Recent Advancements in CRISPR-Cas9 Technology for Precision Gene Editing and Therapeutic Applications
DOI:
https://doi.org/10.63682/jns.v14i7.6384Keywords:
CRISPR-Cas9, gene editing, base editing, prime editing, genome engineering, high-fidelity Cas9, off-target effects, precision medicineAbstract
The CRISPR-Cas9 system has emerged as a transformative tool in genetic engineering, enabling scientists to edit genomes with unprecedented precision, efficiency, and simplicity. Since its adaptation from a prokaryotic immune mechanism to a gene-editing platform, CRISPR-Cas9 has rapidly progressed from bench research to translational and clinical applications. This paper presents a comprehensive review of the most recent advancements in CRISPR-Cas9 technology, particularly focusing on innovations that enhance the accuracy, versatility, and therapeutic utility of gene editing. Key breakthroughs include the development of base editing and prime editing technologies, which allow for single-nucleotide substitutions and complex DNA insertions or deletions without creating double-stranded breaks. These tools have significantly expanded the scope of precise genetic modifications and minimized genotoxicity.
Moreover, the engineering of high-fidelity Cas9 variants—such as eSpCas9, SpCas9-HF1, and HypaCas9—has markedly reduced off-target activity, thereby addressing one of the major limitations in clinical genome editing. Innovations in delivery strategies, including the use of viral vectors (e.g., AAV, lentivirus), lipid nanoparticles, and electroporation of ribonucleoprotein complexes, have improved the in vivo and ex vivo application of CRISPR-Cas9 for therapeutic purposes. Notable clinical progress has been observed in the treatment of genetic disorders such as sickle cell disease, β-thalassemia, and hereditary blindness, with several patients experiencing durable therapeutic benefits. Simultaneously, CRISPR-based immunotherapies are being explored for cancers and viral infections, such as HIV, marking a shift toward more personalized and targeted treatments.
Despite these advances, challenges remain, including immune responses to Cas9 proteins, potential mosaicism in edited cells, ethical concerns regarding germline editing, and regulatory hurdles that govern clinical translation. Furthermore, the integration of computational tools, including machine learning and deep learning algorithms, has become critical for optimizing guide RNA design, predicting off-target effects, and refining editing outcomes. This integration of biotechnology and computational sciences is propelling the CRISPR field into a new era of precision medicine.
In conclusion, recent advancements in CRISPR-Cas9 technology are not only pushing the boundaries of what is technically feasible in genome editing but are also laying the groundwork for safe, effective, and personalized therapeutic applications. As the technology continues to mature, it holds the promise to redefine the future of medicine, particularly in the treatment and potential cure of a wide range of genetic and complex diseases.
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Anzalone, A. V., Randolph, P. B., Davis, J. R., Sousa, A. A., Koblan, L. W., Levy, J. M., ... & Liu, D. R. (2019). Search-and-replace genome editing without double-strand breaks or donor DNA. Nature, 576(7785), 149–157.
Bao, C., & Liu, F. (2024). DeepFM-Crispr: Prediction of CRISPR On-Target Effects via Deep Learning. arXiv preprint arXiv:2409.05938.
Cheng, Q., Wei, T., Jia, Y., Farbiak, L., Zhou, K., Zhang, Y., ... & Siegwart, D. J. (2021). Dendrimer-Based Lipid Nanoparticles Deliver Therapeutic FAH mRNA to Normalize Liver Function and Extend Survival in a Mouse Model of Hepatorenal Tyrosinemia Type I. Advanced Materials, 33(50), 2102064.
Cruz, E., & Kay, M. A. (2021). Delivery of CRISPR-Cas9 for Therapeutic Genome Editing: Challenges and Future Prospects. Gene Therapy, 28(10), 683–692.
Doudna, J. A., & Charpentier, E. (2014). The new frontier of genome engineering with CRISPR-Cas9. Science, 346(6213), 1258096.
Gillmore, J. D., Gane, E., Taubel, J., Kao, J., Fontana, M., Maitland, M. L., ... & Lebwohl, D. (2021). CRISPR-Cas9 In Vivo Gene Editing for Transthyretin Amyloidosis. New England Journal of Medicine, 385(6), 493–502.
Huang, K., Qu, Y., Cousins, H. R., Johnson, W. A., Yin, D., Shah, M., ... & Wang, M. (2024). CRISPR-GPT: An LLM Agent for Automated Design of Gene-Editing Experiments. arXiv preprint arXiv:2404.18021.
Jinek, M., Chylinski, K., Fonfara, I., Hauer, M., Doudna, J. A., & Charpentier, E. (2012). A programmable dual-RNA–guided DNA endonuclease in adaptive bacterial immunity. Science, 337(6096), 816–821.
Koblan, L. W., Doman, J. L., Wilson, C., Levy, J. M., Tay, T., Newby, G. A., ... & Liu, D. R. (2018). Improving cytidine and adenine base editors by expression optimization and ancestral reconstruction. Nature Biotechnology, 36(9), 843–846.
Li, H., Yang, Y., Hong, W., Huang, M., Wu, M., & Zhao, X. (2020). Applications of genome editing technology in the targeted therapy of human diseases: mechanisms, advances and prospects. Signal Transduction and Targeted Therapy, 5(1), 1–23.
Liu, J., & Ma, J. (2023). Comparative Analysis of Machine Learning Algorithms for Predicting On-Target and Off-Target Effects of CRISPR-Cas13d for Gene Editing. arXiv preprint arXiv:2305.06769.
Liu, X., Zhang, Y., Chen, Y., Li, M., Zhou, Y., & Zhao, X. (2021). Recent advances in delivery strategies for CRISPR/Cas9 gene editing. Frontiers in Bioengineering and Biotechnology, 9, 719553.
Maeder, M. L., & Gersbach, C. A. (2016). Genome-editing technologies for gene and cell therapy. Molecular Therapy, 24(3), 430–446.
Musunuru, K., Chadwick, A. C., Mizoguchi, T., Garcia, S. P., DeNizio, J. E., Reiss, C. W., ... & Vonderheide, R. H. (2021). In vivo CRISPR base editing of PCSK9 durably lowers cholesterol in primates. Nature, 593(7859), 429–434.
Qiu, M., Glass, Z., Chen, J., Haas, M., Jin, X., & Xu, Q. (2021). Lipid nanoparticle-mediated codelivery of Cas9 mRNA and single-guide RNA achieves liver-specific in vivo genome editing of Angptl3. Proceedings of the National Academy of Sciences, 118(10), e2020401118.
Ran, F. A., Hsu, P. D., Wright, J., Agarwala, V., Scott, D. A., & Zhang, F. (2013). Genome engineering using the CRISPR-Cas9 system. Nature Protocols, 8(11), 2281–2308.
Rees, H. A., & Liu, D. R. (2018). Base editing: precision chemistry on the genome and transcriptome of living cells. Nature Reviews Genetics, 19(12), 770–788.
Sago, C. D., Lokugamage, M. P., Islam, F. Z., Krupczak, B. R., Sato, M., & Dahlman, J. E. (2018). Nanoparticles that deliver RNA to bone marrow identified by in vivo directed evolution. Journal of the American Chemical Society, 140(49), 17095–17105.
Sanjana, N. E., Shalem, O., & Zhang, F. (2014). Improved vectors and genome-wide libraries for CRISPR screening. Nature Methods, 11(8), 783–784.
Schwank, G., Koo, B. K., Sasselli, V., Dekkers, J. F., Heo, I., Demircan, T., ... & Clevers, H. (2013). Functional repair of CFTR by CRISPR/Cas9 in intestinal stem cell organoids of cystic fibrosis patients. Cell Stem Cell, 13(6), 653–658.
Sharma, R., Anguela, X. M., Doyon, Y., Wechsler, T., DeKelver, R. C., Sproul, S., ... & High, K. A. (2015). In vivo genome editing of the albumin locus as a platform for protein replacement therapy. Blood, 126(15), 1777–1784.
Wang, D., Zhang, F., & Gao, G. (2020). CRISPR-based therapeutic genome editing: strategies and in vivo delivery by AAV vectors. Cell, 181(1), 136–150.
Wang, H. X., Li, M., Lee, C. M., Chakraborty, S., Kim, H. W., Bao, G., & Leong, K. W. (2017). CRISPR/Cas9-based genome editing for disease modeling and therapy: challenges and opportunities for nonviral delivery. Chemical Reviews, 117(15), 9874–9906.
Zhang, Y., Zhang, F., & Li, X. (2021). CRISPR/Cas9 genome editing: progress, challenges, and future prospects. Signal Transduction and Targeted Therapy, 6(1), 1–23.
Zhou, J., & Rossi, J. (2017). Aptamers as targeted therapeutics: current potential and challenges. Nature Reviews Drug Discovery, 16(3), 181–202.
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