Gene editing and CRISPR in the clinic: current and future perspectives

Author:

Hirakawa Matthew P.1,Krishnakumar Raga1,Timlin Jerilyn A.2,Carney James P.3,Butler Kimberly S.2ORCID

Affiliation:

1. Systems Biology, Sandia National Laboratories, Livermore, CA 94551, U.S.A.

2. Molecular and Microbiology, Sandia National Laboratories, Albuquerque, NM 87185, U.S.A.

3. Advanced Materials Laboratory, Sandia National Laboratories, Albuquerque, NM 87185, U.S.A.

Abstract

Abstract Genome editing technologies, particularly those based on zinc-finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), and CRISPR (clustered regularly interspaced short palindromic repeat DNA sequences)/Cas9 are rapidly progressing into clinical trials. Most clinical use of CRISPR to date has focused on ex vivo gene editing of cells followed by their re-introduction back into the patient. The ex vivo editing approach is highly effective for many disease states, including cancers and sickle cell disease, but ideally genome editing would also be applied to diseases which require cell modification in vivo. However, in vivo use of CRISPR technologies can be confounded by problems such as off-target editing, inefficient or off-target delivery, and stimulation of counterproductive immune responses. Current research addressing these issues may provide new opportunities for use of CRISPR in the clinical space. In this review, we examine the current status and scientific basis of clinical trials featuring ZFNs, TALENs, and CRISPR-based genome editing, the known limitations of CRISPR use in humans, and the rapidly developing CRISPR engineering space that should lay the groundwork for further translation to clinical application.

Publisher

Portland Press Ltd.

Subject

Cell Biology,Molecular Biology,Biochemistry,Biophysics

Reference296 articles.

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