Journal
HUMAN GENE THERAPY
Volume 33, Issue 17-18, Pages 879-888Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/hum.2022.169
Keywords
liver; gene therapy; review; adeno-associated virus (AAV); monogenetic
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Gene therapy is an exciting therapeutic concept offering hope for curing a variety of genetic and acquired disorders, with the liver as a key target due to its essential biological functions. Recent advances in liver-targeted gene therapy have shown promising clinical efficacy, with approval of the first gene therapy for hemophilia A in Europe and others in final stages of approval, heralding a potential new era of curative molecular medicine.
Gene therapy is an exciting therapeutic concept that offers the promise of a cure for an array of inherited and acquired disorders. The liver has always been a key target for gene therapy as it controls essential biological processes including digestion, metabolism, detoxification, immunity, and blood coagulation. Metabolic disorders of hepatic origin number several hundreds, and for many, liver transplantation remains the only cure. Liver-targeted gene therapy is an attractive treatment modality for many of these conditions. After years of failure, substantial progress in this field in the past decade has resulted in promising clinical efficacy and safety in patients with monogenetic disorders with Valoctocogene roxaparvovec (Roctavian), the first gene therapy for treatment for hemophilia A, to be approved in Europe. Another, Etranacogene dezaparvovec (AMT-061) for hemophilia B is also in the final stages of approval. A number of other liver targeted gene therapy products are at an advanced stage of development, thus heralding a new era of potentially curative molecular medicine. This review explores the recent clinical advances in liver targeted gene therapy as well as the challenges that need to be overcome for the widespread adoption of this new treatment paradigm.
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