期刊
CURRENT GENE THERAPY
卷 7, 期 5, 页码 297-305出版社
BENTHAM SCIENCE PUBL LTD
DOI: 10.2174/156652307782151452
关键词
Helper-Dependent; adenovirus; innate immunity; gene therapy
资金
- NIDDK NIH HHS [5 P30 DK056338, R01 DK56787, T32 DK060445] Funding Source: Medline
Adenovirus-mediated gene therapy holds significant potential especially for applications requiring high levels of target tissue transduction. While significant advances in clinical adenoviral gene therapy applications have been made in cancer, the clinical translation of adenoviral gene replacement therapy for genetic disease has lagged. Encouragingly, advances in vector production have led to the development of Helper-Dependent (gutted or high capacity) adenoviral vectors (HDV) deleted of all viral coding genes, HDV significantly reduces the chronic toxicity associated with early generation adenoviral vectors that has been most significant after systemic administration in both small and large animal models. However, the field remains confounded by innate immune responses inherent to adenovirus, and more generally, to the adaptive immune response to transgene. Together they decrease the effective therapeutic index for any particular treatment. This review summarizes the current advances toward understanding the decisive cell and molecular mechanisms underlying the acute toxicity to systemic HDV administration. We focus on the complex immune response and consequences of systemic vector delivery in the context of liver-directed monogenic disease therapy. Future development of interventions to avoid the innate immune response, including vector and pharmacologic manipulations, should further contribute to minimizing vector toxicity while maximizing the efficacy of systemic HDV gene transfer.
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