心脏重构与再生专刊

心血管疾病的基因治疗

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  • 中国科学院上海生命科学研究院营养科学研究所, 上海200031
丁秋蓉(1981—), 女, 教授, 博士生导师, 博士, 研究方向为干细胞与转化医学. E-mail: qrding@sibs.ac.cn

收稿日期: 2016-04-19

  网络出版日期: 2016-06-30

基金资助

上海市浦江人才计划资助项目(15PJ1409200)

Gene therapy for cardiovascular disease

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  • Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China

Received date: 2016-04-19

  Online published: 2016-06-30

摘要

基因治疗在先天遗传性以及后天获得性心血管疾病治疗中均具有广阔的发展前景. 对心血管疾病致病机理的深入认识和疾病基因组学研究的发展, 进一步促进了临床前基因治疗的研究进展. 但基因治疗过程中存在的机体细胞免疫反应、外源基因表达水平不足、在体基因转导效率低下等因素都成为基因治疗临床应用转化的瓶颈. 近年来, 基因导入载体和基因组编辑技术的发展为上述问题的改善和解决提供了新的思路. 目前成族规律间隔短回文重复序列(clustered regularly interspaced short palindromic repeats, CRISPR)/Cas9 基因组编辑技术已经成功应用于动物模型的在体基因编辑, 达到了显著改善血脂指标的疗效. 进一步研究体内组织特异和高效的基因导入方式, 提高基因编辑的靶向效率和特异性, 并建立全面有效的安全评估实验体系, 将推动基因治疗向临床应用的转化. 针对心血管疾病基因治疗中基因导入载体的研究以及CRISPR/Cas9 基因组编辑技术的应用展开讨论.

本文引用格式

丁秋蓉, 陈彦好 . 心血管疾病的基因治疗[J]. 上海大学学报(自然科学版), 2016 , 22(3) : 270 -279 . DOI: 10.3969/j.issn.1007-2861.2016.03.013

Abstract

Gene therapy shows great promise in the treatment of both inherited and acquired cardiovascular diseases. Identification of key molecule players in pathophysiology of cardiovascular disease and development of human disease genomic research lead to encouraging preclinical gene therapy studies in animal models. However, the presence of cellular immune responses, insufficient gene expression level and overall limited in vivo gene transduction efficiencies have hampered the translational progress to clinical use of gene therapy. In recent years, improvements in gene delivery system and discovery of advanced genome editing technologies open new therapeutic perspectives, with clustered regularly interspaced short palindromic repeats (CRISRP)/Cas9 genome editing technology already being successfully used in animal models to treat hypercholesterolemia. Further improvement in gene delivery efficiency, increase in targeting specificity of genome editing tools, and establishment of experimental systems for a thorough analysis of potential safety problems would help eventually bring gene therapy for heart disease to reality. In this review, recent advances in the use of different delivery vectors and CRISPR/Cas9 genome editing technology in gene therapy research to treat cardiovascular diseases are discussed.

参考文献

[1] Mozaffarian D, Benjamin E J, Go A S, et al. Heart disease and stroke statistics—2016 update a report from the American Heart Association [J]. Circulation, 2016, 133(4): 447-545.
[2] Gheorghiade M, Pang P S. Acute heart failure syndromes [J]. J Am Coll Cardiol, 2009, 53(7): 557-573.
[3] Tilemann L, Ishikawa K, Weber T, et al. Gene therapy for heart failure [J]. Circ Res, 2012, 110(5): 777-793.
[4] Yerevanian A, Yerevanian A, Hajjar R J. Progress in gene therapy for heart failure [J]. J Cardiovasc Pharm, 2014, 63(2): 95-106.

[5] Gao M H, Lai N C, Miyanohara A, et al. Intravenous adeno-associated virus serotype 8 encoding urocortin-2 provides sustained augmentation of left ventricular function in mice [J].
Hum Gene Ther, 2013, 24(9): 777-785.
[6] Lai N C, Tang T, Gao M H, et al. Improved function of the failing rat heart by regulated expression of insulin-like growth factor Ⅰvia intramuscular gene transfer [J]. Hum Gene Ther,
2012, 23(3): 255-261.
[7] Ding Q R, Strong A, Patel K M, et al. Permanent alteration of PCSK9 with in vivo CRISPRCas9 genome editing [J]. Circ Res, 2014, 115(5): 488-492.
[8] Su C H, Wu Y J, Wang H H, et al. Nonviral gene therapy targeting cardiovascular system [J]. Am J Physiol Heart C, 2012, 303(6): H629-H638.
[9] Gyongyosi M, Khorsand A, Zamini S, et al. NOGA-guided analysis of regional myocardial perfusion abnormalities treated with intramyocardial injections of plasmid encoding vascular endothelial growth factor A-165 in patients with chronic myocardial ischemia—subanalysis of the EUROINJECT-ONE multicenter double-blind randomized study [J]. Circulation, 2005, 112(9): 1157-1165.
[10] Scimia M C, Cannavo A, KochWJ. Gene therapy for heart disease: molecular targets, vectors and modes of delivery to myocardium [J]. Expert Rev Cardiovasc Ther, 2013, 11(8): 999-1013.
[11] Ferrara K, Pollard R, Borden M. Ultrasound microbubble contrast agents: fundamentals and application to gene and drug delivery [J]. Annu Rev Biomed Eng, 2007, 9: 415-447.
[12] Fujii H, Sun Z, Li S H, et al. Ultrasound-targeted gene delivery induces angiogenesis after a myocardial infarction in mice [J]. JACC Cardiovasc Imaging, 2009, 2(7): 869-879.
[13] Fujii H, Li S H, Wu J, et al. Repeated and targeted transfer of angiogenic plasmids into the infarcted rat heart via ultrasound targeted microbubble destruction enhances cardiac repair [J]. Eur Heart J, 2011, 32(16): 2075-2084.
[14] Gill S L, O’neill H, McCoy R J, et al. Enhanced delivery of microRNA mimics to cardiomyocytes using ultrasound responsive microbubbles reverses hypertrophy in an in-vitro
model [J]. Technol Health Care, 2014, 22(1): 37-51.
[15] Petrus I, Chuah M, Vandendriessche T. Gene therapy strategies for hemophilia: benefits versus risks [J]. J Gene Med, 2010, 12(10): 797-809.
[16] Kay M A. State-of-the-art gene-based therapies: the road ahead [J]. Nat Rev Genet, 2011, 12(5): 316-328.
[17] Schneider C K, Salmikangas P, Jilma B, et al. Challenges with advanced therapy medicinal products and how to meet them [J]. Nat Rev Drug Disc, 2010, 9(3): 195-201.
[18] Mingozzi F, High K A. Immune responses to AAV vectors: overcoming barriers to successful gene therapy [J]. Blood, 2013, 122(1): 23-36.
[19] Wasala N B, Shin J H, Duan D S. The evolution of heart gene delivery vectors [J]. J Gene Med, 2011, 13(10): 557-565.
[20] Parker A L, Nicklin S A, Baker A H. Interactions of adenovirus vectors with blood: implications for intravascular gene therapy applications [J]. Curr Opin Mol Ther, 2008, 10(5):
439-448.

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