摘要
糖原贮积病(GSD)包括10多个离散条件,其生化及遗传基础已确定,且新疗法已在开发中。基因治疗研究已对I型GSD(肝糖原累积症)和II型GSD(庞贝氏症)进行了概念验证。这些基因疗法的关键包括载体和检测盒的选择,最近含有组织特异性启动子的腺相关病毒(AAV)载体已实现高疗效。基因治疗庞贝氏症的疗效取决于诱导免疫耐受的治疗酶。肝糖原贮积症的疗效是短暂的,并随时间逐步减弱。小分子疗法被作为提高医疗疗效或改善与GSDs相关的细胞畸形的评估标准。庞贝氏症受体介导摄取的治疗酶因β2激动剂作用而增强。GSD III中观察到雷帕霉素可降低肝纤维化,基因治疗的进一步发展可为GSD患者提供更好疗效,若临床前研究的疗效在未来的临床试验中也可观察到,则这些疗法在临床上也是可行的。
关键词: 腺相关病毒(AAV),糖原贮积病,庞贝氏症,肝糖原贮积症
Current Gene Therapy
Title:Preclinical Development of New Therapy for Glycogen Storage Diseases
Volume: 15 Issue: 4
Author(s): Baodong Sun, Elizabeth D. Brooks and Dwight D. Koeberl
Affiliation:
关键词: 腺相关病毒(AAV),糖原贮积病,庞贝氏症,肝糖原贮积症
摘要: Glycogen storage disease (GSD) consists of more than 10 discrete conditions for which the biochemical and genetic bases have been determined, and new therapies have been under development for several of these conditions. Gene therapy research has generated proof-of-concept for GSD types I (von Gierke disease) and II (Pompe disease). Key features of these gene therapy strategies include the choice of vector and regulatory cassette, and recently adeno-associated virus (AAV) vectors containing tissue-specific promoters have achieved a high degree of efficacy. Efficacy of gene therapy for Pompe disease depend upon the induction of immune tolerance to the therapeutic enzyme. Efficacy of von Gierke disease is transient, waning gradually over the months following vector administration. Small molecule therapies have been evaluated with the goal of improving standard of care therapy or ameliorating the cellular abnormalities associated with specific GSDs. The receptor-mediated uptake of the therapeutic enzyme in Pompe disease was enhanced by administration of β2 agonists. Rapamycin reduced the liver fibrosis observed in GSD III. Further development of gene therapy could provide curative therapy for patients with GSD, if efficacy from preclinical research is observed in future clinical trials and these treatments become clinically available.
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Baodong Sun, Elizabeth D. Brooks and Dwight D. Koeberl , Preclinical Development of New Therapy for Glycogen Storage Diseases, Current Gene Therapy 2015; 15 (4) . https://dx.doi.org/10.2174/1566523215666150630132253
DOI https://dx.doi.org/10.2174/1566523215666150630132253 |
Print ISSN 1566-5232 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5631 |
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