Beam Therapeutics, 238 Main Street, Cambridge, MA 02142, USA.
Gene Therapy Department, UMass Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
Mol Ther. 2022 Apr 6;30(4):1396-1406. doi: 10.1016/j.ymthe.2022.01.040. Epub 2022 Feb 2.
Alpha-1 antitrypsin deficiency (AATD) is a rare autosomal codominant disease caused by mutations within the SERPINA1 gene. The most prevalent variant in patients is PiZ SERPINA1, containing a single G > A transition mutation. PiZ alpha-1 antitrypsin (AAT) is prone to misfolding, leading to the accumulation of toxic aggregates within hepatocytes. In addition, the abnormally low level of AAT secreted into circulation provides insufficient inhibition of neutrophil elastase within the lungs, eventually causing emphysema. Cytosine and adenine base editors enable the programmable conversion of C⋅G to T⋅A and A⋅T to G⋅C base pairs, respectively. In this study, two different base editing approaches were developed: use of a cytosine base editor to install a compensatory mutation (p.Met374Ile) and use of an adenine base editor to mediate the correction of the pathogenic PiZ mutation. After treatment with lipid nanoparticles formulated with base editing reagents, PiZ-transgenic mice exhibited durable editing of SERPINA1 in the liver, increased serum AAT, and improved liver histology. These results indicate that base editing has the potential to address both lung and liver disease in AATD.
α1-抗胰蛋白酶缺乏症(AATD)是一种罕见的常染色体共显性遗传病,由 SERPINA1 基因内的突变引起。患者中最常见的变异是 PiZ SERPINA1,含有单个 G>A 转换突变。PiZ 型α1-抗胰蛋白酶(AAT)易于错误折叠,导致肝细胞内有毒聚集体的积累。此外,循环中异常低水平的 AAT 分泌提供了肺部中性粒细胞弹性蛋白酶抑制不足,最终导致肺气肿。胞嘧啶和腺嘌呤碱基编辑器能够分别实现 C⋅G 到 T⋅A 和 A⋅T 到 G⋅C 碱基对的可编程转换。在这项研究中,开发了两种不同的碱基编辑方法:使用胞嘧啶碱基编辑器引入补偿性突变(p.Met374Ile)和使用腺嘌呤碱基编辑器介导致病性 PiZ 突变的校正。用含有碱基编辑试剂的脂质纳米粒处理后,PiZ 转基因小鼠肝脏中 SERPINA1 持续编辑,血清 AAT 增加,肝组织学改善。这些结果表明,碱基编辑有可能解决 AATD 的肺部和肝脏疾病。
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