Alterations of the 5′GT splice motif or 3′AG splice motif result in severe missplicing and are prevalent in many genetic diseases, including
cystic fibrosis (CF). While
protein-targeted modulator therapies are currently available for treatment of CF, individuals with these canonical splice site variants (CSSVs) are among the ˜10% who remain untreated. The most common CF-causing variant in individuals of African descent is a CSSV, c.2988+1G>A. While >75% of individuals with a CSSV have a modulator eligible in trans
allele, only 50% of the 450 individuals bearing c.2988+1G>A are eligible. Thus, there is a particular unmet need for a treatment for these individuals.
CRISPR / Cas9-mediated adenine base editing (ABE) is an efficient and targeted
genome editing method correct G>A variants. We electroporated NRCH-ABE8e mRNA and a previously optimized sgRNA to non-differentiated human primary nasal (HNE) or bronchial (HBE) epithelial cells from individuals with CF compound heterozygous for c.2988+1G>A. After differentiation of edited cells genomic editing and
recovery of CFTR channel function were assessed. In primary HBEs and primary HNEs, we observed an allelic conversion to WT of 74.7% and 81.3%, respectively, at the +1 site. Interestingly, we also observed high levels of editing at adjacent adenines (+3, +7), which would have a modest effect on mRNA splicing (˜20% reduction). However, this did not preclude
recovery of CFTR channel function. Compared to WT / WT HBEs and HNEs, unedited cells showed ˜5% function, while edited cells achieved >50% function. Since
electroporation is not a translationally viable delivery approach, we investigated polymeric
nanoparticle mediated delivery to both primary HBE and HNE cells by
flow cytometry. GFP mRNA evaluated
transfection efficiency and
cell viability across three dosages (150, 75, 32.5 ng), four
polymer-to-mRNA weight-to-weight ratios (60, 40, 30, 20) and three polymers (R, X, Y). HBEs transfected with polymers R & Y showed ˜57%
transfection at 75 and 32.5 ng, with
polymer X averaging ˜25% across the same dosages.
Polymer Y showed slightly higher viability of HBEs vs.
polymer R. HNEs in comparison achieved a maximum of ˜37% GFP
transfection with polymers R & Y at 32.5 ng compared to a maximum of ˜22% with polymer X at the same
dose, with 75-95% viability across all polymers. The ABE design reported here corrects c.2988+1G>A in
airway epithelia with high efficiency when robust delivery is achieved. Given that
nanoparticle optimization allowed successful delivery to >50% of cells, we anticipate clinically significant
recovery of function
in vivo by combining this ABE design with an optimized polymeric
nanoparticle.