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Latest development of approved COVID-19 drugs and COVID-19 drugs undergoing late stage clinical trials 已获批准的 COVID-19 药物和正在进行后期临床试验的 COVID-19 药物的最新发展情况
Pub Date : 2023-12-01 DOI: 10.3389/fddsv.2023.1304129
Bingru Feng, Kai Fu
As the world adapts to living with SARS-CoV-2, the continuous emergence of new variants has become a primary focus of current studies. In this review, we examined a range of available COVID-19 drugs, including FDA-regulated drugs and those undergoing late-stage clinical trials. Some FDA-regulated drugs, such as Veklury (remdesivir), Olumiant (baricitinib), and Actemra (tocilizumab), have garnered primary clinical status in treatment guidelines, supported by sufficient clinical evidence. Conversely, EUA-authorized therapies, such as some antiviral agents, have demonstrated lower efficacy due to the virus’s constant mutation. We also focused on COVID-19 drugs undergoing late-stage clinical trials, some of which have raised controversy in their administration, such as colchicine and corticosteroids, while others are worth exploring regarding their timing. Several ongoing multi-drug clinical trials are of particular interest, including the “MEDIC-LAUMC” trial that explores drug co-administration, and “ACTIV-2” and “ACTIV-3” trials that compare the effects of different drugs for non-hospitalized and hospitalized patients, respectively. These ongoing clinical trials at a late stage provide essential clinical evidence for future drug authorization and have the potential to provide better drug administration strategies for COVID-19 variants. We look forward to the continued exploration of drug co-administration, comprehensive clinical evidence for treatment, and the investigation of different potential drug utilization.
随着世界适应SARS-CoV-2的生活,新变体的不断出现已成为当前研究的主要焦点。在本综述中,我们检查了一系列可用的COVID-19药物,包括fda监管的药物和正在进行后期临床试验的药物。一些fda监管的药物,如Veklury (remdesivir)、Olumiant (baricitinib)和Actemra (tocilizumab),已经在治疗指南中获得了主要的临床地位,有足够的临床证据支持。相反,eua批准的治疗方法,如一些抗病毒药物,由于病毒不断突变,已证明疗效较低。我们还关注了正在进行后期临床试验的COVID-19药物,其中一些药物在给药方面引发了争议,如秋水仙碱和皮质类固醇,而另一些药物的使用时间值得探索。一些正在进行的多药物临床试验特别令人感兴趣,包括探索药物联合给药的“medici - laumc”试验,以及分别比较不同药物对非住院和住院患者效果的“ACTIV-2”和“ACTIV-3”试验。这些正在进行的后期临床试验为未来的药物授权提供了重要的临床证据,并有可能为COVID-19变体提供更好的药物管理策略。我们期待着继续探索药物联合给药,综合临床证据进行治疗,并研究不同的潜在药物利用。
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引用次数: 0
Introduction to small molecule drug discovery and preclinical development 小分子药物发现和临床前开发简介
Pub Date : 2023-11-30 DOI: 10.3389/fddsv.2023.1314077
Michelle W. Y. Southey, Michael Brunavs
Over 90% of marketed drugs are small molecules, low molecular weight organic compounds that have been discovered, designed, and developed to prompt a specific biological process in the body. Examples include antibiotics (penicillin), analgesics (paracetamol) and synthetic hormones (corticosteroids). On average, it takes 10–15 years to develop a new medicine from initial discovery through to regulatory approval and the total cost is often in the billions. For every drug that makes it to the market, there are many more that do not, and it is the outlay associated with abortive efforts that accounts for most of this expense. The discovery of new drugs remains a significant challenge, involving teams of researchers from chemistry, biology, drug development, computer science and informatics. In this article we will discuss the key concepts and issues encountered in small molecule preclinical drug discovery and introduce some of the emerging technologies being developed to overcome current obstacles.
市场上销售的药物 90% 以上都是小分子、低分子量有机化合物,它们是为了促进体内特定的生物过程而发现、设计和开发的。例如抗生素(青霉素)、止痛药(扑热息痛)和合成激素(皮质类固醇)。开发一种新药从最初发现到获得监管部门批准平均需要 10-15 年的时间,总成本往往高达数十亿美元。每一种新药上市后,都会有更多的新药没有上市,而其中大部分费用都是与失败的努力相关的支出。发现新药仍然是一项巨大的挑战,需要化学、生物学、药物开发、计算机科学和信息学等领域的研究团队共同参与。在本文中,我们将讨论小分子临床前药物发现中遇到的关键概念和问题,并介绍为克服当前障碍而正在开发的一些新兴技术。
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引用次数: 0
HyBryte™ use in early-stage cutaneous T-cell lymphoma HyBryte™ 用于早期皮肤 T 细胞淋巴瘤
Pub Date : 2023-11-27 DOI: 10.3389/fddsv.2023.1298453
B. Poligone, Carolina V Alexander-Savino, Ellen J. Kim, Aaron R. Mangold, Jennifer Desimone, Henry K. Wong, A. Rumage, O. Donini, Andrea M. Haulenbeek, Christopher J. Schaber, Richard Straube, C. Pullion, A. Rook
Cutaneous T-cell lymphoma (CTCL) is a rare type of non-Hodgkin lymphoma of the skin, where at later stages skin-homing malignant T-cells affect lymph nodes, blood, and visceral organs. Even though early CTCL does not affect survival, it can progress to more advanced stages of disease and have a significant effect on the quality of life of patients. Although expectant management is a treatment consideration in early disease stages, most patients cycle through different skin-directed therapies throughout their lifetime. It can become a challenge to manage the serious and accumulating risk of side effects of these therapies, including various skin cancers and skin damage. Adverse effects from topical therapies limit their long-term utility. Thus, there is an unmet need for well-characterized therapies that have a rapid onset of action and minimal long-term/cumulative side effect profile. Most recently, the results of a Phase 3 study of topical HyBryte™ as a potential treatment for CTCL demonstrated its efficacy and safety profile. This article summarizes what is known about HyBryte™, focuses on its mechanism of action, and highlights its effectiveness, safety, and tolerability in the context of other current FDA-approved topical therapies for CTCL.
皮肤 T 细胞淋巴瘤(CTCL)是一种罕见的皮肤非霍奇金淋巴瘤,晚期皮肤上的恶性 T 细胞会影响淋巴结、血液和内脏器官。尽管早期的 CTCL 不会影响患者的生存,但它会发展到晚期,对患者的生活质量产生重大影响。虽然在疾病的早期阶段,预期管理是治疗的一个考虑因素,但大多数患者在其一生中会循环使用不同的皮肤导向疗法。管理这些疗法的副作用(包括各种皮肤癌和皮肤损伤)所带来的严重且不断累积的风险是一项挑战。局部疗法产生的不良反应限制了这些疗法的长期使用。因此,对于起效迅速、长期/累积副作用最小的特性良好的疗法的需求尚未得到满足。最近,一项关于外用 HyBryte™ 作为 CTCL 潜在疗法的 3 期研究结果表明了它的疗效和安全性。本文总结了目前对 HyBryte™ 的了解,重点介绍了其作用机制,并结合目前其他经 FDA 批准的 CTCL 外用疗法,强调了其有效性、安全性和耐受性。
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引用次数: 0
Editorial: Advances in anti-malarial drug discovery 社论:抗疟疾药物研发的进展
Pub Date : 2023-11-23 DOI: 10.3389/fddsv.2023.1335842
Agam Prasad Singh, Brijesh Rathi
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引用次数: 0
Targeting a cancer-specific LYPD3 glycoform for tumor therapy 靶向癌症特异性 LYPD3 糖型治疗肿瘤
Pub Date : 2023-11-22 DOI: 10.3389/fddsv.2023.1298916
Theresa Neumann, Evelyn Hartung, Johanna Gellert, Lisa Weiss, Manon Weiske, Naomi Kast, Stephanie Gurka, Sophie Marinoff, Anika Jäkel, A. Danielczyk, Patrik Kehler
Introduction: One of the most drastic changes in cancer is the altered glycosylation of proteins and lipids, giving rise to truncated O-glycans like the Thomsen Friedenreich (TF) or Thomsen nouvelle (Tn) antigen, which are almost absent on normal cells. Combined protein-carbohydrate epitopes comprising these specific glycans are ideal candidates for potent targeted therapies given their excellent tumor specificity and broad cancer expression.Methods and results: We have generated GT-002, a monoclonal antibody specifically targeting the epithelial glycoprotein LYPD3 only in the presence of a TF glycosylation. It does not cross-react with non-glycosylated LYPD3 or TF on other glycoproteins in ELISA and flow cytometry. GT-002 binds to various tumor cell lines and stains tumor tissues of different cancer indications including squamous cell carcinoma of the head and neck. The remarkable tumor specificity was confirmed in an immunohistochemistry study on a normal human tissue panel including several LYPD3-positive organs, where GT-002 elicited almost completely abolished normal tissue binding. Consequently, we observed markedly reduced binding of GT-002 to normal human tissues compared to Lupartumab, a conventional anti-LYPD3 antibody previously in clinical development as antibody-drug conjugate (BAY1129980). Neuraminidase treatment of healthy tissues, resulting in cleavage of sialic acid residues, re-established binding of GT-002 comparable to Lupartumab, showing that the GT-002 epitope is masked by sialic acid in normal cells.Discussion: We believe that GT-002 is a promising candidate for development of antibody-drug- and radio-conjugates as well as bispecific molecules and chimeric antigen receptor therapeutics and highlights the powerful potential of antibodies against combined protein-carbohydrate epitopes to reduce on-target/off-tumor cytotoxicity.
导言癌症中最剧烈的变化之一是蛋白质和脂质的糖基化改变,从而产生截短的 O 型糖,如正常细胞中几乎不存在的汤姆森-弗里登雷希(TF)或汤姆森-新(Tn)抗原。由于这些特异性聚糖具有极好的肿瘤特异性和广泛的癌症表达,因此由这些特异性聚糖组成的蛋白质-碳水化合物表位组合是强效靶向疗法的理想候选物:我们制备了 GT-002,这是一种单克隆抗体,仅在存在 TF 糖基化的情况下特异性地靶向上皮糖蛋白 LYPD3。在 ELISA 和流式细胞术中,它不会与非糖基化的 LYPD3 或其他糖蛋白上的 TF 发生交叉反应。GT-002 能与多种肿瘤细胞系结合,并能染色不同癌症适应症的肿瘤组织,包括头颈部鳞状细胞癌。在对包括多个 LYPD3 阳性器官在内的正常人体组织面板进行的免疫组化研究中,GT-002 几乎完全消除了与正常组织的结合,从而证实了其显著的肿瘤特异性。因此,与 Lupartumab 相比,我们观察到 GT-002 与正常人体组织的结合明显减少,而 Lupartumab 是一种传统的抗 LYPD3 抗体,以前曾作为抗体药物共轭物(BAY1129980)用于临床开发。对健康组织进行神经氨酸酶处理,导致硅氨酸残基裂解,重新建立了 GT-002 与 Lupartumab 的结合,表明 GT-002 表位在正常细胞中被硅氨酸掩盖:我们认为,GT-002是开发抗体-药物-放射共轭物以及双特异性分子和嵌合抗原受体疗法的有希望的候选药物,并突出了针对蛋白质-碳水化合物联合表位的抗体在降低靶上/靶外肿瘤细胞毒性方面的强大潜力。
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引用次数: 0
Future treatments for the arteriopathy of ectopic calcification disorders 异位钙化症动脉病变的未来治疗方法
Pub Date : 2023-11-21 DOI: 10.3389/fddsv.2023.1249966
Benjamin M. Davies, F. Rutsch, Naren Vyavahare, Alexander Jones
Ectopic calcification disorders, including Generalized Arterial Calcification of Infancy (GACI) and Pseudoxanthoma Elasticum are rare but impactful on individuals, healthcare and society, with significant associated morbidity, mortality and healthcare costs. Available therapies are not curative and focus on reducing extracellular calcification to limit progression of the arteriopathy that is responsible for much of the morbidity and, in the case of GACI, significant early mortality (approximately 50% in infancy). In this article, current and emerging medical approaches are reviewed and critiqued, including dietary manipulation, phosphate binders, bisphosphonates, tissue nonspecific alkaline phosphatase inhibitors, ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) enzyme replacement, allele-specific therapies, gene therapies, and antibody targeted treatment. Available therapies may limit further arterial calcification, but in GACI in particular, significant calcification can be present at birth, contributing to high infant mortality. This highlights the need for new approaches that aim to reverse established calcification, rather than merely slow its progression. Recently, a promising new class of antibody-targeted nanoparticle therapeutics has emerged that can reverse established arterial calcification in animals, restoring arterial elasticity. In one realization, nanoparticles carry established chelators, such as ethylenediaminetetraacetic disodium acid, to sites of arterial damage, concentrating the impact of the chelator where it is needed and limiting off-target effects. Such drugs would complement existing and emerging therapies, such as ENPP1 enzyme replacement, that slow or prevent progression of calcification, by offering an opportunity to “reset” arterial health in ectopic calcification disorders. At present, ectopic calcification disorders are challenging to treat effectively and carry a high burden of morbidity and mortality, particularly in GACI. Recent drug developments offer good reason to be hopeful for a new era of effective therapeutics that may reverse established arterial disease as well as halt its progression.
异位钙化症(包括婴儿全身动脉钙化症(GACI)和假黄疽弹性瘤)虽然罕见,但对个人、医疗保健和社会都有很大影响,相关的发病率、死亡率和医疗保健成本都很高。现有的治疗方法无法根治,只能通过减少细胞外钙化来限制动脉病变的发展,而动脉病变是大部分发病率的罪魁祸首,就 GACI 而言,早期死亡率很高(婴儿期约为 50%)。本文对当前和新兴的医疗方法进行了回顾和评论,包括饮食调节、磷酸盐结合剂、双磷酸盐、组织非特异性碱性磷酸酶抑制剂、外显子核苷酸焦磷酸酶/磷酸二酯酶 1 (ENPP1) 酶替代、等位基因特异性疗法、基因疗法和抗体靶向治疗。现有的疗法可以限制动脉钙化的进一步发展,但特别是在 GACI 患者中,出生时就可能出现明显的钙化,导致婴儿死亡率居高不下。这就凸显了对旨在逆转已形成的钙化而不仅仅是减缓其进展的新方法的需求。最近,出现了一种很有前景的新型抗体靶向纳米粒子疗法,它可以逆转动物体内已形成的动脉钙化,恢复动脉弹性。在一种实现方式中,纳米粒子携带乙二胺四乙酸二钠盐等螯合剂到达动脉损伤部位,将螯合剂的作用集中在需要的地方,并限制脱靶效应。这类药物将补充现有和新出现的疗法,如ENPP1酶替代疗法,这些疗法可减缓或防止钙化的进展,为异位钙化症患者的动脉健康提供了 "重置 "的机会。目前,异位钙化症很难得到有效治疗,发病率和死亡率都很高,尤其是在 GACI 中。最近的药物研发成果让我们有理由对新时代的有效疗法充满希望,这种疗法可能会逆转已形成的动脉疾病并阻止其发展。
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引用次数: 0
In vitro drug interaction of ionophores with artemisinin and chloroquine against Plasmodium falciparum 3D7 blood-stage infection 离子载体与青蒿素、氯喹对恶性疟原虫3D7血期感染的体外药物相互作用
Pub Date : 2023-11-14 DOI: 10.3389/fddsv.2023.1257698
Vinoth Rajendran, Keerthana Gurukkalot
The prevalence of clinical resistance of P. falciparum towards artemisinin and its partner drugs has significantly hampered malarial chemotherapy. To circumvent this situation, identifying a new class of partner drugs with significant anti-malarial efficacy and multi-stage activity can slow the development of resistance. This study demonstrates the potential interactions of carboxylic ionophores such as monensin (MON), maduramicin (MAD) or salinomycin (SAL) with standard antimalarial drugs artemisinin (ART) or chloroquine (CQ). The in vitro drug interactions were studied in P. falciparum 3D7 strain by a growth inhibition SYBR green 1 assay. The asynchronized parasites were exposed for 48 h in the presence of varying proportions of two drug concentrations using the modified fixed-ratio isobologram method. We determined the growth inhibition response and the sums of the fractional inhibitory concentrations (ΣFICs) of the following drug combinations (4:1, 3:2, 2:3, 1:4) and (1:1, 1:3, 3:1) were calculated for 50% inhibitory concentrations (IC 50 s). Combining artemisinin with monensin, maduramicin, or salinomycin showed significant additive interaction. A combination of chloroquine with monensin, maduramicin, or salinomycin showed slight synergism to additive interaction. None of the drug combinations displayed an antagonistic effect indicating ionophores usage in combination therapy to treat drug-resistant malarial infections.
恶性疟原虫对青蒿素及其伴生药物的临床耐药严重阻碍了疟疾化疗。为了避免这种情况,确定一类具有显著抗疟疾功效和多阶段活性的新伙伴药物可以减缓耐药性的发展。这项研究证明了羧基离子载体如莫能菌素(MON)、麦杜拉霉素(MAD)或盐碱霉素(SAL)与标准抗疟药物青蒿素(ART)或氯喹(CQ)的潜在相互作用。采用生长抑制SYBR绿1法研究恶性疟原虫3D7菌株的体外药物相互作用。采用改进的固定比例等线图法,对不同比例的两种药物浓度进行暴露48 h。我们测定了生长抑制反应,并计算了以下药物组合(4:1,3:2,2:3,1:4)和(1:1,1:3,3:1)对50%抑制浓度(ic50 s)的分数抑制浓度之和(ΣFICs)。青蒿素与莫能菌素、maduramicin或盐碱霉素联合使用显示出显著的加性相互作用。氯喹与莫能菌素、马杜洛霉素或盐碱霉素联合使用时,对加性相互作用有轻微的增效作用。没有一种药物组合显示出拮抗作用,表明离子载体用于联合治疗耐药疟疾感染。
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引用次数: 0
An improved method for large scale generation and high-throughput functional characterization of human iPSC-derived microglia 人类ipsc衍生小胶质细胞大规模生成和高通量功能表征的改进方法
Pub Date : 2023-10-30 DOI: 10.3389/fddsv.2023.1289314
Manisha Padmakumar, Steven Biesmans, Jorge S. Valadas, Jan R. Detrez, Gaëlle Gillet, Priscillia Bresler, Marie-Laure Clénet, Irena Kadiu
Neuroscience drug discovery has faced significant challenges due to restricted access to relevant human cell models and limited translatability of existing preclinical findings to human pathophysiology. Induced pluripotent stem cells (iPSCs) have emerged as a promising solution, offering the potential to generate patient-specific cell types, including in the recent years, iPSC-derived microglia (iMGL). Current methods rely on complex and time-consuming differentiation procedures, leading to considerable batch-to-batch variability consequently hindering the establishment of standardized and reproducible high-throughput functional screening approaches. Addressing these challenges is critical in ensuring the generation of homogenous iMGL populations with consistent functional properties. In this study we describe an improved high-yield protocol for generating iMGL, which allows for increased reproducibility and flexibility in the execution of high-throughput functional screens. We introduce a two-step process in embryoid bodie (EB) maintenance and a stop point allowing for cryopreservation at the hematopoietic progenitor cell (iHPC) stages. Furthermore, we demonstrate inter-operator robustness of this modified protocol in a range of high-throughput functional assays including phagocytosis, lysosomal acidification, chemotaxis, and cytokine release. Our study underscores the importance of quality control checks at various stages of iPSC-differentiation and functional assay set up, highlighting novel workarounds to the existing challenges such as limited yield, flexibility, and reproducibility, all critical in drug discovery.
由于相关人类细胞模型的获取受限,以及现有临床前研究结果对人类病理生理学的可翻译性有限,神经科学药物的发现面临着重大挑战。诱导多能干细胞(iPSCs)已成为一种有前景的解决方案,提供了产生患者特异性细胞类型的潜力,包括近年来ipsc衍生的小胶质细胞(iMGL)。目前的方法依赖于复杂且耗时的区分程序,导致批次之间存在相当大的可变性,从而阻碍了标准化和可重复的高通量功能筛选方法的建立。解决这些挑战对于确保生成具有一致功能特性的同质iMGL种群至关重要。在这项研究中,我们描述了一种改进的高产量协议,用于生成iMGL,它允许在执行高通量功能屏幕时增加再现性和灵活性。我们介绍了胚胎样体(EB)维持的两步过程和允许在造血祖细胞(iHPC)阶段冷冻保存的停止点。此外,我们在一系列高通量功能分析中证明了这种修改后的方案在操作者之间的稳健性,包括吞噬作用、溶酶体酸化、趋化性和细胞因子释放。我们的研究强调了在ipsc分化和功能分析设置的各个阶段进行质量控制检查的重要性,强调了针对现有挑战的新解决方案,如有限的产量,灵活性和可重复性,这些都是药物发现的关键。
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引用次数: 0
State-of-the-art strategies to prioritize Mycobacterium tuberculosis drug targets for drug discovery using a subtractive genomics approach 使用减法基因组学方法优先考虑结核分枝杆菌药物靶标的最先进策略
Pub Date : 2023-09-18 DOI: 10.3389/fddsv.2023.1254656
Adetutu Akinnuwesi, Samuel Egieyeh, Ruben Cloete
Tuberculosis remains one of the causes of death from a single infectious bacterium. The inappropriate use of antibiotics and patients’ non-compliance among other factors drive the emergence of drug-resistant tuberculosis. Multidrug-resistant and extensively drug-resistant strains of tuberculosis pose significant challenges to current treatment regimens, as their reduced efficacy against these strains limits successful patient outcomes. Furthermore, the limited effectiveness and associated toxicity of second-line drugs further compound the issue. Moreover, the scarcity of novel pharmacological targets and the subsequent decline in the number of anti-TB compounds in the drug development pipeline has further hindered the emergence of new therapies. As a result, researchers need to develop innovative approaches to identify potential new anti-TB drugs. The evolution of technology and the breakthrough in omics data allow the use of computational biology approaches, for example, metabolomic analysis to uncover pharmacological targets for structured-based drug design. The role of metabolism in pathogen development, growth, survival, and infection has been established. Therefore, this review focuses on the M. tb metabolic network as a hub for novel target identification and highlights a step-by-step subtractive genomics approach for target prioritization.
结核病仍然是单一传染性细菌造成死亡的原因之一。抗生素使用不当和患者不遵医嘱等因素推动了耐药结核病的出现。耐多药和广泛耐药结核病菌株对目前的治疗方案构成重大挑战,因为它们对这些菌株的疗效降低,限制了患者的成功治疗结果。此外,二线药物的有限有效性和相关毒性进一步加剧了这一问题。此外,新的药理学靶点的缺乏以及药物开发管道中抗结核化合物数量的下降进一步阻碍了新疗法的出现。因此,研究人员需要开发创新的方法来识别潜在的新的抗结核药物。技术的发展和组学数据的突破允许使用计算生物学方法,例如,代谢组学分析来揭示基于结构的药物设计的药理学靶点。代谢在病原体发育、生长、生存和感染中的作用已经确立。因此,本文将重点介绍结核分枝杆菌代谢网络作为新靶点鉴定的枢纽,并强调了一种逐步减少的基因组学方法来确定靶点的优先级。
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引用次数: 0
Harnessing bioluminescence for drug discovery and epigenetic research 利用生物发光进行药物发现和表观遗传学研究
Pub Date : 2023-09-05 DOI: 10.3389/fddsv.2023.1249507
Hannah J. Gleneadie, Andrew Dimond, Amanda G. Fisher
The naturally occurring phenomenon of bioluminescence has intrigued on-lookers for decades and is now being developed as a powerful tool for medical research and preclinical imaging. Luciferase enzymes emit light upon substrate encounter, enabling their activity to be visualised and dynamically tracked. By inserting luciferase genes into specific sites in the genome, it is possible to engineer reporters to monitor gene expression in its native context, and to detect epigenetic change in vivo. Endogenous bioluminescent reporters provide a highly sensitive, quantitative read-out of gene expression that is both well suited to longitudinal studies and can be adapted for high-throughput drug screens. In this article we outline some of the applications and benefits of bioluminescent reporters for epigenetic research, with a particular focus on revealing new therapeutic options for treating genetic and epigenetic disorders.
几十年来,自然发生的生物发光现象引起了旁观者的兴趣,现在正被开发为医学研究和临床前成像的有力工具。荧光素酶在遇到底物时发光,使其活性可视化和动态跟踪。通过将荧光素酶基因插入基因组中的特定位点,可以设计报告基因来监测其天然环境下的基因表达,并检测体内的表观遗传变化。内源性生物发光报告器提供了一种高度敏感的基因表达定量读数,既适合纵向研究,也适用于高通量药物筛选。在这篇文章中,我们概述了生物发光报告在表观遗传学研究中的一些应用和好处,特别侧重于揭示治疗遗传和表观遗传疾病的新治疗选择。
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引用次数: 0
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