遺伝性失明症に遺伝子治療が有効(Gene therapy effective in hereditary blindness)

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2024-09-10 カロリンスカ研究所(KI)

スウェーデンのカロリンスカ研究所が行った研究で、遺伝性の失明疾患であるBothniaジストロフィーに対する遺伝子治療が効果的であることが示されました。この疾患は主にスウェーデンのヴェステルボッテン地方で見られ、進行性の視力低下を引き起こします。研究者たちは、損傷したRLBP1遺伝子を修復するため、ウイルスベクターを使用して12人の患者に治療を施しました。その結果、11人の患者で視力が大幅に改善し、特に夜間視力が向上しました。今後は、治療群と対照群を比較する大規模な研究が予定されています。

<関連情報>

RLBP1関連網膜ジストロフィーに対する遺伝子治療の中間安全性と有効性:第1/2相試験 Interim safety and efficacy of gene therapy for RLBP1-associated retinal dystrophy: a phase 1/2 trial

Anders Kvanta,Nalini Rangaswamy,Karen Holopigian,Christine Watters,Nicki Jennings,Melissa S. H. Liew,Chad Bigelow,Cynthia Grosskreutz,Marie Burstedt,Abinaya Venkataraman,Sofie Westman,Asbjörg Geirsdottir,Kalliopi Stasi & Helder André
Nature Communications  Published:10 September 2024
DOI:https://doi.org/10.1038/s41467-024-51575-4

遺伝性失明症に遺伝子治療が有効(Gene therapy effective in hereditary blindness)

Abstract

Gene therapy holds promise for treatment of inherited retinal dystrophies, a group of rare genetic disorders characterized by severe loss of vision. Here, we report up to 3-year pre-specified interim safety and efficacy results of an open-label first-in-human dose-escalation phase 1/2 gene therapy clinical trial in 12 patients with retinal dystrophy caused by biallelic mutations in the retinaldehyde-binding protein 1 (RLBP1) gene of the visual cycle. The primary endpoints were systemic and ocular safety and recovery of dark adaptation. Secondary endpoints included microperimetry, visual field sensitivity, dominant eye test and patient-reported outcomes. Subretinal delivery of an adeno-associated viral vector (AAV8-RLBP1) was well tolerated with dose-dependent intraocular inflammation which responded to corticosteroid treatment, and focal atrophy of the retinal pigment epithelium as the dose limiting toxicity. Dark adaptation kinetics, the primary efficacy endpoint, improved significantly in all dose-cohorts. Treatment with AAV8-RLBP1 resulted in the resolution of disease-related retinal deposits, suggestive of successful restoration of the visual cycle. In conclusion, to date, AAV8-RLBP1 has shown preliminary safety and efficacy in patients with RLBP1-associated retinal dystrophy. Trial number: NCT03374657.

医療・健康
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