1. Base editing of haematopoietic stem cells rescues sickle cell disease in mice
- Author
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Jonathan Yen, Gregory A. Newby, Kalin Mayberry, Akshay Sharma, Michelle Richter, Thiyagaraj Mayuranathan, Kevin T. Zhao, Cicera R. Lazzarotto, Christophe Lechauve, Theodosia A. Kalfa, Elizabeth Thaman, Luke W. Koblan, Shondra M. Pruett-Miller, Heather Sheppard-Tillman, David R. Liu, Mitchell J. Weiss, Shengdar Q. Tsai, John F. Tisdale, Kaitly J. Woodard, Yoonjeong Jang, Christopher J. Podracky, Kelcee A. Everette, Shannon M. Miller, Tina Wang, Shaina N. Porter, Anton P. McCaffrey, Jordana M. Henderson, Yichao Li, and Yu Yao
- Subjects
Male ,0301 basic medicine ,medicine.medical_treatment ,Cell ,Antigens, CD34 ,Anemia, Sickle Cell ,beta-Globins ,Hematopoietic stem cell transplantation ,Article ,Mice ,03 medical and health sciences ,0302 clinical medicine ,CRISPR-Associated Protein 9 ,medicine ,Animals ,Humans ,Progenitor cell ,Gene Editing ,Multidisciplinary ,Genome, Human ,business.industry ,Adenine ,Hematopoietic Stem Cell Transplantation ,Genetic Therapy ,Hematopoietic Stem Cells ,Transplantation ,Disease Models, Animal ,Haematopoiesis ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Cancer research ,Female ,Bone marrow ,Stem cell ,business ,Ex vivo - Abstract
Sickle cell disease (SCD) is caused by a mutation in the β-globin gene HBB1. We used a custom adenine base editor (ABE8e-NRCH)2,3 to convert the SCD allele (HBBS) into Makassar β-globin (HBBG), a non-pathogenic variant4,5. Ex vivo delivery of mRNA encoding the base editor with a targeting guide RNA into haematopoietic stem and progenitor cells (HSPCs) from patients with SCD resulted in 80% conversion of HBBS to HBBG. Sixteen weeks after transplantation of edited human HSPCs into immunodeficient mice, the frequency of HBBG was 68% and hypoxia-induced sickling of bone marrow reticulocytes had decreased fivefold, indicating durable gene editing. To assess the physiological effects of HBBS base editing, we delivered ABE8e-NRCH and guide RNA into HSPCs from a humanized SCD mouse6 and then transplanted these cells into irradiated mice. After sixteen weeks, Makassar β-globin represented 79% of β-globin protein in blood, and hypoxia-induced sickling was reduced threefold. Mice that received base-edited HSPCs showed near-normal haematological parameters and reduced splenic pathology compared to mice that received unedited cells. Secondary transplantation of edited bone marrow confirmed that the gene editing was durable in long-term haematopoietic stem cells and showed that HBBS-to-HBBG editing of 20% or more is sufficient for phenotypic rescue. Base editing of human HSPCs avoided the p53 activation and larger deletions that have been observed following Cas9 nuclease treatment. These findings point towards a one-time autologous treatment for SCD that eliminates pathogenic HBBS, generates benign HBBG, and minimizes the undesired consequences of double-strand DNA breaks. A custom adenine base editor can edit the variant of the β-globin gene that causes sickle cell disease into a non-pathogenic variant in human and mouse cells, and transplantation of the edited cells rescues sickle cell disease in mice.
- Published
- 2021
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