基因疗法 - AAV 载体
腺相关病毒 (AAV) 载体可以用于将基因转移到光感受器和视网膜色素上皮 (RPE) 细胞。此治疗已用于不同类型视网膜变性的大鼠中。2008 年,临床试验开始用于有异常基因 RPE65的人类受试者。使用 AAV 载体将 RPE65 基因注入到患者的视网膜中。[24]Bainbridge JW, Smith AJ, Barker SS, et al. Effect of gene therapy on visual function in Leber's congenital amaurosis. N Engl J Med. 2008;358:2231-2239.http://www.nejm.org/doi/full/10.1056/NEJMoa0802268#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/18441371?tool=bestpractice.com[25]Bainbridge JW, Ali RR. Success in sight: the eyes have it! Ocular gene therapy trials for LCA look promising. Gene Ther. 2008;15:1191-1192.http://www.nature.com/gt/journal/v15/n17/full/gt2008117a.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/18711389?tool=bestpractice.comX-连锁无脉络膜症患者中的临床试验也已开始。[26]MacLaren RE, Groppe M, Barnard AR, et al. Retinal gene therapy in patients with choroideremia: initial findings from a phase 1/2 clinical trial. Lancet. 2014;383:1129-1137.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171740/http://www.ncbi.nlm.nih.gov/pubmed/24439297?tool=bestpractice.com
二十二碳六烯酸
二十二碳六烯酸是一种ω-3 脂肪酸。它先前已用于视网膜色素变性的患者中,但是成功概率有限。更近的一项研究使用二十二碳六烯酸联合维生素 A(视黄醇)进行治疗,已显示出在治疗的头2 年内对疾病进展的控制有轻微效果。[27]Berson EL, Rosner B, Sandberg MA, et al. Clinical trial of docosahexaenoic acid in patients with retinitis pigmentosa receiving vitamin A treatment. Arch Ophthalmol. 2004;122:1297-1305.http://www.ncbi.nlm.nih.gov/pubmed/15364708?tool=bestpractice.com[28]Hoffman DR, Locke KG, Wheaton DH, et al. A randomized, placebo-controlled clinical trial of docosahexaenoic acid supplementation for X-linked retinitis pigmentosa. Am J Ophthalmol. 2004;137:704-718.http://www.ncbi.nlm.nih.gov/pubmed/15059710?tool=bestpractice.com[29]Berson EL, Rosner B, Sandberg MA, et al. Further evaluation of docosahexaenoic acid in patients with retinitis pigmentosa receiving vitamin A treatment: subgroup analyses. Arch Ophthalmol. 2004;122:1306-1314.http://www.ncbi.nlm.nih.gov/pubmed/15364709?tool=bestpractice.com
干细胞治疗、移植和人工视觉
这些是所有目前正在研究中的领域,希望它们可以成为视网膜色素变性和伴随夜盲症相关疾病的患者的治疗方法。RP Fighting Blindness: research