Regional Variation in Cardiovascular Genes Enables a Tractable Genome Editing Strategy

BACKGROUND: To realize the potential of genome engineering therapeutics, tractable strategies must be identified that balance personalized therapy with the need for off-the-shelf availability. We hypothesized that regional clustering of pathogenic variants can inform the design of rational prime editing therapeutics to treat the majority of genetic cardiovascular diseases with a limited number of reagents.

METHODS: We collated 2435 high-confidence pathogenic/likely pathogenic (P/LP) variants in 82 cardiovascular disease genes from ClinVar. We assessed the regional density of these variants by defining a regional clustering index. We then combined a highly active base editor with prime editing to demonstrate the feasibility of a P/LP hotspot-directed genome engineering therapeutic strategy in vitro.

RESULTS: P/LP variants in cardiovascular disease genes display higher regional density than rare variants found in the general population. P/LP missense variants displayed higher average regional density than P/LP truncating variants. Following hypermutagenesis at a pathogenic hotspot, mean prime editing efficiency across introduced variants was 57±27%.

CONCLUSIONS: Designing therapeutics that target pathogenic hotspots will not only address known missense P/LP variants but also novel P/LP variants identified in these hotspots as well. Moreover, the clustering of P/LP missense rather than truncating variants in these hotspots suggests that prime editing technology is particularly valuable for dominant negative disease. Although prime editing technology in relation to cardiac health continues to improve, this study presents an approach to targeting the most impactful regions of the genome for inherited cardiovascular disease.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:17

Enthalten in:

Circulation. Genomic and precision medicine - 17(2024), 2 vom: 18. Apr., Seite e004370

Sprache:

Englisch

Beteiligte Personen:

Krysov, Vikki A [VerfasserIn]
Wilson, Rachel H [VerfasserIn]
Ten, Nicholas S [VerfasserIn]
Youlton, Nathan [VerfasserIn]
De Jong, Hannah N [VerfasserIn]
Sutton, Shirley [VerfasserIn]
Huang, Yong [VerfasserIn]
Reuter, Chloe M [VerfasserIn]
Grove, Megan E [VerfasserIn]
Wheeler, Matthew T [VerfasserIn]
Ashley, Euan A [VerfasserIn]
Parikh, Victoria N [VerfasserIn]

Links:

Volltext

Themen:

Cluster analysis
Feasibility studies
Gene editing
Genetics
Journal Article
Mutagenesis

Anmerkungen:

Date Completed 18.04.2024

Date Revised 18.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1161/CIRCGEN.123.004370

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369956605