https://doi.org/10.18502/jovr.v15i3.7457
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authors
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Geoffrey A. Casey
Geoffrey A. Casey
Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Canada
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Kimberly M. Papp
Kimberly M. Papp
Faculty of Science, University of Alberta, Canada
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Ian M. MacDonald
Ian M. MacDonald
Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Canada
Published Date
- Jul 29, 2020
Ocular Gene Therapy with Adeno-associated Virus Vectors: Current Outlook for Patients and Researchers
Abstract
In this “Perspective”, we discuss ocular gene therapy – the patient’s perspective, the various strategies of gene replacement and gene editing, the place of adenoassociated virus vectors, routes of delivery to the eye and the remaining question - “why does immunity continue to limit efficacy?” Through the coordinated efforts of patients, researchers, granting agencies and industry, and after many years of pre-clinical studies, biochemical, cellular, and animal models, we are seeing clinical trials emerge for many previously untreatable heritable ocular disorders. The pathway to therapies has been led by the successful treatment of the RPE65 form of Leber congenital amaurosis with LUXTURNATM. In some cases, immune reactions to the vectors continue to occur, limiting efficacy. The underlying mechanisms of inflammation require further study, and new vectors need to be designed that limit the triggers of immunity. Researchers studying ocular gene therapies and clinicians enrolling patients in clinical trials must recognize the current limitations of these therapies to properly manage expectations and avoid disappointment, but we believe that gene therapies are well on their way to successful, widespread utilization to treat heritable ocular disorders.
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