Corneal Regeneration Using Gene Therapy Approaches

Abstract

One of the most remarkable advancements in medical treatments of corneal diseases in recent decades has been corneal transplantation. However, corneal transplants, including lamellar strategies, have their own set of challenges, such as graft rejection, delayed graft failure, shortage of donor corneas, repeated treatments, and post-surgical complications. Corneal defects and diseases are one of the leading causes of blindness globally; therefore, there is a need for gene-based interventions that may mitigate some of these challenges and help reduce the burden of blindness. Corneas being immune-advantaged, uniquely avascular, and transparent is ideal for gene therapy approaches. Well-established corneal surgical techniques as well as their ease of accessibility for examination and manipulation makes corneas suitable for in vivo and ex vivo gene therapy. In this review, we focus on the most recent advances in the area of corneal regeneration using gene therapy and on the strategies involved in the development of such therapies. We also discuss the challenges and potential of gene therapy for the treatment of corneal diseases. Additionally, we discuss the translational aspects of gene therapy, including different types of vectors, particularly focusing on recombinant AAV that may help advance targeted therapeutics for corneal defects and diseases.

Current Advances in Regenerative Strategies for Dry Eye Diseases: A Comprehensive Review

“…On the other hand, non-viral vectors, although safer, currently suffer from low delivery efficiency, presenting a significant obstacle in clinical applications [63]. Various approaches, including topical drops as well as intrastromal and subconjunctival injections, can be explored to enhance the accurate and targeted delivery of the therapeutic gene [64]. Gene therapy for treating inherited corneal dystrophies operates through three methods: (a) suppressing or deactivating the mutated gene causing harmful effects on cells; (b) repairing or substituting the mutated gene with a functional version of a healthy gene; or (c) introducing a healthy version of the gene that will produce the therapeutic protein elsewhere to alleviate the disease symptoms [64].…”