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      Cas9-AAV6 gene correction of beta-globin in autologous HSCs improves sickle cell disease erythropoiesis in mice

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          Abstract

          CRISPR/Cas9-mediated beta-globin ( HBB) gene correction of sickle cell disease (SCD) patient-derived hematopoietic stem cells (HSCs) in combination with autologous transplantation represents a recent paradigm in gene therapy. Although several Cas9-based HBB-correction approaches have been proposed, functional correction of in vivo erythropoiesis has not been investigated previously. Here, we use a humanized globin-cluster SCD mouse model to study Cas9-AAV6-mediated HBB-correction in functional HSCs within the context of autologous transplantation. We discover that long-term multipotent HSCs can be gene corrected ex vivo and stable hemoglobin-A production can be achieved in vivo from HBB-corrected HSCs following autologous transplantation. We observe a direct correlation between increased HBB-corrected myeloid chimerism and normalized in vivo red blood cell (RBC) features, but even low levels of chimerism resulted in robust hemoglobin-A levels. Moreover, this study offers a platform for gene editing of mouse HSCs for both basic and translational research.

          Abstract

          CRISPR mediated gene correction of sickle cell disease (SCD) in patient-derived hematopoietic stem cells is a promising avenue for therapy. Here the authors use a humanized SCD mouse model to study gene editing in the context of autologous transplantation.

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          Most cited references41

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          CRISPR/Cas9 β-globin gene targeting in human haematopoietic stem cells.

          The β-haemoglobinopathies, such as sickle cell disease and β-thalassaemia, are caused by mutations in the β-globin (HBB) gene and affect millions of people worldwide. Ex vivo gene correction in patient-derived haematopoietic stem cells followed by autologous transplantation could be used to cure β-haemoglobinopathies. Here we present a CRISPR/Cas9 gene-editing system that combines Cas9 ribonucleoproteins and adeno-associated viral vector delivery of a homologous donor to achieve homologous recombination at the HBB gene in haematopoietic stem cells. Notably, we devise an enrichment model to purify a population of haematopoietic stem and progenitor cells with more than 90% targeted integration. We also show efficient correction of the Glu6Val mutation responsible for sickle cell disease by using patient-derived stem and progenitor cells that, after differentiation into erythrocytes, express adult β-globin (HbA) messenger RNA, which confirms intact transcriptional regulation of edited HBB alleles. Collectively, these preclinical studies outline a CRISPR-based methodology for targeting haematopoietic stem cells by homologous recombination at the HBB locus to advance the development of next-generation therapies for β-haemoglobinopathies.
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            A high-fidelity Cas9 mutant delivered as a ribonucleoprotein complex enables efficient gene editing in human haematopoietic stem and progenitor cells

            Translation of the CRISPR/Cas9 system to human therapeutics holds high promise. Specificity remains a concern, however, especially when modifying stem cell populations. We show that existing rationally-engineered Cas9 high fidelity variants have reduced on-target activity using the therapeutically relevant ribonucleoprotein (RNP) delivery method. Therefore, we devised an unbiased bacterial screen to isolate variants that retain activity in the RNP format. Introduction of a single point mutation, R691A (HiFi Cas9), retained high on-target activity while reducing off-target editing. HiFi Cas9 induces robust AAV6-mediated gene targeting at five therapeutically-relevant loci (HBB, IL2RG, CCR5, HEXB, TRAC) in human CD34+ hematopoietic stem and progenitor cells (HSPCs) as well as primary T-cells. We also show that the HiFi Cas9 mediates high-level correction of the sickle cell disease (SCD)-causing Glu6Val mutation in SCD patient derived HSPCs. We anticipate that HiFi Cas9 will have wide utility for both basic science and therapeutic genome editing applications.
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              Increasing the efficiency of homology-directed repair for CRISPR-Cas9-induced precise gene editing in mammalian cells.

              The insertion of precise genetic modifications by genome editing tools such as CRISPR-Cas9 is limited by the relatively low efficiency of homology-directed repair (HDR) compared with the higher efficiency of the nonhomologous end-joining (NHEJ) pathway. To enhance HDR, enabling the insertion of precise genetic modifications, we suppressed the NHEJ key molecules KU70, KU80 or DNA ligase IV by gene silencing, the ligase IV inhibitor SCR7 or the coexpression of adenovirus 4 E1B55K and E4orf6 proteins in a 'traffic light' and other reporter systems. Suppression of KU70 and DNA ligase IV promotes the efficiency of HDR 4-5-fold. When co-expressed with the Cas9 system, E1B55K and E4orf6 improved the efficiency of HDR up to eightfold and essentially abolished NHEJ activity in both human and mouse cell lines. Our findings provide useful tools to improve the frequency of precise gene modifications in mammalian cells.
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                Author and article information

                Contributors
                adamcw@stanford.edu
                nakauchi@stanford.edu
                mporteus@stanford.edu
                Journal
                Nat Commun
                Nat Commun
                Nature Communications
                Nature Publishing Group UK (London )
                2041-1723
                29 January 2021
                29 January 2021
                2021
                : 12
                : 686
                Affiliations
                [1 ]GRID grid.168010.e, ISNI 0000000419368956, Institute for Stem Cell Biology and Regenerative Medicine, , Stanford University School of Medicine, ; Lorry I. Lokey Stem Cell Research Building, 265 Campus Drive, Stanford, CA USA
                [2 ]GRID grid.168010.e, ISNI 0000000419368956, Department of Genetics, , Stanford University School of Medicine, ; Stanford, CA USA
                [3 ]GRID grid.168010.e, ISNI 0000000419368956, Department of Pediatrics, , Stanford University School of Medicine, ; Stanford, CA USA
                [4 ]GRID grid.26999.3d, ISNI 0000 0001 2151 536X, Division of Stem Cell Therapy, Distinguished Professor Unit, The Institute of Medical Science, , The University of Tokyo, ; Tokyo, 108-8639 Japan
                Author information
                http://orcid.org/0000-0001-7406-0151
                http://orcid.org/0000-0001-5966-4803
                http://orcid.org/0000-0002-3102-5820
                http://orcid.org/0000-0003-1317-685X
                http://orcid.org/0000-0002-9841-6973
                http://orcid.org/0000-0002-3850-4648
                Article
                20909
                10.1038/s41467-021-20909-x
                7846836
                33514718
                a2bdb67f-5a35-439a-a29d-6c25754fabe8
                © The Author(s) 2021

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 5 October 2020
                : 23 December 2020
                Funding
                Funded by: FundRef https://doi.org/10.13039/100000050, U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI);
                Award ID: K99HL150218
                Award ID: R01HL135607
                Award ID: R01HL147124
                Award Recipient :
                Funded by: FundRef https://doi.org/10.13039/100005189, Leukemia and Lymphoma Society (Leukemia & Lymphoma Society);
                Award ID: 3385-19
                Award Recipient :
                Funded by: U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI)
                Funded by: FundRef https://doi.org/10.13039/100000062, U.S. Department of Health & Human Services | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (National Institute of Diabetes & Digestive & Kidney Diseases);
                Award ID: R01DK116944
                Award Recipient :
                Funded by: U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI)
                Funded by: FundRef https://doi.org/10.13039/100000900, California Institute for Regenerative Medicine (CIRM);
                Award ID: LA1_C12-06917
                Award Recipient :
                Funded by: FundRef https://doi.org/10.13039/100000862, Doris Duke Charitable Foundation (DDCF);
                Award ID: 2019112
                Award Recipient :
                Funded by: FundRef https://doi.org/10.13039/100000060, U.S. Department of Health & Human Services | NIH | National Institute of Allergy and Infectious Diseases (NIAID);
                Award ID: R01AI097320
                Award ID: R01AI120766
                Award Recipient :
                Funded by: U.S. Department of Health & Human Services | NIH | National Institute of Allergy and Infectious Diseases (NIAID)
                Categories
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                Custom metadata
                © The Author(s) 2021

                Uncategorized
                targeted gene repair,crispr-cas9 genome editing,haematopoietic stem cells
                Uncategorized
                targeted gene repair, crispr-cas9 genome editing, haematopoietic stem cells

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