biopreparatБИОпрепараты. Профилактика, диагностика, лечениеBiological Products. Prevention, Diagnosis, Treatment2221-996X2619-1156Scientific Centre for Expert Evaluation of Medicinal Products10.30895/2221-996X-2019-19-4-225-232biopreparat-254Research ArticleОБЗОРЫREVIEWSТерапия генетических заболеваний: актуальные направления разработки биомедицинских клеточных продуктовTreatment of Genetic Diseases: Current Trends in the Development of Biomedical Cell Productshttps://orcid.org/0000-0002-9555-1950РачинскаяО. А.RachinskayaO. A.

Рачинская Ольга Анатольевна, канд. биол. наук

Петровский б-р, д. 8, стр. 2, Москва, 127051

Olga A. Rachinskaya, Cand. Sci. (Biol.)

8/2 Petrovsky Blvd, Moscow 127051

Rachinskaya@expmed.ruhttps://orcid.org/0000-0002-6008-0554ВодяковаМ. А.VodyakovaM. A.

Водякова Марина Андреевна

Петровский б-р, д. 8, стр. 2, Москва, 127051

Marina A. Vodyakova

8/2 Petrovsky Blvd, Moscow 127051

vodyakova@expmed.ruhttps://orcid.org/0000-0002-9585-3545МельниковаЕ. В.MelnikovaE. V.

Мельникова Екатерина Валерьевна, канд. биол. наук

Петровский б-р, д. 8, стр. 2, Москва, 127051

Ekaterina V. Melnikova, Cand. Sci. (Biol.)

8/2 Petrovsky Blvd, Moscow 127051

Melnikova@expmed.ruhttps://orcid.org/0000-0003-4891-973XМеркуловВ. А.MerkulovV. A.

Меркулов Вадим Анатольевич, д-р мед. наук, проф.

Петровский б-р, д. 8, стр. 2, Москва, 127051;Трубецкая ул., д. 8, стр. 2, Москва, 119991

Vadim A. Merkulov, Dr. Sci. (Med.), Professor

8/2 Petrovsky Blvd, Moscow 127051;8/2 Trubetskaya St., Moscow 119991

Merkulov@expmed.ruФедеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской ФедерацииРоссияScientific Centre for Expert Evaluation of Medicinal ProductsRussian FederationФедеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской Федерации; Федеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет им. И. М. Сеченова» Министерства здравоохранения Российской ФедерацииРоссияScientific Centre for Expert Evaluation of Medicinal Products; I. M. Sechenov First Moscow State Medical UniversityRussian Federation201915112019194225232Copyright © Рачинская О.А., Водякова М.А., Мельникова Е.В., Меркулов В.А., 20192019Рачинская О.А., Водякова М.А., Мельникова Е.В., Меркулов В.А.Rachinskaya O.A., Vodyakova M.A., Melnikova E.V., Merkulov V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.biopreparations.ru/jour/article/view/254

Генетические заболевания в большинстве случаев носят прогрессирующий характер и без соответствующего лечения приводят к смерти или инвалидизации человека. Актуальными проблемами мирового здравоохранения являются как трудность диагностики, так и отсутствие эффективного лечения для многих генетических заболеваний. Медицинская помощь пациентам с генетическими заболеваниями часто сводится к симптоматическому и паллиативному лечению. Начиная с 2000-х годов перспективным направлением для терапии таких заболеваний являются препараты на основе жизнеспособных клеток человека (в соответствии с законодательством Российской Федерации — биомедицинские клеточные продукты) и генотерапевтические препараты. Цель работы — обзор актуальных направлений разработки биомедицинских клеточных продуктов для лечения генетических заболеваний. В работе рассмотрены препараты на основе клеток для лечения таких моногенных генетических заболеваний, как тяжелый комбинированный иммунодефицит (SCID), рецессивный дистрофический буллезный эпидермолиз (RDEB), β-гемоглобинопатии, дефицит альфа-1-антитрипсина, гемофилия А и мышечная дистрофия Дюшенна. Разработка подобных препаратов осуществляется во многих странах и находится на разных стадиях: доклинические и разные фазы клинических исследований. Для одного заболевания могут разрабатываться препараты, содержащие разные типы жизнеспособных клеток: дифференцированных, стволовых и фибробластов, индуцированных плюрипотентных, а также ex vivo генетически модифицированных. Приоритетными задачами разработки таких препаратов являются отказ от проведения заместительной терапии или паллиативного лечения, а также существенное увеличение продолжительности и качества жизни пациентов.

Genetic diseases are often progressive in nature, and without proper treatment may result in disability or death. Difficulties with diagnosis of genetic diseases and lack of effective treatment are global public health challenges. Medical care for patients with genetic diseases is often confined to symptomatic and palliative care. Starting from the 2000s, great hopes have been placed on cell-based medicinal products (which are referred to as biomedical cell products in the Russian legislation) and gene therapy products. The aim of the study was to review current trends in the development of biomedical cell products for the treatment of genetic diseases. The paper focuses on cell-based products for the treatment of monogenic genetic diseases, such as severe combined immunodeficiency (SCID), recessive dystrophic epidermolysis bullosa (RDEB), beta-haemoglobinopathies, alpha-1-antitrypsin deficiency, haemophilia A, and Duchenne muscular dystrophy. Such drugs are being developed in many countries and are now entering preclinical and different stages of clinical trials. Products based on various types of viable cells, including differentiated cells, stem cells, induced pluripotent cells, as well as cells genetically modified ex vivo, may be developed for the treatment of one and the same disease. The main priority is the creation of such products that will obviate the need for replacement therapy or palliative care, and that will significantly increase life expectancy and quality of life.

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The authors declare that there are no conflicts of interest present.