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Published on: March 12, 2018
Advancing Gene Therapy for Phenylketonuria: From Precision Editing to Clinical Translation
1Department of Biohealth Convergence, College of Science and Convergence Technology, Seoul Women's University, Seoul 01797, Republic of Korea.
Insights
Gene therapy offers new hope for phenylketonuria (PKU), an inherited disorder. Adenine base editing and viral gene transfer show promise in preclinical studies for treating PKU.
Area of Science:
- Biochemistry
- Genetics
- Medical Genetics
Background:
- Phenylketonuria (PKU) is an inherited metabolic disorder caused by phenylalanine hydroxylase (PAH) gene mutations.
- Elevated phenylalanine (Phe) levels in the blood due to PAH deficiency can lead to severe neurological damage.
- Current treatments, including low-Phe diets and tetrahydrobiopterin (BH4) therapy, have limitations and require lifelong adherence.
Purpose of the Study:
- To review the pathophysiology of PKU and current treatment strategies.
- To explore recent advancements in gene therapy for PKU, focusing on gene editing and viral-mediated gene delivery.
- To discuss the translational challenges and future directions for gene therapy in PKU treatment.
Main Methods:
- Review of preclinical and clinical studies on gene therapy for PKU.
- Focus on adenine base editors (ABEs) and CRISPR-based gene editing systems.
- Analysis of delivery methods including lipid nanoparticles (LNPs) and recombinant adeno-associated viruses (rAAV).
Main Results:
- Gene editing technologies like ABEs and CRISPR show significant therapeutic potential in preclinical PKU models.
- Viral-mediated gene transfer using rAAV vectors has demonstrated efficacy in delivering therapeutic genes.
- Lipid nanoparticles (LNPs) are emerging as effective delivery vehicles for gene-editing components.
Conclusions:
- Gene therapy, particularly adenine base editing and rAAV-mediated gene transfer, represents a promising therapeutic avenue for PKU.
- Overcoming translational challenges related to delivery, safety, and long-term efficacy is crucial for clinical application.
- Further research and development are needed to ensure the safety and effectiveness of gene therapies for widespread PKU treatment.
Abstract:
Phenylketonuria (PKU) is an inherited disorder caused by mutations in the phenylalanine hydroxylase (PAH) gene that result in the amino acid phenylalanine (Phe) building up in the blood. Current therapies suggest low-Phe dietary management and (6R)-L-erythro-5,6,7,8-tetrahydrobiopterin (BH4) therapy, which are limited in efficacy and require lifelong treatment. Recent advances in gene therapy, including gene editing and viral-mediated gene delivery, produce therapeutic effects. Advancements in gene editing technologies, notably adenine base editors (ABEs) and CRISPR-based systems, in conjunction with enhanced delivery methods such as lipid nanoparticles (LNPs) and recombinant viruses, have demonstrated substantial promise in preclinical studies. This review details the pathophysiology of PKU treatment, and progress in preclinical and clinical gene therapy strategies. Emphasis is on adenine base editing using LNPs, recombinant adeno-associated virus (rAAV)-mediated gene transfer, and the translational challenges associated with these technologies. We also discuss future directions for therapeutic reach and ensuring long-term safety and efficacy.
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