被嫌弃的AAV病毒递送系统

Core Viewpoint - The AAV (Adeno-Associated Virus) gene therapy sector is facing unprecedented challenges, including safety issues, high costs, and a significant withdrawal of major pharmaceutical companies from AAV projects [1][2][3][4]. Industry Challenges - AAV has transitioned from a highly sought-after delivery system to one facing skepticism and abandonment by major pharmaceutical companies [2][3]. - The industry is experiencing a crisis of confidence due to multiple safety incidents, including patient deaths linked to AAV therapies [13][14]. - High costs associated with AAV therapies, often exceeding $1 million, limit accessibility and create financial burdens for companies [10][12]. Technical Limitations - AAV's small capacity (approximately 4.7 kb) restricts its ability to deliver larger genes, necessitating complex strategies that may compromise efficacy [6]. - Immune responses triggered by AAV can lead to severe complications, including inflammation and organ damage, complicating treatment outcomes [7][8][9]. - The presence of neutralizing antibodies in the population poses significant barriers to the effectiveness of AAV therapies, limiting patient eligibility and treatment options [9]. Market Dynamics - Major companies like Pfizer, Roche, and Takeda have withdrawn from AAV research, reallocating resources to more promising areas [14][15]. - The capital market's enthusiasm for AAV has shifted to a more cautious approach, leading to financing difficulties for biotech firms focused on AAV therapies [15][16]. Future Directions - Despite the challenges, some companies are exploring new delivery systems, such as lipid nanoparticles (LNPs) and polymer nanoparticles, which may offer advantages over AAV [18]. - Companies like uniQure are focusing on optimizing AAV vectors and targeting specific diseases, indicating that AAV may still have a role in certain niches [19][21]. - The industry consensus suggests that while gene therapy remains promising, AAV is no longer the sole solution, and innovation in delivery methods is essential for future success [21].