基于CRISPR/ cas9的基因编辑用于纠正遗传性通道病。

IF 2.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Hadrian Hoang-Vu Tran, Audrey Thu, Anu Radha Twayana, Axel Fuertes, Marco Gonzalez, Krutagni Adwait Mehta, Marina Basta, Maggie James, Daniel Elias, Yghor Myrtho Figaro, Damien Islek, Abraham Lo, William H Frishman, Wilbert S Aronow
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引用次数: 0

摘要

遗传性心脏通道病变,包括长QT综合征、Brugada综合征和儿茶酚胺能多形性室性心动过速,是年轻人心律失常和心源性猝死的主要原因。目前的治疗方法,如药物、植入式心律转复除颤器和生活方式的改变,降低了风险,但未能纠正潜在的遗传基础,因此迫切需要治疗策略。CRISPR/Cas9基因组编辑已经成为一个具有直接修复致病变异潜力的变革性平台。碱基和引物编辑的最新进展,以及新的病毒和非病毒传递平台,已经能够在临床前模型中精确校正致病突变。使用动物模型和患者来源的ipsc心肌细胞进行的概念验证研究表明,电生理稳定性的恢复、心律失常的抑制和持久的功能益处。然而,翻译的挑战仍然存在,包括脱靶效应、传递障碍、免疫反应、可扩展性和伦理考虑。正在进行的创新,如工程核酸酶、改进的递送载体、免疫原性缓解策略和个性化指南设计的人工智能集成,有望加速临床翻译。这篇综述综合了目前关于基于crispr的遗传通道病变策略的知识,强调了基因编辑作为一种能够预防心源性猝死的持久、疾病修饰疗法的前景和局限性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CRISPR/Cas9-Based Gene Editing for Correcting Inherited Channelopathies.

Inherited cardiac channelopathies, including long QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia, are major causes of arrhythmic morbidity and sudden cardiac death in young individuals. Current therapies, such as pharmacologic agents, implantable cardioverter-defibrillators, and lifestyle modifications, reduce risk but fail to correct the underlying genetic substrate, creating an urgent need for curative strategies. CRISPR/Cas9 genome editing has emerged as a transformative platform with the potential to directly repair pathogenic variants. Recent advances in base and prime editing, together with novel viral and nonviral delivery platforms, have enabled precise correction of disease-causing mutations in preclinical models. Proof-of-concept studies using animal models and patient-derived iPSC-cardiomyocytes demonstrate restoration of electrophysiologic stability, suppression of arrhythmias, and durable functional benefit. Nevertheless, translational challenges remain, including off-target effects, delivery barriers, immune responses, scalability, and ethical considerations. Ongoing innovations-such as engineered nucleases, improved delivery vectors, immunogenicity mitigation strategies, and integration of artificial intelligence for personalized guide design-are expected to accelerate clinical translation. This review synthesizes current knowledge on CRISPR-based strategies for inherited channelopathies, highlighting both the promise and limitations of gene editing as a path toward durable, disease-modifying therapies capable of preventing sudden cardiac death.

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来源期刊
Cardiology in Review
Cardiology in Review CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.60
自引率
0.00%
发文量
76
审稿时长
>12 weeks
期刊介绍: The mission of Cardiology in Review is to publish reviews on topics of current interest in cardiology that will foster increased understanding of the pathogenesis, diagnosis, clinical course, prevention, and treatment of cardiovascular disorders. Articles of the highest quality are written by authorities in the field and published promptly in a readable format with visual appeal
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