Provided herein are methods of inserting a
nucleic acid encoding a polypeptide of interest into a target genomic locus in a
cell or a
population of cells in a subject, methods of expressing a polypeptide of interest from a target genomic locus in a
cell or a
population of cells in a subject, methods of treating an
enzyme deficiency in a subject in need thereof, and methods of preventing or reducing the onset of a
sign or symptom of an
enzyme deficiency in a subject in need thereof. Some methods, such as when a subject has preexisting against an
immunogen to be administered, use
plasma cell depleting agents or combinations comprising
plasma cell depleting agents to mitigate immune response and facilitate redosing of
nucleic acid constructs encoding a polypeptide of interest and
nuclease agents targeting a target genomic locus to achieve, for example, a step-wise increase in expression of a polypeptide of interest in a subject following
insertion of the
nucleic acid construct without overshooting. Other methods, such as when a subject has no preexisting
immunity against an
immunogen to be administered, use
B cell depleting agents (e.g., anti-CD20xCD3
antibody or functional fragment thereof) to mitigate immune response and facilitate redosing of nucleic acid constructs encoding a polypeptide of interest and
nuclease agents targeting a target genomic locus to achieve, for example, a step-wise increase in expression of a polypeptide of interest in a subject following
insertion of the nucleic acid construct without overshooting.