国际眼科纵览 ›› 2026, Vol. 50 ›› Issue (3): 161-171.doi: 10.3760/cma.j.cn115500-20251031-26301

• 综述 •    下一篇

基因编辑技术在眼病研究中的应用

陈志宇1  王升1  张琳昳1  王伟伟2  熊思维3   

  1. 1 陕西中医药大学第二附属医院眼科 陕西中医药大学,陕西咸阳 712046; 2 西安市人民医院(西安市第四医院)陕西省眼科医院,西安 710004; 3西安医学院,西安 710021

  • 收稿日期:2025-10-31 出版日期:2026-06-22 发布日期:2026-06-06
  • 通讯作者: 王伟伟,Email:hybweiwei@126.com
  • 基金资助:
    国家自然科学基金(81500719)

Application of gene editing technology in ocular diseases research

Chen Zhiyu1, Wang Sheng1, Zhang Linyi1, Wang Weiwei2, Xiong Siwei3   

  1. 1 Department of Ophthalmology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Shaanxi University of Chinese Medicine, Xianyang Shaanxi 712046, China; 2 Shaanxi Eye Hospital, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an 710004, China; 3 Xi’an Medical University, Xi’an 710021, China
  • Received:2025-10-31 Online:2026-06-22 Published:2026-06-06
  • Contact: Wang Weiwei, Email: hybweiwei@126.com
  • Supported by:
    National Natural Science Foundation of China (81500719)

摘要: 基因编辑是指通过基因编辑技术对生物体基因组特定目标进行修饰的过程,目前主要采用成簇规律间隔短回文重复序列及其相关蛋白9(clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9, CRISPR/Cas9)为代表的第三代编辑工具。CRISPR基因编辑疗法的EDIT-101改善了部分10型Leber先天性黑矇患者的视功能,对常染色体显性遗传视网膜色素变性(retinitis pigmentosa, RP)进展到了更精准的先导编辑,X连锁遗传RP也在小鼠模型的治疗中取得了较好的效果且已构造出更理想的犬动物模型;Stargardt病在非人灵长类动物中实现了对光感受器和色素上皮细胞的高效编辑。在年龄相关性黄斑变性中,新生血管性年龄相关性黄斑变性的HG202疗法已进入临床试验,早期结果显示疗效良好;干性年龄相关性黄斑变性则在细胞模型上完成了对补体因子基因的编辑。靶向房水生成相关基因的编辑可降低青光眼小鼠眼压,并对神经节细胞起到保护作用。基因编辑治疗单纯疱疹病毒性角膜炎和转化生长因子β诱导角膜营养不良的临床研究已证实了良好的安全性和抗病毒效果。然而,基因编辑技术仍面临递送系统的效率与容量限制、编辑的精准性与脱靶风险和长期应用的未知副作用等重大挑战。

关键词: 基因编辑, 碱基编辑, 先导编辑, RNA编辑, 遗传性视网膜病

Abstract: Gene editing refers to the process of modifying specific targets in an organism’s genome using gene-editing technologies, with the third-generation editing tools represented by clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) currently being the primary approach. In Leber congenital amaurosis type 10, EDIT-101 yielded anatomical and functional improvements in a subset of patients. For autosomal dominant retinitis pigmentosa (RP), therapeutic strategies have evolved toward more precise prime editing; similarly, X-linked RP has shown favorable outcomes in murine models, alongside the establishment of optimized dog animal models. In Stargardt disease, efficient editing of photoreceptors and retinal pigment epithelial cells has been achieved in non-human primates. Regarding age-related macular degeneration (AMD), the HG202 therapy for neovascular AMD has entered clinical trials, with early data indicating favorable therapeutic efficacy; meanwhile, dry AMD studies have successfully targeted complement factor genes in cellular models. In glaucoma, editing genes associated with aqueous humor production effectively lowered intraocular pressure in mouse models and conferred protection to retinal ganglion cells. Furthermore, clinical investigations into herpes simplex keratitis and transforming growth factor beta induced corneal dystrophy have confirmed the safety profile and robust antiviral effects of gene editing interventions. Nevertheless, significant challenges remain, including limitations in delivery system efficiency and capacity, precision and off-target risks, and unknown long-term side effects.

Key words: Gene editing, Base editing, Prime editing, RNA base editing, Inherited retinal diseases