[HTML][HTML] CRISPR/Cas9-induced (CTG⋅ CAG) n repeat instability in the myotonic dystrophy type 1 locus: implications for therapeutic genome editing

EL Van Agtmaal, LM André, M Willemse, SA Cumming… - Molecular therapy, 2017 - cell.com
EL Van Agtmaal, LM André, M Willemse, SA Cumming, ID Van Kessel, WJ Van Den Broek…
Molecular therapy, 2017cell.com
Myotonic dystrophy type 1 (DM1) is caused by (CTG⋅ CAG) n-repeat expansion within the
DMPK gene and thought to be mediated by a toxic RNA gain of function. Current attempts to
develop therapy for this disease mainly aim at destroying or blocking abnormal properties of
mutant DMPK (CUG) n RNA. Here, we explored a DNA-directed strategy and demonstrate
that single clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9-
cleavage in either its 5′ or 3′ unique flank promotes uncontrollable deletion of large …
Myotonic dystrophy type 1 (DM1) is caused by (CTG⋅CAG)n-repeat expansion within the DMPK gene and thought to be mediated by a toxic RNA gain of function. Current attempts to develop therapy for this disease mainly aim at destroying or blocking abnormal properties of mutant DMPK (CUG)n RNA. Here, we explored a DNA-directed strategy and demonstrate that single clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9-cleavage in either its 5′ or 3′ unique flank promotes uncontrollable deletion of large segments from the expanded trinucleotide repeat, rather than formation of short indels usually seen after double-strand break repair. Complete and precise excision of the repeat tract from normal and large expanded DMPK alleles in myoblasts from unaffected individuals, DM1 patients, and a DM1 mouse model could be achieved at high frequency by dual CRISPR/Cas9-cleavage at either side of the (CTG⋅CAG)n sequence. Importantly, removal of the repeat appeared to have no detrimental effects on the expression of genes in the DM1 locus. Moreover, myogenic capacity, nucleocytoplasmic distribution, and abnormal RNP-binding behavior of transcripts from the edited DMPK gene were normalized. Dual sgRNA-guided excision of the (CTG⋅CAG)n tract by CRISPR/Cas9 technology is applicable for developing isogenic cell lines for research and may provide new therapeutic opportunities for patients with DM1.
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