of Dutch clinical centres in large phase III international multicenter immuno-gene therapy trials on prostate cancer sponsored by an American company. Translational gene therapy research in The Netherlands is boosted at a governmental level by the Dutch Ministry of Health via a dedicated funding programme. This paper presents an overview on milestones in Dutch basic gene therapy research as well as on past, present and future clinical gene therapy trials in The Netherlands.     

Adenoviral gene therapy, radiation, and prostate cancer

Viral gene therapy has exceptional potential as a specifically tailored cancer treatment. However, enthusiasm for cancer gene therapy has varied over the years, partly owing to safety concerns after the death of a young volunteer in a clinical trial for a genetic disease. Since this singular tragedy, results from numerous clinical trials over the past 10 years have restored the excellent safety profile of adenoviral vectors. These vectors have been extensively studied in phase I and II trials as intraprostatically administered agents for patients with locally recurrent and high-risk local prostate cancer. Promising therapeutic responses have been reported in several studies with both oncolytic and suicide gene therapy strategies. The additional benefit of combining gene therapy with radiation therapy has also been realized; replicating adenoviruses inhibit DNA repair pathways, resulting in a synergistic sensitization to radiation. Other, nonreplicating suicide gene therapy strategies are also significantly enhanced with radiation. Combined radiation/gene therapy is currently being studied in phase I and II clinical trials and will likely be the first adenoviral gene therapy mechanism to become available to urologists in the clinic. Systemic gene therapy for metastatic disease is also a major goal of the field, and clinical trials are currently under way for hormone-resistant metastatic prostate cancer. Second- and third-generation "re-targeted" viral vectors, currently being developed in the laboratory, are likely to further improve these systemic trials.     

Gene therapy. Therapeutic approaches and implications

The present article is an overview of gene therapy with an emphasis on different approaches and its implications in the clinic. Genetic interventions have been applied to the diagnosis of and therapy for an array of human diseases. The initial concept of gene therapy was focused on the treatment of genetic diseases. Subsequently, the field of gene therapy has been expanded, with a major focus on cancer. Although the results of early gene therapy-based clinical trials have been encouraging, there is a need for gene delivery vectors that feature reduced immunogenicity and improved targeting ability. The results of phases I/II clinical trials have suggested the important role of gene therapy as a versatile and powerful treatment tool, especially for human cancers. One reasonable expectation is that performing gene therapy at an earlier stage in the disease process or for minimal residual disease may be more advantageous.     

Technology for gene transfer into hematopoietic stem cells (Part 2)]

A hematopoietic stem cell is considered to be one of the ideal targets for gene therapy, and there is expectation that gene therapy will be established based on the technology of hematopoietic stem cell transplantation. However, in recent clinical trials of stem cell gene therapy for monogenic diseases, significant clinical improvement has not been reported. One of the main obstacles is the low efficiency of gene transfer into hematopoietic stem cells. Many investigators have been trying to improve the transduction efficiency to the clinically applicable level. Another approach to solve this problem is to develop the method for selective expansion of transduced hematopoietic stem cells in vivo. We are currently developing novel regulatory genes (selective amplifier genes) for stem cell gene therapy.     

Gene therapy techniques.

The most dramatic event of the past year in the field of gene therapy has been the initiation of clinical trials involving the introduction of genetically altered cells into human beings. Four studies, three involving new approaches to cancer therapy and one involving the treatment of adenosine deaminase deficiency, are presently under way. There has also been significant recent progress in the technology of gene transfer relevant to gene therapy. This progress, along with the recent clinical therapy trials, is the subject of this review.     

Clinical experience with gene therapy for the treatment of prostate cancer

Localized prostate cancer can be treated effectively with radical prostatectomy or radiation therapy. The treatment options for metastatic prostate cancer are limited to hormonal therapy; hormone-refractory cancer is treated with taxane-based chemotherapy, which provides only a modest survival benefit. New treatments are needed. The gene for the initiation of prostate cancer has not been identified; however, gene therapy can involve tumor injection of a gene to kill cells, systemic gene delivery to target and kill metastases, or local gene expression intended to generate a systemic response. This review will provide an overview of the various strategies of cancer gene therapy, focusing on those that have gone to clinical trial, detailing clinical experience in prostate cancer patients.     

An overview of gene therapy in head and neck cancer

Gene therapy is a new treatment modality in which new gene is introduced or existing gene is manipulated to cause cancer cell death or slow the growth of the tumor. In this review, we have discussed the different treatment approaches for cancer gene therapy; gene addition therapy, immunotherapy, gene therapy using oncolytic viruses, antisense ribonucleic acid (RNA) and RNA interference-based gene therapy. Clinical trials to date in head and neck cancer have shown evidence of gene transduction and expression, mediation of apoptosis and clinical response including pathological complete responses. The objective of this article is to provide an overview of the current available gene therapies for head and neck cancer.     

Computational Models of HIV-1 Resistance to Gene Therapy Elucidate Therapy Design Principles

Gene therapy is an emerging alternative to conventional anti-HIV-1 drugs, and can potentially control the virus while alleviating major limitations of current approaches. Yet, HIV-1''s ability to rapidly acquire mutations and escape therapy presents a critical challenge to any novel treatment paradigm. Viral escape is thus a key consideration in the design of any gene-based technique. We develop a computational model of HIV''s evolutionary dynamics in vivo in the presence of a genetic therapy to explore the impact of therapy parameters and strategies on the development of resistance. Our model is generic and captures the properties of a broad class of gene-based agents that inhibit early stages of the viral life cycle. We highlight the differences in viral resistance dynamics between gene and standard antiretroviral therapies, and identify key factors that impact long-term viral suppression. In particular, we underscore the importance of mutationally-induced viral fitness losses in cells that are not genetically modified, as these can severely constrain the replication of resistant virus. We also propose and investigate a novel treatment strategy that leverages upon gene therapy''s unique capacity to deliver different genes to distinct cell populations, and we find that such a strategy can dramatically improve efficacy when used judiciously within a certain parametric regime. Finally, we revisit a previously-suggested idea of improving clinical outcomes by boosting the proliferation of the genetically-modified cells, but we find that such an approach has mixed effects on resistance dynamics. Our results provide insights into the short- and long-term effects of gene therapy and the role of its key properties in the evolution of resistance, which can serve as guidelines for the choice and optimization of effective therapeutic agents.