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Editorial: Pharmacological targets for the control of tissue remodelling and fibrosis 编辑:控制组织重塑和纤维化的药理学靶点。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-05-20 DOI: 10.1016/j.pharmthera.2025.108880
Peter Holzer
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引用次数: 0
Human intestinal enteroids: Nonclinical applications for predicting oral drug disposition, toxicity, and efficacy 人类肠道类肠:预测口服药物处置、毒性和疗效的非临床应用。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-05-19 DOI: 10.1016/j.pharmthera.2025.108879
Eimear T. O’Mahony , Christopher M. Arian , Kayenat S. Aryeh , Kai Wang , Kenneth E. Thummel , Edward J. Kelly
The application of human enteroid systems presents a significant opportunity within the drug development pipeline, highlighting considerable potential for advancements in the characterization and evaluation of new molecular entities. Derived from LGR5+ crypt-based columnar cells, enteroid systems more accurately recapitulate the microanatomy and physiological processes of the human intestinal mucosa compared to traditionally used systems. They contain the complement of major mucosal epithelial cell types, maintain the genetic identity of the donor and intestinal segment they were derived from, and exhibit biological functions and specific activities that are seen in vivo. In this review, we examine the applications of human enteroid systems in nonclinical drug development and compare findings to existing and emerging in vitro models of the small intestine. Specifically, we explore enteroid systems in the context of predicting oral drug disposition, focusing on apparent permeability, intestinal first-pass metabolism, and drug interactions, as well as their utility in assessing drug-induced gastrointestinal toxicity and screening therapeutic efficacy against enteric diseases. Additionally, we highlight aspects of enteroid systems that warrant further study.
人类肠道系统的应用在药物开发管道中提供了一个重要的机会,突出了在新分子实体的表征和评估方面取得进展的巨大潜力。肠样系统来源于LGR5+隐窝柱状细胞,与传统系统相比,它更准确地概括了人类肠粘膜的微观解剖和生理过程。它们含有主要粘膜上皮细胞类型的补体,保持其来源的供体和肠段的遗传特性,并表现出体内可见的生物学功能和特定活性。在这篇综述中,我们研究了人类肠样系统在非临床药物开发中的应用,并将研究结果与现有和新兴的体外小肠模型进行了比较。具体来说,我们在预测口服药物处置的背景下探索肠道系统,重点关注表观通透性、肠道首过代谢和药物相互作用,以及它们在评估药物诱导的胃肠道毒性和筛选针对肠道疾病的治疗效果方面的应用。此外,我们强调肠系统的方面,值得进一步研究。
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引用次数: 0
The many facets of biased signaling: Mechanisms and possible therapeutic implications 偏倚信号的许多方面:机制和可能的治疗意义。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-05-16 DOI: 10.1016/j.pharmthera.2025.108877
K. Helivier Solís, M. Teresa Romero-Ávila, Rocío Alcántara-Hernández, J. Adolfo García-Sáinz
Receptor-mediated cell activation frequently results in a plethora of effects, and interestingly, not all agonists that act on a given receptor activate all of those actions to the same extent. Biased agonism refers to this fact, i.e., the possibility to activate only a part of the receptor's signaling capabilities. It is worth mentioning that Biased Signaling is an integral concept that includes the system (organisms, isolated tissues, or cells), the individual receptor studied, and the ligands. It should be remembered that the system's genetic expression profile defines the type, abundance, and cellular localization of proteins that participate in signaling. This short review will be focused on G protein receptors, but biased signaling occurs in many other receptor types.
Biased signaling can be related to the G proteins and β-arrestins available. Similarly, enzymes that catalyze receptor posttranslational modifications, such as phosphorylation, acylation, or ubiquitination, can play a role. G protein-coupled receptor signaling occurs at the plasma membrane, but it is well-established that endosomal signaling is a functional reality. Therefore, paying attention to cellular elements that participate in receptor endosomal traffic and destination (recycling to the plasma membrane/ degradation) is pertinent. There is still much to be known about these bias mechanisms, which are essential for basic knowledge of receptor drug action and for treating many pathological entities.
受体介导的细胞激活经常导致过多的影响,有趣的是,并不是所有的激动剂作用于一个给定的受体激活所有这些作用的程度相同。偏激激动作用指的是这一事实,即可能只激活受体的部分信号能力。值得一提的是,偏置信号是一个整体概念,包括系统(生物体、分离组织或细胞)、所研究的个体受体和配体。应该记住,系统的基因表达谱决定了参与信号传导的蛋白质的类型、丰度和细胞定位。这篇简短的综述将集中在G蛋白受体上,但在许多其他类型的受体中也存在偏倚信号。偏倚信号可能与可用的G蛋白和β-阻滞蛋白有关。同样,催化受体翻译后修饰的酶,如磷酸化、酰化或泛素化,也可以发挥作用。G蛋白偶联受体信号发生在质膜上,但内体信号是一种功能现实。因此,关注参与受体内体运输和目的地(再循环到质膜/降解)的细胞元件是相关的。关于这些偏倚机制还有很多需要了解的,这对于了解受体药物作用的基本知识和治疗许多病理实体是必不可少的。
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引用次数: 0
The free fatty acid receptor 2 (FFA2): Mechanisms of action, biased signaling, and clinical prospects 游离脂肪酸受体2 (FFA2):作用机制、偏倚信号和临床前景
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-05-16 DOI: 10.1016/j.pharmthera.2025.108878
Yang Li , Qiao Liu , Chuan-Ying Pan , Xian-Yong Lan
Free Fatty Acid Receptor 2 (FFA2), also known as GPR43, is a receptor activated by short-chain fatty acids (SCFAs) with fewer than six carbons in their aliphatic chains. This receptor is expressed in immune cells, adipose tissue, the gastrointestinal tract, and pancreatic islet cells, where it plays a crucial role in the modulation of inflammation, lipid metabolism, insulin secretion, and appetite regulation. Extensive research has been conducted to elucidate the structural attributes and physiological functions of FFA2. Furthermore, several synthetic agonists have been developed for FFA2 that can preferentially activate certain G-proteins, demonstrating potential pharmacological advantages in both in vivo and in vitro studies. Herein, we review the structure and physiological functions of FFA2 and its synthetic ligands, discussing the structural basis of FFA2's biased signaling and the potential role of biased ligands targeting this receptor in the treatment of metabolic and neurodegenerative diseases.
游离脂肪酸受体2 (FFA2),也称为GPR43,是一种由脂肪链中少于6个碳的短链脂肪酸(scfa)激活的受体。该受体在免疫细胞、脂肪组织、胃肠道和胰岛细胞中表达,在炎症、脂质代谢、胰岛素分泌和食欲调节中起着至关重要的作用。人们对FFA2的结构属性和生理功能进行了大量的研究。此外,已经开发了几种用于FFA2的合成激动剂,它们可以优先激活某些g蛋白,在体内和体外研究中都显示出潜在的药理优势。本文综述了FFA2及其合成配体的结构和生理功能,讨论了FFA2偏倚信号的结构基础,以及针对该受体的偏倚配体在代谢性和神经退行性疾病治疗中的潜在作用。
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引用次数: 0
Neuromuscular and cardiac organoids and assembloids: Advanced platforms for drug testing 神经肌肉和心脏类器官和组合体:先进的药物测试平台。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-05-14 DOI: 10.1016/j.pharmthera.2025.108876
Lorenzo Fontanelli , Noemi Nisini , Sergio Pirola , Fabio A. Recchia
The inherent technical difficulties, ethical/regulatory issues and costs of experimental studies in animal models is prompting investigators to replace as much as possible living organisms with in vitro physiological models named organoids and assembloids. Generated from induced pluripotent stem cells, these three-dimensional structures approximate the complexity of tissues and their interactions, enabling personalized disease modelling and drug testing. The integration of multiple components in assembloids further enhances their predictive value for multi-system interactions and toxicities. This review describes how neuromuscular organoids, incorporating functional neuromuscular junctions and contractile muscle tissue, have been used to replicate, in vitro, complex neuromuscular morpho-functional structures, offering very valuable platforms to study molecular mechanisms and drug effects in models of incurable diseases such as spinal muscular atrophy and amyotrophic lateral sclerosis. In the cardiological field, cardiac organoids and assembloids are proving reliable models for testing drug effects at molecular, morphological, electrophysiological and mechanical level. Recently, the integration of neuronal components into cardiac organoids has provided a potential approach to investigate autonomic function, a fundamental aspect of many neurological, neuromuscular and cardiac diseases. Challenges and limitations still remain, including the non-uniform differentiation protocols across studies, the incomplete maturation of cell phenotypes, and the lack of integrated pharmacokinetic modelling. We discussed some future developments aimed at overcoming such hurdles. Despite their current limitations, organoids and assembloids clearly hold great promises and will help advancing many fields of biomedicine.
固有的技术困难、伦理/监管问题和动物模型实验研究的成本促使研究人员尽可能多地用体外生理模型替代活体生物体,称为类器官和组合体。这些由诱导多能干细胞产生的三维结构近似于组织及其相互作用的复杂性,使个性化疾病建模和药物测试成为可能。组装体中多个组分的集成进一步提高了它们对多系统相互作用和毒性的预测价值。本文综述了神经肌肉类器官,包括功能性神经肌肉连接和可收缩的肌肉组织,如何在体外复制复杂的神经肌肉形态功能结构,为研究脊髓性肌萎缩症和肌萎缩侧索硬化症等不治之症的分子机制和药物效应提供了非常有价值的平台。在心脏病学领域,心脏类器官和组合体在分子、形态、电生理和机械水平上被证明是检测药物作用的可靠模型。最近,将神经元成分整合到心脏类器官中为研究自主神经功能提供了一种潜在的方法,自主神经功能是许多神经、神经肌肉和心脏疾病的基本方面。挑战和限制仍然存在,包括不同研究的不统一的分化方案,细胞表型的不完全成熟,以及缺乏整合的药代动力学模型。我们讨论了一些旨在克服这些障碍的未来发展。尽管它们目前的局限性,类器官和组装体显然具有巨大的前景,并将有助于推进生物医学的许多领域。
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引用次数: 0
Management of drug-resistant hypertension as a heterogeneous disorder 作为异质性疾病的耐药高血压的管理
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-05-06 DOI: 10.1016/j.pharmthera.2025.108875
Reza Tabrizchi
Approximately 1.3 billion adults globally have hypertension, and are at higher risk of death associated with cardiovascular disease. Adjusted death rate primarily due to high blood pressure is 31.3 per 100,000. The prevalence of drug-resistant hypertension is estimated to be up to 20 % in hypertensive individuals, and is more common in those with chronic kidney disease and obstructive sleep apnea. It occurs in individuals on ≥3 antihypertensive drugs including a diuretic. The addition of spironolactone, as a fourth drug has been found at times to be effective in management of blood pressure. Other strategies include sequential nephron block (e.g., spironolactone + furosemide + amiloride), and use of drugs such as alpha2 agonists, endothelin antagonists, and nonsteroidal mineralocorticoid antagonists. Use of positive airway pressure and pharmacotherapy have been found to be of value in individuals with sleep apnea in lowering blood pressure. In contrast, baroreceptor stimulation and/or renal denervation combined with pharmacotherapy seem to offer little in a way of consistent efficacy of optimally lowering blood pressures. Remarkably, evidence in the literature strongly supports the view that life style changes including regular exercise and appropriate diet combined with pharmacotherapy can lead to positive outcomes in helping to significantly reduce blood pressure. There is also ample data in literature suggesting the non-compliance to antihypertensive medications as a significant barrier to lowering blood pressure in this group. Accordingly, education regarding pharmacotherapy, and appropriate exercise regimen, including changes to diet should underpin any strategy in the management of high blood pressure in this population.
全球约有13亿成年人患有高血压,并且与心血管疾病相关的死亡风险更高。高血压导致的调整死亡率为每10万人31.3人。据估计,高血压患者中耐药高血压的患病率高达20%,在慢性肾病和阻塞性睡眠呼吸暂停患者中更为常见。它发生在服用3种以上抗高血压药物的个体中,包括一种利尿剂。添加螺内酯作为第四种药物,有时被发现对控制血压有效。其他策略包括序贯肾素阻滞(例如,螺内酯+呋塞米+阿米洛利)和使用药物,如α 2激动剂、内皮素拮抗剂和非甾体矿物皮质激素拮抗剂。使用气道正压通气和药物治疗已被发现对睡眠呼吸暂停患者降低血压有价值。相比之下,压力感受器刺激和/或肾去神经支配联合药物治疗似乎在降低血压方面几乎没有一致的效果。值得注意的是,文献中的证据强烈支持这样一种观点,即生活方式的改变,包括定期锻炼和适当的饮食,结合药物治疗,可以在帮助显著降低血压方面产生积极的结果。文献中也有大量数据表明,不遵医嘱服用降压药是这一群体降低血压的重要障碍。因此,关于药物治疗的教育和适当的运动方案,包括改变饮食,应该是这一人群高血压管理策略的基础。
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引用次数: 0
Unlocking the power of affibody conjugated radioactive metallopharmaceuticals for targeted cancer diagnosis and therapy 释放粘附体结合放射性金属药物在靶向癌症诊断和治疗中的作用。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-26 DOI: 10.1016/j.pharmthera.2025.108863
Dhanashree Murugan , Harashkumar Vasanthakumari Thirumalaiswamy , Vasanth Murugesan , Janarthanan Venkatesan , Unnikrishnan Balachandran , Kalaiarasu Lakshminarayanan , Drishty Satpati , Stefan Nikolić , Loganathan Rangasamy
Cancer is the second-largest death-causing disease after cardiovascular diseases. Effective research on cancer diagnosis and subsequent elimination plays a vital role in reducing the cancer-related death toll. Radiotherapy is one of the best strategies that could kill masses of solid tumour tissues; however, the efficacy is limited due to the bystander effect. This issue could be solved by the emergence of targeted delivery of radiometallic complexes, enabling clinicians to monitor the tumour regions and effectively destroy the tumour. Affibody® molecules are a class of synthetic peptides known as antibody mimics having the binding sites of an antibody. The specificity of affibodies is found to be greater than that of antibodies due to their small size. This review intends to highlight the recent developments in the field of affibody-targeted radiometallopharmaceuticals. These approaches could be essential for early cancer detection, tumour staging, and monitoring the response to therapy and could produce better therapeutic outcomes. In an attempt to provide ideas and inspiration for the researchers to design affibody-conjugated radiopharmaceuticals that are clinically applicable, we have provided an in-depth exploration of the various types of affibody-conjugated radiopharmaceuticals that are currently in clinical trials and various other pre-clinically tested conjugates in this article. Only a few review reports on affibody-conjugated radiometallopharmaceuticals, typically focusing on a specific molecular target or radionuclides reported. In this review, we provide a comprehensive overview of most radiometals, such as 111In, 68Ga, 64Cu, 55Co, 57Co, 44Sc, 99mTc, 89Zr, 90Y, 211At, 188Re, and 177Lu, choice of chelators, and potential cancer-associated molecular targets such HER2, EGFR or HER1, HER3, IGF-1R, PDGFRβ, VEGFR2, PD-L1, CAIX, PD-L1, neonatal Fc receptor (FcRn) and B7-H3. This approach highlights the advancements made over the past twenty years in affibody conjugates for radio imaging and therapy in oncology.
癌症是仅次于心血管疾病的第二大致死疾病。有效的癌症诊断和随后的消除研究对减少癌症相关死亡人数起着至关重要的作用。放射治疗是能够杀死大量实体肿瘤组织的最佳策略之一;但由于旁观者效应的存在,其效果有限。这个问题可以通过放射性金属复合物的靶向递送的出现来解决,使临床医生能够监测肿瘤区域并有效地摧毁肿瘤。附着体®分子是一类被称为抗体模拟物的合成肽,具有抗体的结合位点。由于其体积小,发现其特异性比抗体大。本文综述了近年来靶向放射性金属药物领域的研究进展。这些方法对于早期癌症检测、肿瘤分期和监测治疗反应至关重要,并可能产生更好的治疗效果。为了给研究人员设计临床应用的词缀共轭放射性药物提供思路和灵感,我们在本文中深入探讨了目前正在临床试验的各种类型的词缀共轭放射性药物以及其他各种临床前测试的缀合物。目前仅有少数针对特定分子靶点或放射性核素缀合放射性金属药物的综述报道。在这篇综述中,我们全面概述了大多数放射性金属,如111In、68Ga、64Cu、55Co、57Co、44Sc、99mTc、89Zr、90Y、2111at、188Re和177Lu,螯合剂的选择,以及潜在的癌症相关分子靶点,如HER2、EGFR或HER1、HER3、IGF-1R、PDGFRβ、VEGFR2、PD-L1、CAIX、PD-L1、新生儿Fc受体(FcRn)和B7-H3。这种方法突出了过去二十年来在肿瘤放射成像和治疗中所取得的进展。
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引用次数: 0
USP1 inhibition: A journey from target discovery to clinical translation USP1抑制:从靶点发现到临床转化的旅程
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-22 DOI: 10.1016/j.pharmthera.2025.108865
Carlos Torrado , Nicholas W. Ashton , Alan D. D'Andrea , Timothy A. Yap
Ubiquitin-specific protease 1 (USP1) is a deubiquitinating enzyme involved in the DNA damage response. Upon DNA damage, USP1 stabilizes replication forks by removing monoubiquitin from PCNA and FANCD2-FANCI, thereby catalyzing critical final steps in translesion synthesis and interstrand crosslink (ICL) repair. This function is particularly crucial in BRCA1 mutant cancers, where the homologous recombination pathway is compromised, leading tumors to rely on USP1 for effective repair. USP1 is also overexpressed in BRCA1 mutant cancers, as well as other tumor types. Preclinical studies have demonstrated that knockout of USP1 is synthetically lethal in tumors with biallelic BRCA1 mutations, and this relationship is enhanced by combination with PARP inhibitors. Newly developed USP1 inhibitors have confirmed this synthetic lethality in BRCA1-deficient tumor cells. Moreover, these drugs have the potential for resensitizing platinum-resistant tumors. Currently, potent and specific USP1 inhibitors are undergoing evaluation in phase I clinical trials. RO7623066 (KSQ-4279) reported an acceptable safety profile during a phase I dose escalation study, with anemia being the most common side effect, and demonstrated robust pharmacokinetic, pharmacodynamic, and clinical activity. Other USP1 inhibitors, including SIM0501, XL309–101, and HSK39775, are currently in early clinical development. In this review, we provide an overview of the molecular function of USP1 and its importance as a therapeutic target in oncology, before focusing on the current state of preclinical and clinical development of USP1 inhibitors.
泛素特异性蛋白酶1 (USP1)是一种参与DNA损伤反应的去泛素化酶。在DNA损伤时,USP1通过从PCNA和FANCD2-FANCI中去除单泛素来稳定复制叉,从而催化翻译合成和链间交联(ICL)修复的关键最后步骤。这一功能在BRCA1突变癌症中尤为重要,其中同源重组途径受损,导致肿瘤依赖USP1进行有效修复。USP1在BRCA1突变型癌症以及其他肿瘤类型中也过表达。临床前研究表明,敲除USP1在BRCA1双等位基因突变的肿瘤中具有合成致死性,并且与PARP抑制剂联合使用可增强这种关系。新开发的USP1抑制剂在brca1缺陷肿瘤细胞中证实了这种合成致死性。此外,这些药物有可能使铂耐药肿瘤重致敏。目前,强效和特异性USP1抑制剂正在I期临床试验中进行评估。RO7623066 (KSQ-4279)在一项I期剂量递增研究中报告了可接受的安全性,贫血是最常见的副作用,并显示出强大的药代动力学、药效学和临床活性。其他USP1抑制剂,包括SIM0501、XL309-101和HSK39775,目前处于早期临床开发阶段。在这篇综述中,我们概述了USP1的分子功能及其作为肿瘤治疗靶点的重要性,然后重点介绍了USP1抑制剂的临床前和临床开发现状。
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引用次数: 0
Therapeutic potential of natural flavonoids in atherosclerosis through endothelium-protective mechanisms: An update 天然类黄酮通过内皮保护机制治疗动脉粥样硬化的潜力:最新进展
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-22 DOI: 10.1016/j.pharmthera.2025.108864
Chao Zhong , Keke Deng , Xiaoya Lang , Dan Shan , Yanfei Xie , Wen Pan , Jun Yu
Atherosclerosis and its associated cardiovascular complications remain significant global public health challenges, underscoring the urgent need for effective therapeutic strategies. Endothelial cells are critical for maintaining vascular health and homeostasis, and their dysfunction is a key contributor to the initiation and progression of atherosclerosis. Targeting endothelial dysfunction has, therefore, emerged as a promising approach for the prevention and management of atherosclerosis. Among natural products, flavonoids, a diverse class of plant-derived phenolic compounds, have garnered significant attention for their anti-atherosclerotic properties. A growing body of evidence demonstrates that flavonoids can mitigate endothelial dysfunction, highlighting their potential as endothelial dysfunction-targeted therapeutics for atherosclerosis. In this review, we summarize current knowledge on the roles of natural flavonoids in modulating various aspects of endothelial dysfunction and their therapeutic effects on atherosclerosis, focusing on the underlying molecular mechanisms. We also discuss the challenges and future prospects of translating natural flavonoids into clinical applications for cardiovascular medicine. This review aims to provide critical insights to advance the development of novel endothelium-protective pharmacotherapies for atherosclerosis.
动脉粥样硬化及其相关心血管并发症仍然是重大的全球公共卫生挑战,强调迫切需要有效的治疗策略。内皮细胞对维持血管健康和体内平衡至关重要,其功能障碍是动脉粥样硬化发生和发展的关键因素。因此,靶向内皮功能障碍已成为预防和管理动脉粥样硬化的一种有希望的方法。在天然产物中,黄酮类化合物是一类来自植物的酚类化合物,因其抗动脉粥样硬化的特性而受到广泛关注。越来越多的证据表明,类黄酮可以减轻内皮功能障碍,突出了它们作为动脉粥样硬化内皮功能障碍靶向治疗药物的潜力。在这篇综述中,我们总结了目前对天然类黄酮在调节内皮功能障碍的各个方面的作用及其对动脉粥样硬化的治疗作用的了解,重点讨论了潜在的分子机制。我们还讨论了将天然类黄酮转化为心血管医学临床应用的挑战和未来前景。本文综述的目的是提供关键的见解,以推进新型内皮保护药物治疗动脉粥样硬化的发展。
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引用次数: 0
Retina-directed gene therapy: Achievements and remaining challenges 视网膜导向基因治疗:成就与挑战
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-21 DOI: 10.1016/j.pharmthera.2025.108862
Josef Biber , Catharina Gandor , Elvir Becirovic , Stylianos Michalakis
Gene therapy is an innovative medical approach that offers new treatment options for congenital and acquired diseases by transferring, correcting, inactivating or regulating genes to supplement, replace or modify a gene function. The approval of voretigene neparvovec (Luxturna), a gene therapy for RPE65-associated retinopathy, has marked a milestone for the field of retinal gene therapy, but has also helped to accelerate the development of gene therapies for genetic diseases affecting other organs. Voretigene neparvovec is a vector based on adeno-associated virus (AAV) that delivers a functional copy of RPE65 to supplement the missing function of this gene. The AAV-based gene delivery has proven to be versatile and safe for the transfer of genetic material to retinal cells. However, challenges remain in treating additional inherited as well as acquired retinopathies with this technology. Despite the high level of activity in this field, no other AAV gene therapy for retinal diseases has been approved since voretigene neparvovec. Ongoing research focuses on overcoming the current restraints through innovative strategies like AAV capsid engineering, dual-AAV vector systems, or CRISPR/Cas-mediated genome editing. Additionally, AAV gene therapy is being explored for the treatment of complex acquired diseases like age-related macular degeneration (AMD) and diabetic retinopathy (DR) by targeting molecules involved in the pathobiology of the degenerative processes. This review outlines the current state of retinal gene therapy, highlighting ongoing challenges and future directions.
基因治疗是一种创新的医学方法,通过转移、纠正、失活或调节基因来补充、替代或修改基因功能,为先天性和获得性疾病提供了新的治疗选择。rpe65相关视网膜病变的基因治疗药物voretigene neparvovec (Luxturna)的批准,标志着视网膜基因治疗领域的一个里程碑,但也有助于加速影响其他器官的遗传性疾病的基因治疗的发展。Voretigene neparvovec是一种基于腺相关病毒(AAV)的载体,它提供RPE65的功能拷贝,以补充该基因缺失的功能。基于aav的基因传递已被证明是多功能和安全的遗传物质转移到视网膜细胞。然而,在使用该技术治疗其他遗传性和获得性视网膜病变方面仍然存在挑战。尽管在这一领域具有很高的活性,但自voretigene neparvovec以来,还没有其他AAV基因疗法被批准用于视网膜疾病。正在进行的研究重点是通过创新策略,如AAV衣壳工程、双AAV载体系统或CRISPR/ cas介导的基因组编辑来克服当前的限制。此外,AAV基因疗法正在探索通过靶向参与退行性过程的病理生物学分子来治疗复杂的获得性疾病,如年龄相关性黄斑变性(AMD)和糖尿病性视网膜病变(DR)。本文综述了视网膜基因治疗的现状,强调了当前的挑战和未来的方向。
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