Gene Therapy for Mitochondrial Diseases: Current Status and Future Perspective.

Gene Therapy for Mitochondrial Diseases: Current Status and Future Perspective.
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DOI:
10.3390/pharmaceutics14061287
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发表时间:
2022-06-17
期刊:
影响因子:
5.4
通讯作者:
Brunetti, Dario
Brunetti, Dario
中科院分区:
医学2区
文献类型:
--
作者:
Di Donfrancesco, Alessia;Massaro, Giulia;Di Meo, Ivano;Tiranti, Valeria;Bottani, Emanuela;Brunetti, Dario

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线粒体疾病(Mitochondrial diseases,MD)是由编码氧化磷酸化(oxidative phosphorylation,OXPHOS)系统蛋白质的核或线粒体基因组突变引起的一组严重遗传性疾病。MD具有广泛的症状,从器官特异性到多系统功能障碍,具有不同的临床结果。缺乏自然病史信息,目前可用的临床前模型的限制,以及在MD患者中观察到的广泛的表型表现都阻碍了有效疗法的开发。在过去的十年中,越来越多的临床前和临床试验表明,基因治疗是治疗MD的一种可行的精确医学选择。然而,必须克服几个障碍,包括载体设计、靶向组织向性和有效递送、转基因表达和免疫毒性。这份手稿提供了一个全面的概述,最先进的基因治疗在MD,解决主要的挑战,最可行的解决方案,以及该领域的未来前景。
Mitochondrial diseases (MDs) are a group of severe genetic disorders caused by mutations in the nuclear or mitochondrial genome encoding proteins involved in the oxidative phosphorylation (OXPHOS) system. MDs have a wide range of symptoms, ranging from organ-specific to multisystemic dysfunctions, with different clinical outcomes. The lack of natural history information, the limits of currently available preclinical models, and the wide range of phenotypic presentations seen in MD patients have all hampered the development of effective therapies. The growing number of pre-clinical and clinical trials over the last decade has shown that gene therapy is a viable precision medicine option for treating MD. However, several obstacles must be overcome, including vector design, targeted tissue tropism and efficient delivery, transgene expression, and immunotoxicity. This manuscript offers a comprehensive overview of the state of the art of gene therapy in MD, addressing the main challenges, the most feasible solutions, and the future perspectives of the field.
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