[Advances in gene therapy for β-thalassemia and hemophilia based on the CRISPR/Cas9 technology].

Thalassemia and hemophilia are common inherited blood disorders caused by genetic abnormalities. These diseases are difficult to cure and can be inherited to the next generation, causing severe family and social burden. The emergence of gene therapy provides a new treatment for genetic diseases. However, since its first clinical trial in 1990, the development of gene therapy has not been as optimistic in the past three decades as one could hope. The development of gene-editing technology, particularly the third generation gene-editing technology CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9), has given hope in such therapeutic approach for having advantages in high editing efficiency, simple operation, and low cost. Gene editing-mediated gene therapy has thus received increasing attention from the biomedical community. It has shown promises for the treatment of inherited blood disorders, such as thalassemia and hemophilia. This paper reviews the fundamental research progress of gene therapy for β-thalassemia and hemophilia based on CRISPR/Cas9 technology in the past six years. It also summarizes the CRISPR/Cas9-based clinical trials of gene therapy. The problems and possible solutions to this technology for gene therapy are also discussed, thereby providing a reference for the research on gene therapy of inherited blood disorders based on CRISPR/Cas9 technology.地中海贫血和血友病是由基因异常引发的常见的遗传性血液病,难以根治且可遗传给下一代,造成严重的家庭和社会负担。基因治疗的出现为遗传性疾病提供了新的治疗方案,但自1990年第1项基因治疗临床试验被批准以来,30年间基因治疗的发展并不乐观。随着基因编辑技术的发展,尤其具有编辑效率高、操作简单、成本低等优势的第三代基因编辑技术CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/ CRISPR-associated protein 9)的发展,基因编辑介导的基因治疗越来越受到关注,有望根治地中海贫血和血友病等遗传性血液病。本文综述了近6年(2014~2020年)基于CRISPR/Cas9技术的β-地中海贫血和血友病基因治疗基础研究进展,总结了基于CRISPR/Cas9技术的基因治疗临床试验概况,并对CRISPR/Cas9技术用于基因治疗存在的问题和可能的解决方案进行探讨,以期为基于CRISPR/Cas9技术的遗传性血液病基因治疗相关研究提供参考。.