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A New Era for Rare Genetic Diseases: Messenger RNA Therapy

机译:罕见遗传病的新时代:信使RNA疗法

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摘要

Exogenous delivery of messenger RNA (mRNA) is emerging as a new class of medicine with broad applicability including the potential to treat rare monogenic disorders. Recent advances in mRNA technology, including modifications to the mRNA itself along with improvements to the delivery vehicle, have transformed the utility of mRNA as a potential therapy to restore or replace different types of therapeutic proteins. Preclinical proof-of-concept has been demonstrated for mRNA therapy for three different rare metabolic disorders: methylmalonic acidemia, acute intermittent porphyria, and Fabry disease. Herein, we review those preclinical efficacy and safety studies in multiple animal models. For all three disorders, mRNA therapy restored functional protein to therapeutically relevant levels in target organs, led to sustained and reproducible pharmacology following each dose administration of mRNA, and was well tolerated as supported by liver function tests evaluated in animal models including nonhuman primates. These data provide compelling support for the clinical development of mRNA therapy as a treatment for various rare metabolic disorders.
机译:信使RNA(mRNA)的外源性递送正在成为一类具有广泛适用性的新型药物,包括治疗罕见单基因疾病的潜力。mRNA技术的最新进展,包括对mRNA本身的修改以及对递送载体的改进,已经改变了mRNA作为恢复或替代不同类型治疗性蛋白质的潜在疗法的效用。临床前概念验证已被证明可用于治疗三种不同的罕见代谢紊乱:甲基丙二酸血症、急性间歇性卟啉症和法布里病。在此,我们回顾了在多种动物模型中的临床前疗效和安全性研究。对于这三种疾病,mRNA疗法将靶器官中的功能蛋白恢复到治疗相关水平,在每次给药mRNA后产生持续且可重复的药理学,并且耐受性良好,这在包括非人灵长类动物在内的动物模型中评估的肝功能测试支持。这些数据为mRNA疗法作为治疗各种罕见代谢紊乱的临床开发提供了令人信服的支持。

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