Cabré-Romans Júlia-Jié, Cuella-Martin Raquel
Department of Human Genetics, McGill University, Montreal, QC, Canada.
Victor Phillip Dahdaleh Institute of Genomic Medicine, McGill University, Montreal, QC, Canada.
Front Genome Ed. 2025 Apr 2;7:1553590. doi: 10.3389/fgeed.2025.1553590. eCollection 2025.
Rare monogenic disorders are caused by mutations in single genes and have an incidence rate of less than 0.5%. Due to their low prevalence, these diseases often attract limited research and commercial interest, leading to significant unmet medical needs. In a therapeutic landscape where treatments are targeted to manage symptoms, gene editing therapy emerges as a promising approach to craft curative and lasting treatments for these patients, often referred to as "one-and-done" therapeutics. CRISPR-dependent base editing enables the precise correction of genetic mutations by direct modification of DNA bases without creating potentially deleterious DNA double-strand breaks. Base editors combine a nickase version of Cas9 with cytosine or adenine deaminases to convert C·G to T·A and A·T to G·C, respectively. Together, cytosine (CBE) and adenine (ABE) base editors can theoretically correct ∼95% of pathogenic transition mutations cataloged in ClinVar. This mini-review explores the application of base editing as a therapeutic approach for rare monogenic disorders. It provides an overview of the state of gene therapies and a comprehensive compilation of preclinical studies using base editing to treat rare monogenic disorders. Key considerations for designing base editing-driven therapeutics are summarized in a user-friendly guide for researchers interested in applying this technology to a specific rare monogenic disorder. Finally, we discuss the prospects and challenges for bench-to-bedside translation of base editing therapies for rare monogenic disorders.
罕见单基因疾病是由单个基因突变引起的,发病率低于0.5%。由于其低患病率,这些疾病往往吸引的研究和商业兴趣有限,导致大量未满足的医疗需求。在一个治疗方法旨在控制症状的治疗领域,基因编辑疗法成为一种有前景的方法,可为这些患者制定治愈性和持久性的治疗方案,通常被称为“一次治疗,终身受益”的疗法。依赖CRISPR的碱基编辑能够通过直接修饰DNA碱基来精确纠正基因突变,而不会产生潜在有害的DNA双链断裂。碱基编辑器将Cas9的切口酶版本与胞嘧啶或腺嘌呤脱氨酶结合,分别将C·G转化为T·A和A·T转化为G·C。总之,胞嘧啶碱基编辑器(CBE)和腺嘌呤碱基编辑器(ABE)理论上可以纠正ClinVar中列出的约95%的致病性转换突变。这篇综述探讨了碱基编辑作为罕见单基因疾病治疗方法的应用。它概述了基因治疗的现状,并全面汇编了使用碱基编辑治疗罕见单基因疾病的临床前研究。针对有兴趣将该技术应用于特定罕见单基因疾病的研究人员,以用户友好的指南形式总结了设计碱基编辑驱动疗法的关键考虑因素。最后,我们讨论了罕见单基因疾病碱基编辑疗法从 bench 到 bedside 转化的前景和挑战。
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