tailieunhanh - An Introduction to Molecular Medicine and Gene Therapy - part 10

Cân nhắc trong việc lựa chọn BỆNH mục tiêu cho liệu pháp gen Một loạt các phương pháp đã được sử dụng cho việc giới thiệu của các axit nucleic (chủ yếu là DNA) vào trong tế bào. Chúng bao gồm việc sử dụng các phương pháp giao gen của virus và nonviral. Modified retrovirus, adenovirus, virus adenoassociated (AAV), và vir | 356 APPENDIX COMMERCIAL IMPLICATIONS CONSIDERATIONS IN CHOOSING A TARGET DISEASE FOR GENE THERAPY A variety of approaches have been utilized for the introduction of nucleic acids principally DNA into cells. These include the use of viral and nonviral methods for gene delivery. Modified retroviruses adenovirus adenoassociated virus AAV and herpes virus have been investigated for virally based delivery see Chapter 4 . Naked DNA cationic lipids liposomes and cationic polypeptides are being pursued as nonviral approaches for gene therapy see Chapters 4 and 5 . Matching a gene therapy methodology to a target disease involves a number of factors. The technical issues that must be considered include determining the tissue and cell specificity needed for expression of the therapeutic gene the number of cells that need to be targeted and therapeutic level and duration of transgene expression. The delivery vehicle identifies the tissues and cell types that the therapeutic DNA can be delivered. If the choice of delivery vehicles is limited then target diseases or genes will also be limited. The delivery vehicle will dictate the number of cells targeted and the duration of expression of the transgene therapeutic gene . Therapies that require high levels of gene expression or require targeting a large percentage of cells likely require viral delivery vectors rather than nonviral delivery vectors. This is because at present viral vectors are more efficient at delivery. The delivered gene may be integrated into the host chromosome using AAV or retrovirus vectors see Chapter 4 . These may give longer duration of expression of the transgene than would be expected with adenovirus or nonviral delivery vectors. However if the gene is to be delivered multiple times during the course of treatment nonviral vectors may avoid the development of immune responses that can occur with viral delivery systems. Regulation of the therapeutic gene is another factor to consider when choosing a .

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