Efficient in vivo genome editing prevents hypertrophic cardiomyopathy in mice.

Efficient in vivo genome editing prevents hypertrophic cardiomyopathy in mice.
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DOI:
10.1038/s41591-022-02190-7
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发表时间:
2023-03
期刊:
影响因子:
82.9
通讯作者:
Seidman, Christine
Seidman, Christine
中科院分区:
医学1区
文献类型:
--
作者:
Reichart, Daniel;Newby, Gregory A.;Wakimoto, Hiroko;Lun, Mingyue;Gorham, Joshua M.;Curran, Justin J.;Raguram, Aditya;DeLaughter, Daniel M.;Conner, David A.;Marsiglia, Julia D. C.;Kohli, Sajeev;Chmatal, Lukas;Page, David C.;Zabaleta, Nerea;Vandenberghe, Luk;Liu, David R.;Seidman, Jonathan G.;Seidman, Christine

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心肌肌球蛋白重链的显性错义致病变异可导致肥厚性心肌病(HCM),这是一种目前无法治愈的疾病,可增加中风、心力衰竭和心源性猝死的风险。在这项研究中,我们评估了两种不同的遗传疗法——腺嘌呤碱基编辑器(ABE8e)和由aav9递送的强效Cas9核酸酶——来预防携带HCM杂合子致病变异肌球蛋白R403Q的小鼠的疾病。一剂双aav9载体,每个载体携带一半rna引导的ABE8e,在≥70%的心室心肌细胞中纠正致病变异,并维持持久、正常的心脏结构和功能。额外的剂量在心房中提供了更多的编辑,但也增加了旁观者的编辑。AAV9递送rna引导的Cas9核酸酶有效地灭活了致病等位基因,尽管具有剂量依赖性毒性,需要狭窄的治疗窗口来维持健康。这些临床前研究表明,单剂量基因疗法在纠正或沉默致病性变异和预防HCM发展方面具有相当大的潜力。使用腺嘌呤碱基编辑器和Cas9核酸酶的两种方法阻止了携带Myh6基因致病性突变的小鼠肥厚性心肌病的发展,突出了单剂量基因疗法治疗心脏病的潜力。
Dominant missense pathogenic variants in cardiac myosin heavy chain cause hypertrophic cardiomyopathy (HCM), a currently incurable disorder that increases risk for stroke, heart failure and sudden cardiac death. In this study, we assessed two different genetic therapies—an adenine base editor (ABE8e) and a potent Cas9 nuclease delivered by AAV9—to prevent disease in mice carrying the heterozygous HCM pathogenic variant myosin R403Q. One dose of dual-AAV9 vectors, each carrying one half of RNA-guided ABE8e, corrected the pathogenic variant in ≥70% of ventricular cardiomyocytes and maintained durable, normal cardiac structure and function. An additional dose provided more editing in the atria but also increased bystander editing. AAV9 delivery of RNA-guided Cas9 nuclease effectively inactivated the pathogenic allele, albeit with dose-dependent toxicities, necessitating a narrow therapeutic window to maintain health. These preclinical studies demonstrate considerable potential for single-dose genetic therapies to correct or silence pathogenic variants and prevent the development of HCM. Two approaches using an adenine base editor and a Cas9 nuclease prevented the development of hypertrophic cardiomyopathy in mice carrying a pathogenic mutation on the Myh6 gene, highlighting the potential of single-dose genetic therapies for the treatment of cardiac disease.
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