摘要
包括严重的β地中海贫血和镰状细胞病在内的血红蛋白病是全世界最常见的单基因疾病。异基因造血干细胞移植(allo-HCT)是这些综合征唯一获批的治疗选择,尽管仅限于患有合适供体的患者。基因治疗通过利用患者自身的造血干细胞通过病毒载体引入β-珠蛋白基因的正常拷贝,弥合了血红蛋白病患者治愈需求与缺乏供者之间的差距,而不引起allo-HSCT的免疫学风险。然而,血红蛋白病的基因治疗几十年来一直困难而难以捉摸,直到最近,慢病毒载体基因治疗才成功转移到临床。重要的是,在过去几年中,基于通过使用可编程核酸酶和下一代基因组修饰工具来操纵基因组的能力,正在开发针对地中海贫血和镰状细胞病患者的附加治疗选项,从而提供令人振奋的靶向原位基因矫正。在这篇综述中,我们将总结当前血红蛋白病治疗新时代的发展,阐述基因治疗试验的经验教训,讨论基因组编辑的前景和挑战。
关键词: 血红蛋白病,地中海贫血,镰状细胞性贫血,基因治疗,基因组编辑,造血干细胞。
Current Gene Therapy
Title:A New Era for Hemoglobinopathies: More Than One Curative Option
Volume: 17 Issue: 5
关键词: 血红蛋白病,地中海贫血,镰状细胞性贫血,基因治疗,基因组编辑,造血干细胞。
摘要: Hemoglobinopathies, including severe β-thalassemia and sickle cell disease, represent the most common monogenic disorders worldwide. Allogeneic hematopoietic stem cell transplantation (allo-HCT) is the only approved curative option for these syndromes, albeit limited to patients having a suitable donor. Gene therapy, by making use of the patient’s own hematopoietic stem cells to introduce a normal copy of the β-globin gene by viral vectors, bridged the gap between the need for cure of patients with hemoglobinopathies and the lack of a donor, without incurring the immunological risks of allo-HSCT. However, gene therapy for hemoglobinopathies proved a difficult and elusive goal for decades and only recently, lenti-viral vector gene therapy was successfully transferred to the clinic. Importantly, during the last years, additional curative options for patients with thalassemia and sickle cell disease are being developed, based on the ability to manipulate the genome by employing programmable nucleases and next-generation genome-modifying tools, thus providing the exciting prospects of targeted in-situ gene correction. In this review, we will summarize current developments in the new era of treatment for hemoglobinopathies, elaborate on lessons gained from gene therapy trials and discuss the exciting prospects and challenges of genome editing.
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Cite this article as:
A New Era for Hemoglobinopathies: More Than One Curative Option, Current Gene Therapy 2017; 17 (5) . https://dx.doi.org/10.2174/1566523218666180119123655
DOI https://dx.doi.org/10.2174/1566523218666180119123655 |
Print ISSN 1566-5232 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5631 |
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