Gene Therapy and Oligonucleotide Thrapy (EXAM 3) Flashcards

1
Q

What is Gene therapy used for?

A

-Replacing a missing or defective gene (CFTR - cystic fibrosis)
-silencing overactive genes (STAT 3)
-repair genes - genome editing
-prosthetic gene therapy

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2
Q

Two types of Gene therapy

A

Targets somatic cells
Targets germ cells (eggs, sperm) - not in development

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3
Q

How are genes delivered for gene therapy?

A

Means of delivery: Vectors or non-viral approaches

Mode of delivery:
Direct (in vivo): IV into the tissue or giving a drug
Indirect (ex vivo): cell is isolated from the body (in vitro) -> editing -> put back into the patient (in vivo)

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4
Q

What happens with the virus once it delivers the gene into the host cell?

A

-integration into the host genome
-episomal: replication of viral genes without integrating

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5
Q

How can viruses be used as a vector for gene therapy?

A

-Retrovirus: integrating virus, stable modification of target cells bc integrated, cant infect non-dividing cells (no dividing - no integration), mild immunogenicity

-Adenovirus: episomal - non-intergrating (uses machinery for replication), brief activity, can infect a non-dividing cell, high immunogenicity

-Adeno-associated Virus: integrating and episomal, can infect non-dividing cells, duration of gene expression for a long period, mild immunogenicity

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6
Q

How can viruses be used as a vector for gene therapy?

A

-Retrovirus: integrating virus, stable modification of target cells bc integrated, cant infect non-dividing cells (no dividing - no integration), mild immunogenicity

-Adenovirus: episomal - non-integrating (uses machinery for replication), brief activity, can infect a non-dividing cell, high immunogenicity

-Adeno-associated Virus: integrating and episomal, can infect non-dividing cells, duration of gene expression for a long period, mild immunogenicity

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7
Q

How is the replication of delivered viruses (vectors) ensured?

A

-remove genes that is essential for viral replication and replace it with the gene of interest -> place the altered virus + vector with essential genes separately into HEK cells -> the virus can duplicate bc of the essential genes on the plasmid -> harvest the viruses and use it to deliver genes into human -> the virus is safe because it doesn’t have the genes to replicate independently

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8
Q

Risks of virus-based gene delivery

A

-Immune reaction
-virus may insert the gene of interest in the wrong place
-affect other genes, inactivate genes

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9
Q

What is a tool used for ex vivo editing?

A

CRISPR-CAS -> correction of mutant beta-globin gene to correct sickle cell anemia

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10
Q

What are non-viral approaches to delivering genes?

A

-Synthetic liposomes mimicking the cell membrane

-DNA is negatively charged, the quaternary lipid amines are positively charged -> liposomes protect DNA/RNA from nucleases

-Compared to viral delivery the transfection is not as efficient -> with liposomes the DNA/RNA enters the nucleus randomly (when a cell divides pores open up)

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11
Q

Advantages, and Disadvantages of non-viral delivery

A

Advantage:
-non-immunogenic
-multiple administration
-less chance of mutagenesis
-can be manipulated easily

Disadvantages:
-low transduction efficacy, non-specific uptake of the vector
-poor delivery
-gene expression is not sustained

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12
Q

Chimeric antigen therapy (CAR-T)
EX-VIVO Gene transfer

A

T-cells harvested from patient -> ex vivo gene transfer: equip T-cells with CD19 receptors -> now able to recognize cancerous B-cells (lymphoma) -> plant it back to the patient

-Human T-cell: KYMRIAH, YESCARTA

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13
Q

How does Luxturna work?
Lux (latin): light

A

-cells processing the light are degenerating
-adenovirus carries the gene -> cells (non-dividing) take up the virus and replace the “broken” gene

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14
Q

Gene Therapy for Spinal muscular Atrophy

A

SMA = protein required for motor proteins -> degenerates when not sufficient

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15
Q

What are ways to use Oligonucleotides in therapy?

A

-SiRNA
-miRNA
-Aptamers
-CpG
-Antisense (ASO)

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16
Q

MOA of Antisense Oligos

A

-ASO binds and promotes endonuclease digestion

-ASO binds and produces an altered protein

17
Q

Antisense treatment: Fomiversen

A

-15-40% of HIV patients (low immune system) suffer from CMV-retinitis (blindness)

-ASO binds to viral mRNA and mediates endonuclease

18
Q

Duchenne Muscular Distrophy

A

alteration of dystrophin causes progressive muscle degeneration and weakness

-engineered ASO binds to frameshift mutation site -> leading to Exon Skipping: the exon causing the mutation is skipped during transcription due to ASO binding there

-the altered product is party functional
-helps 13% of DMD patients

19
Q

small interference RNA interference: siRNA

A

-siRNA ad ds and can bind specifically to mRNA
-bind to protein complex containing the mRNA = RISC
-bind to their target and prevent ribosome from translation + mark the mRNA for destruction

20
Q

Patisiran: siRNA

A

-gain of function mutation -> liver produces more TTR protein than it should -> TTR binds to Amyloid fibrils -> plaques deposited in organs (heart, lungs)

-destroys mRNA and prevents amyloid accumulation

21
Q

What are Aptamers?

A

-RNA and DNA that takes 3D structure (protein-like)
Able to bind to proteins specifically with high affinity like antibodies
-easier to make
-not immunogenic

22
Q

Aptamer: Pegaptanib (MACUGEN)

A

-used for wet Macular degeneration
-VEGF causes blood vessel generation -> becomes leaky and fluid builds up and damages the retina causing blindness
-Pegaptanib is PEGylated and has a longer-half-life

23
Q

How does PEGylation prolong the half-life of a drug?

A

-Digesting enzymes cant bin readily
-drugs cant be filtered well in the glomerulus due to enlargement due to PEGylation

24
Q

What are CpG Oligonucleotides?

A

-(bacterial CpG can trigger immune system)

-unmethylated cytosine-phosphodiester-guanine (CpG) acting as immunostimulants to cells with TLR9 -> B-cells, macrophages, dendritic cells, monocytes

-this triggering factor can be used as adjuvant

25
Q

Barriers of Antisense Oligonucleotides (AON)

A

-susceptible to nucleases
-accumulate in kidneys, liver, bone marrow, muscles
-poor cellular uptake
-short half-life