CRISPR-Directed Therapeutic Correction at the NCF1 Locus Is Challenged by Frequent Incidence of Chromosomal Deletions
MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT
Authors: Wrona, Dominik; Pastukhov, Oleksandr; Pritchard, Robert S.; Raimondi, Federica; Tchinda, Joelle; Jinek, Martin; Siler, Ulrich; Reichenbach, Janine
Abstract
Resurrection of non-processed pseudogenes may increase the efficacy of therapeutic gene editing, upon simultaneous targeting of a mutated gene and its highly homologous pseudogenes. To investigate the potency of this approach for clinical gene therapy of human diseases, we corrected a pseudogene-associated disorder, the immunodeficiency p47(phox)-deficient chronic granulomatous disease (p47(phox) CGD), using clustered regularly interspaced short palindromic repeats-associated nuclease Cas9 (CRISPR-Cas9) to target mutated neutrophil cytosolic factor 1 (NCF1). Being separated by less than two million base pairs, NCF1 and two pseudogenes are closely co-localized on chromosome 7. In healthy people, a two-nucleotide GT deletion (DGT) is present in the NCF1B and NCF1C pseudogenes only. In the majority of patients with p47(phox) CGD, the NCF1 gene is inactivated due to a DGT transfer from one of the two non-processed pseudogenes. Here we demonstrate that concurrent targeting and correction of mutated NCF1 and its pseudogenes results in therapeutic CGD phenotype correction, but also causes potentially harmful chromosomal deletions between the targeted loci in a p47(phox)-deficient CGD cell line model. Therefore, development of genome-editing-based treatment of pseudogene-related disorders mandates thorough safety examination, as well as technological advances, limiting concurrent induction of multiple double-strand breaks on a single chromosome.
Clinical, Functional and Genetic Analysis of Twenty-Four Patients with Chronic Granulomatous Disease - Identification of Eight Novel Mutations in CYBB and NCF2 Genes
JOURNAL OF CLINICAL IMMUNOLOGY
Authors: Martel, Cecile; Mollin, Michelle; Beaumel, Sylvain; Brion, Jean Paul; Coutton, Charles; Satre, Veronique; Vieville, Gaelle; Callanan, Mary; Lefebvre, Christine; Salmon, Alexandra; Pagnier, Anne; Plantaz, Dominique; Bost-Bru, Cecile; Eitenschenck, Laurence; Durieu, Isabelle; Floret, Daniel; Galambrun, Claire; Chambost, Herve; Michel, Gerard; Stephan, Jean-Louis; Hermine, Olivier; Blanche, Stephane; Blot, Nathalie; Rubie, Herve; Pouessel, Guillaume; Drillon-Haus, Stephanie; Conrad, Bernard; Posfay-Barbe, Klara M.; Havlicekova, Zuzana; Voskresenky-Baricic, Tamara; Jadranka, Kelecic; Cristina Arriazu, Maria; Alberto Garcia, Luis; Ben Mansour, Lamia Sfaihi; Bordigoni, Pierre; Stasia, Marie Jose
Abstract
Chronic granulomatous disease is an inherited disorder in which phagocytes lack a functional NADPH oxidase and cannot produce superoxide anions. The most common form is caused by mutations in CYBB encoding gp91phox. We investigated 24 CGD patients and their families. Twenty-one mutations in CYBB were classified as X91(0), X91(+) or X91(-) variants according to cytochrome b (558) expression. Point mutations in encoding regions represented 50 % of the mutations found in CYBB, splice site mutations 27 %, deletions and insertions 23 %. Eight mutations in CYBB were novel leading to X91(0)CGD cases. Two of these were point mutations: c493G > T and a double mutation c625C > G in exon 6 and c1510C > T in exon 12 leading to a premature stop codon at Gly165 in gp91phox and missense mutations His209Arg/Thr503Ile respectively. Two novel splice mutations in 5'intronic regions of introns 1 and 6 were found. A novel deletion/insertion c1024_1026delCTG/insT results in a frameshift introducing a stop codon at position 346 in gp91phox. The last novel mutation was the insertion of a T at c1373 leading to a frameshift and a premature stop codon at position 484 in gp91phox. For the first time the precise size of two large mutations in CYBB was determined by array-comparative genomic hybridization and carriers' status were evaluated by multiplex ligation-dependent probe amplification assay. No clear correlation between clinical severity and CYBB mutations could be established. Of three mutations in CYBA, NCF1 and NCF2 leading to rare autosomal recessive CGD, one nonsense mutation c29G > A in exon 1 of NCF2 was new.