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Gene Therapy

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  • January 30, 2024
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  • 2022/2023
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Gene Therapy
Genetic Therapeutics
Introduction to Gene Therapy
 Gene therapy has potential to treat many disorders
o Inherited diseases- e.g. Cystic Fibrosis
o Cancers
o Infectious diseases
o Immune disorders

What do we meant by gene therapy?
Definition
 Describes any procedure intended to treat or alleviate disease by genetically modifying cells of patient
 Method of gene therapy can include- use of DNA, RNA or oligonucleotides

Categories of Gene Therapy
There are two broad categories of gene therapy:
 Germ line cells- genetically modified to produce permanent modification
o This can be transmitted to descendants
o Its achieved by modifying DNA of gamete (egg or sperm), zygote, or early embryo
o Germ-line therapy is banned in humans for ethical reasons
 Somatic cells- genetically modified
o Somatic cells are any adult cells that isn’t gametes, germ cells or stem cells
o This seeks to modify specific cells or tissues of patient in a way that its not passed on and is confined only to
that patient

Somatic Cell Gene Therapy: Strategies
Cells that are targeted are typically cells that are involved in pathogenesis of disease
There are usually two strategies:
1. Modify disease cells to alleviate disease
2. Selectively kill disease cell
Strategy can depend on type of mutation in disease cells
Strategy 1- modifying disease cell can include gene augmentation, gene silencing or repair of mutant gene
Gene Augmentation
 Gene augmentation- where functional copied of gene are added back into
cells that lack it
 Works well if disease is caused by loss of function mutation
Gene Silencing
 Gene silencing- where expression of gene is selectively inhibited
 Useful if gene being expressed is harmful
o E.g. gain of function mutation
 Can be achieved by turning off transcription of harmful gene- leading to
gene silencing
Gene Repair
 Strategy involves trying to repair gene mutation
 Restore normal gene function or to minimise effect of
mutation

Selectively killing
diseased cells
 Directly kill disease causing cells

, o Involved directly targeting harmful cells with gene that will kill them- called
suicide gene
 Targeting disease cells in more INDIRECT way- assisted killing- where immune system
is modified to enhance its response to disease cells and initiate cell death

Gene Transfer
 Gene transfer relies on delivery of genetic material into
patient
 Identifying best delivery mechanism possible for cell types being targeted
 Two general approaches for gene transfer:
o In-vivo- direct delivery
o Ex-vivo- cell-based delivery

Gene transfer in different cell types
 Challenge to gene therapy- life span of cells being
targeted
o Some cells are much shorter lived than others
 Short lived cells- need to divide to replenish last cells and genetic material being used
for gene therapy might not be passed onto newly divided cells
o Consequence- loss of therapeutic effectiveness
 Long lived cells- non-dividing; genetic information isn’t lost
o Consequence- easier to treat that short lived cells
But, therapeutic effect still depends on efficiency of transferring therapeutic genetic material into cells

Technology of Gene Therapy
 Gene transfer- potential of this technique to treat disease relies on method to get DNA into patient cell
o Non-toxic
o Target DNA to particular cells
o Introduce DNA into cell in transcriptionally active form
o Express gene at reasonable level for sufficient time

DNA must be packaged in delivery vehicle
 Non-viral
o Liposomes
 Viral
o Retrovirus
o Lentivirus
o Adenovirus
o Adeno-associated viruses

Liposomes
 Liposomes contain therapeutic gene
 Take up into cell via endocytosis or clathrin coated pits
 DNA avoids degradation by lysosomes and is taken up into nucleus
 Once in nucleus, gene needs to be expressed

Plasmid Expression Vector
 To achieve high levels of expression gene must be placed into plasmid
expression vector

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