0 cm in diameter (1,745 0f 2,464, 71%) compared to patients with no reported comorbidities (996 of 2,596, 38%, P < 0.001). Conclusion: Although more HCC patients were diagnosed with early disease over time, the use of curative treatments in this patient group has recently plateaued. Efforts to identify and treat more eligible candidates for curative therapy could be beneficial. (Hepatology 2014;60:1637–1644) "
“Adeno-associated virus (AAV) vectors are ideal for performing gene repair due to their ability to target buy LDK378 multiple different genomic loci, low immunogenicity, capability
to achieve targeted and stable expression through integration, and low mutagenic and oncogenic potential. However, many handicaps to gene repair therapy remain. Most notable is the low frequency of correction in vivo. To date, this frequency is too low to be of therapeutic value for any disease. To address this, a point-mutation–based mouse model of the metabolic disease hereditary tyrosinemia type I was used to test whether targeted AAV integration by homologous recombination could
achieve high-level stable gene repair in vivo. Both neonatal and adult mice were treated with AAV serotypes 2 and 8 carrying a wild-type genomic sequence for repairing the mutated Fah (fumarylacetoacetate hydrolase) gene. Hepatic gene repair was quantified by immunohistochemistry and supported with reverse transcription polymerase chain reaction and serology for functional correction parameters. Successful gene repair was observed with both serotypes but was more efficient with AAV8. Correction frequencies of Tamoxifen in vitro up to 10−3 were achieved selleck chemicals and highly reproducible within typical dose ranges. In this model, repaired hepatocytes have a selective growth advantage
and are thus able to proliferate to efficiently repopulate mutant livers and cure the underlying metabolic disease. Conclusion: AAV-mediated gene repair is feasible in vivo and can functionally correct an appropriate selection-based metabolic liver disease in both adults and neonates. (HEPATOLOGY 2010.) Gene therapy is a promising means to cure many monogenic diseases. However, traditional gene therapies are best suited to treat diseases of deficient or absent gene products rather than those diseases caused by aberrantly functioning proteins. Even now, gene therapy efforts remain focused on gene addition strategies using full-length complementary DNA (cDNA) cassettes for the mutated gene of interest, driven by promoter and enhancer sequences.1 Despite many advances, gene addition approaches with adeno-associated virus (AAV) are limited by transient and unregulated expression,2 highly random integrations,3 transgene silencing,4 and increased mutagenic and oncogenic risks.5 Not all protein-coding genes have open reading frames small enough to fit within the low coding capacity of AAV (4.7 kb), thus, this type of gene therapy is not applicable for all disorders.