Curative Measures for Cystic Fibrosis: A Perspective on Current Stem Cell–Based, Gene, and Small Molecule Therapies

P. Ajilore, Henry Y. Yang, Anastassia Kerasidis, R. Castro
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Abstract

Cystic fibrosis (CF), which is caused by a defect or deficiency in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, continues to be a life-limiting multiorgan disease with severe phenotypic manifestations in affected patients. Current approaches to CF therapy have advanced far beyond symptomatic treatment, targeting the aberrant CFTR for therapeutic results. Novel small molecule treatments, or CF modulators, were the first to significantly improve the quality of life for patients with CF. These low-molecular-weight drugs can easily traverse the cell membrane and effect transcriptive changes in cells, albeit only for those with the specific mutations addressed by the drugs. However, other stem cell–based treatments, such as mesenchymal stromal cell therapy or induced pluripotent stem cell therapy, and gene therapies, such as CRISPR/Cas9 and viral vectors, are being researched as potential mutation-independent cures. These therapies have yet to progress to clinical trials, but their efficacies in various CF models prove their promise as future treatment options and potential cures. In this review, 3 potential contemporary therapies for CF and their current statuses and trajectories as clinical tools are discussed.
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囊性纤维化的治疗措施:当前基于干细胞、基因和小分子治疗的观点
囊性纤维化(CF)是由囊性纤维化跨膜传导调节因子(CFTR)基因缺陷或缺乏引起的,是一种限制生命的多器官疾病,在受影响的患者中具有严重的表型表现。目前的CF治疗方法已经远远超出了对症治疗,针对异常CFTR的治疗结果。新颖的小分子治疗,或CF调节剂,是第一个显著改善CF患者生活质量的药物。这些低分子量药物可以很容易地穿过细胞膜,影响细胞的转录变化,尽管仅适用于那些具有特定突变的药物。然而,其他基于干细胞的治疗,如间充质基质细胞治疗或诱导多能干细胞治疗,以及基因治疗,如CRISPR/Cas9和病毒载体,正在研究作为潜在的不依赖突变的治疗方法。这些疗法尚未进入临床试验阶段,但它们在各种CF模型中的疗效证明了它们作为未来治疗选择和潜在治愈方法的前景。在这篇综述中,讨论了CF的3种潜在的当代治疗方法及其作为临床工具的现状和发展轨迹。
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