(1) Background: Existing lipid-lowering therapies have difficulty in achieving lipid target levels in patients with familial hypercholesterolemia (FH), especially in the treatment of patients with homozygous familial hypercholesterolemia. (2) Method: All of the literature data containing “Familial hypercholesterolemia” and “Gene Therapy” in PubMed and Clinical Trials from 2018 to 2022 were selected. (3) Results: The rapid development of gene therapy technology in recent years is expected to change the treatment status of FH patients. As emerging gene therapy vectors, the optimized adeno-associated viruses, exosomes, and lipid nanoparticles have demonstrated an improved safety and higher transfection efficiency. Various RNA-targeted therapies are in phase 1–3 clinical trials, such as small interfering RNA-based drugs inclisiran, ARO-ANG3, ARO-APOC3, olpasiran, SLN360, and antisense oligonucleotide-based drugs AZD8233, vupanorsen, volanesorsen, IONIS-APO(a)Rx, etc., all of which have demonstrated excellent lipid-lowering effects. With gene editing technologies, such as CRISPR-Cas 9 and meganuclease, completing animal experiments in mice or cynomolgus monkeys and demonstrating lasting lipid-lowering effects, patients with FH are expected to reach a permanent cure in the future. (4) Conclusion: Gene therapy is being widely used for the lipid-lowering treatment of FH patients and has shown excellent therapeutic promise, but the current delivery efficiency, economic burden, immunogenicity and the precision of gene therapy can be further optimized.
DEET (N, N-diethyl-m-toluamide) is a widely used insect repellent with potential neurotoxic effects. However, its impact on mental health in the general population remains unclear. This study investigates the association between DEET exposure and depression and sleep disorders, exploring the mediating roles of obesity indicators and serum albumin. Data from the National Health and Nutrition Examination Survey (NHANES) 2007–2016 were analyzed. Urinary levels of 3-(diethylaminoformyl) benzoic acid (DCBA), a DEET metabolite, were used as an exposure marker. Depression was defined according to the scores of Patient Health questionnaire-9 (PHQ-9), and sleep disorders were diagnosed according to participants' self-reports. Multivariate logistic regression and restricted cubic spline analysis were employed to assess the associations of DCBA with depression and sleep disorders. Mediating analyses explored the roles of obesity indicators and serum albumin. Subgroup analysis further explored the differences among different populations. Higher DCBA levels were positively associated with depression and sleep disorders. Mediating analysis revealed that body mass index (BMI), waist circumference (WC), and serum albumin mediated 11.16%, 12.66%, and 7.04% of the association between DEET exposure and depression, respectively. Subgroup analysis identified increased susceptibility among women and individuals of other races. Sensitivity analysis enhanced the robustness of the results. DEET exposure is associated with an increased risk of depression and sleep disorders, mediated by obesity and liver function indicators. These findings highlight the need for public health measures to reduce DEET exposure and further research into its mechanisms of action on mental health.