CRISPR/Cas9-mediated glycolate oxidase disruption is an efficacious and safe treatment for primary hyperoxaluria type I

Nat Commun. 2018 Dec 21;9(1):5454. doi: 10.1038/s41467-018-07827-1.

Abstract

CRISPR/Cas9 technology offers novel approaches for the development of new therapies for many unmet clinical needs, including a significant number of inherited monogenic diseases. However, in vivo correction of disease-causing genes is still inefficient, especially for those diseases without selective advantage for corrected cells. We reasoned that substrate reduction therapies (SRT) targeting non-essential enzymes could provide an attractive alternative. Here we evaluate the therapeutic efficacy of an in vivo CRISPR/Cas9-mediated SRT to treat primary hyperoxaluria type I (PH1), a rare inborn dysfunction in glyoxylate metabolism that results in excessive hepatic oxalate production causing end-stage renal disease. A single systemic administration of an AAV8-CRISPR/Cas9 vector targeting glycolate oxidase, prevents oxalate overproduction and kidney damage, with no signs of toxicity in Agxt1-/- mice. Our results reveal that CRISPR/Cas9-mediated SRT represents a promising therapeutic option for PH1 that can be potentially applied to other metabolic diseases caused by the accumulation of toxic metabolites.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alcohol Oxidoreductases / antagonists & inhibitors*
  • Alcohol Oxidoreductases / genetics
  • Animals
  • CRISPR-Cas Systems*
  • Disease Models, Animal
  • Gene Editing
  • Genetic Therapy / methods*
  • HEK293 Cells
  • Humans
  • Hyperoxaluria, Primary / therapy*
  • Male
  • Mice
  • Nephrocalcinosis / prevention & control
  • Oxalates / urine*

Substances

  • Oxalates
  • Alcohol Oxidoreductases
  • glycollate oxidase

Supplementary concepts

  • Primary hyperoxaluria type 1