Department of Biology, East Carolina University, Greenville, North Carolina, USA.
J Cell Physiol. 2021 Apr;236(4):2459-2481. doi: 10.1002/jcp.30064. Epub 2020 Sep 22.
Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated enzyme (Cas) is a naturally occurring genome editing tool adopted from the prokaryotic adaptive immune defense system. Currently, CRISPR/Cas9-based genome editing has been becoming one of the most promising tools for treating human genetic diseases, including cardiovascular diseases, neuro-disorders, and cancers. As the quick modification of the CRISPR/Cas9 system, including delivery system, CRISPR/Cas9-based gene therapy has been extensively studied in preclinic and clinic treatments. CRISPR/Cas genome editing is also a robust tool to create animal genetic models for studying and treating human genetic disorders, particularly diseases associated with point mutations. However, significant challenges also remain before CRISPR/Cas technology can be routinely employed in the clinic for treating different genetic diseases, which include toxicity and immune response of treated cells to CRISPR/Cas component, highly throughput delivery method, and potential off-target impact. The off-target effect is one of the major concerns for CRISPR/Cas9 gene therapy, more research should be focused on limiting this impact by designing high specific gRNAs and using high specificity of Cas enzymes. Modifying the CRISPR/Cas9 delivery method not only targets a specific tissue/cell but also potentially limits the off-target impact.
成簇规律间隔短回文重复序列(CRISPR)/CRISPR 相关酶(Cas)是一种天然存在的基因组编辑工具,源自原核生物适应性免疫防御系统。目前,基于 CRISPR/Cas9 的基因组编辑已成为治疗人类遗传疾病的最有前途的工具之一,包括心血管疾病、神经紊乱和癌症。作为 CRISPR/Cas9 系统的快速修饰,包括递送系统,基于 CRISPR/Cas9 的基因治疗已在临床前和临床治疗中得到广泛研究。CRISPR/Cas 基因组编辑也是创建用于研究和治疗人类遗传疾病的动物遗传模型的强大工具,特别是与点突变相关的疾病。然而,在 CRISPR/Cas 技术能够常规用于治疗不同遗传疾病之前,仍然存在重大挑战,包括处理细胞对 CRISPR/Cas 成分的毒性和免疫反应、高通量递送方法和潜在的脱靶影响。脱靶效应是 CRISPR/Cas9 基因治疗的主要关注点之一,应更多地关注通过设计高特异性 gRNA 和使用 Cas 酶的高特异性来限制这种影响。修饰 CRISPR/Cas9 的递送方法不仅可以靶向特定的组织/细胞,还可以潜在地限制脱靶影响。
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