Gene correction for SCID-X1 in long-term hematopoietic stem cells

Nat Commun. 2019 Apr 9;10(1):1634. doi: 10.1038/s41467-019-09614-y.

Abstract

Gene correction in human long-term hematopoietic stem cells (LT-HSCs) could be an effective therapy for monogenic diseases of the blood and immune system. Here we describe an approach for X-linked sSevere cCombined iImmunodeficiency (SCID-X1) using targeted integration of a cDNA into the endogenous start codon to functionally correct disease-causing mutations throughout the gene. Using a CRISPR-Cas9/AAV6 based strategy, we achieve up to 20% targeted integration frequencies in LT-HSCs. As measures of the lack of toxicity we observe no evidence of abnormal hematopoiesis following transplantation and no evidence of off-target mutations using a high-fidelity Cas9 as a ribonucleoprotein complex. We achieve high levels of targeting frequencies (median 45%) in CD34+ HSPCs from six SCID-X1 patients and demonstrate rescue of lymphopoietic defect in a patient derived HSPC population in vitro and in vivo. In sum, our study provides specificity, toxicity and efficacy data supportive of clinical development of genome editing to treat SCID-Xl.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antigens, CD34 / metabolism
  • CRISPR-Cas Systems / genetics
  • Cell Line
  • Codon, Initiator / genetics
  • DNA, Complementary / genetics*
  • Dependovirus
  • Exons / genetics
  • Fetal Blood / cytology
  • Gene Editing / methods*
  • Genetic Vectors / genetics
  • Healthy Volunteers
  • Hematopoietic Stem Cell Transplantation*
  • Hematopoietic Stem Cells / metabolism
  • Humans
  • Interleukin Receptor Common gamma Subunit / genetics*
  • Male
  • Mice
  • Mutation
  • Parvovirinae / genetics
  • Primary Cell Culture
  • Time Factors
  • Transduction, Genetic / methods
  • Transplantation Chimera / genetics
  • Transplantation, Heterologous / methods
  • X-Linked Combined Immunodeficiency Diseases / genetics
  • X-Linked Combined Immunodeficiency Diseases / therapy*

Substances

  • Antigens, CD34
  • Codon, Initiator
  • DNA, Complementary
  • IL2RG protein, human
  • Interleukin Receptor Common gamma Subunit

Supplementary concepts

  • Adeno-associated virus-1