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Research Consortium Identifies 188 New CRISPR Gene-Editing Systems, Some More Accurate than CRISPR

New gene-editing systems could provide markedly improved accuracy for DNA and RNA editing leading to new precision medicine tools and genetic therapies

In what may turn out to be a significant development in genetic engineering, researchers from three institutions have identified nearly 200 new systems that can be used for editing genes. It is believed that a number of these new systems can provide comparable or better accuracy when compared to CRISPER (Clustered Regularly Interspaced Short Palindromic Repeats), currently the most-used gene editing method.

CRISPR-Cas9 has been the standard tool for CRISPR gene editing and genetic engineering. However, publication of these new research findings are expected to give scientists better, more precise tools to edit genes. In turn, these developments could lead to new clinical laboratory tests and precision medicine therapies for patients with inherited genetic diseases.

Researchers from Broad Institute, Massachusetts Institute of Technology (MIT), and the federal National Institutes of Health (NIH) have uncovered 188 new CRISPR systems “in their native habitat of bacteria” with some showing superior editing capabilities, New Atlas reported.

“Best known as a powerful gene-editing tool, CRISPR actually comes from an inbuilt defense system found in bacteria and simple microbes called archaea. CRISPR systems include pairs of ‘molecular scissors’ called Cas enzymes, which allow microbes to cut up the DNA of viruses that attack them. CRISPR technology takes advantage of these scissors to cut genes out of DNA and paste new genes in,” according to Live Science.

In its article, New Atlas noted that the researchers looked to bacteria because “In nature, CRISPR is a self-defense tool used by bacteria.” They developed an algorithm—called FLSHclust—to conduct “a deep dive into three databases of bacteria, found in environments as diverse as Antarctic lakes, breweries, and dog saliva.”

The research team published their findings in the journal Science titled, “Uncovering the Functional Diversity of Rare CRISPR-Cas Systems with Deep Terascale Clustering.”

In their paper, the researchers wrote, “We developed fast locality-sensitive hashing–based clustering (FLSHclust), a parallelized, deep clustering algorithm with linearithmic scaling based on locality-sensitive hashing. FLSHclust approaches MMseqs2, a gold-standard quadratic-scaling algorithm, in clustering performance. We applied FLSHclust in a sensitive CRISPR discovery pipeline and identified 188 previously unreported CRISPR-associated systems, including many rare systems.”

“In lab tests [the newfound CRISPR systems] demonstrated a range of functions, and fell into both known and brand new categories,” New Atlas reported.

Soumya Kannan, PhD

“Some of these microbial systems were exclusively found in water from coal mines,” Soumya Kannan, PhD (above), a Graduate Fellow at MIT’s Zhang Lab and co-first author of the study, told New Atlas. “If someone hadn’t been interested in that, we may never have seen those systems.” These new gene-editing systems could lead to new clinical laboratory genetic tests and therapeutics for chronic diseases. (Photo copyright: MIT McGovern Institute.)

Deeper Look at Advancement                    

The CRISPR-Cas9 made a terrific impact when it was announced in 2012, earning a Nobel Prize in Chemistry.

Though CRISPR-Cas9 brought huge benefits to genetic research, the team noted in their Science paper that “existing methods for sequence mining lag behind the exponentially growing databases that now contain billions of proteins, which restricts the discovery of rare protein families and associations.

“We sought to comprehensively enumerate CRISPR-linked gene modules in all existing publicly available sequencing data,” the scientist continued. “Recently, several previously unknown biochemical activities have been linked to programmable nucleic acid recognition by CRISPR systems, including transposition and protease activity. We reasoned that many more diverse enzymatic activities may be associated with CRISPR systems, many of which could be of low abundance in existing [gene] sequence databases.”

Among the previously unknown gene-editing systems the researchers found were some belonging to the Type 1 CRISPR systems class. These “have longer guide RNA sequences than Cas9. They can be directed to their targets more precisely, reducing the risk of off-target edits—one of the main problems with CRISPR gene editing,” New Atlas reported.

“The authors also identified a CRISPR-Cas enzyme, Cas14, which cuts RNA precisely. These discoveries may help to further improve DNA- and RNA-editing technologies, with wide-ranging applications in medicine and biotechnology,” the Science paper noted.

Testing also showed these systems were able to edit human cells, meaning “their size should allow them to be delivered in the same packages currently used for CRISPR-Cas9,” New Atlas added.

Another newfound gene-editing system demonstrated “collateral activity, breaking down nucleic acids after binding to the target, New Atlas reported. SHERLOCK, a tool used to diagnose single samples of RNA or DNA to diagnose disease, previously utilized this system.

Additionally, New Atlas noted, “a type VII system was found to target RNA, which could unlock a range of new tools through RNA editing. Others could be adapted to record when certain genes are expressed, or as sensors for activity in cells.”

Looking Ahead

The strides in science from the CRISPR-Cas9 give a hint at what can come from the new discovery. “Not only does this study greatly expand the field of possible gene editing tools, but it shows that exploring microbial ecosystems in obscure environments could pay off with potential human benefits,” New Atlas noted.

“This study introduces FLSHclust as a tool to cluster millions of sequences quickly and efficiently, with broad applications in mining large sequence databases. The CRISPR-linked systems that we discovered represent an untapped trove of diverse biochemical activities linked to RNA-guided mechanisms, with great potential for development as biotechnologies,” the researchers wrote in Science.

How these newfound gene-editing tools and the new FLSHclust algorithm will eventually lead to new clinical laboratory tests and precision medicine diagnostics is not yet clear. But the discoveries will certainly improve DNA/RNA editing, and that may eventually lead to new clinical and biomedical applications.

—Kristin Althea O’Connor

Related Information:

Algorithm Identifies 188 New CRISPR Gene-Editing Systems

188 New Types of CRISPR Revealed by Algorithm

FLSHclust, a New Algorithm, Reveals Rare and Previously Unknown CRISPR-Cas Systems

Uncovering the Functional Diversity of Rare CRISPR-Cas Systems with Deep Terascale Clustering

Questions and Answers about CRISPR

Annotation and Classification of CRISPR-Cas Systems

SHERLOCK: Nucleic Acid Detection with CRISPR Nucleases

University of Maryland Scientists Image World’s First ‘Vampire Virus’

Research could lead to improvements in gene therapy and antiviral resistance medications while also possibly leading to a new class of clinical laboratory tests

Scientists at the University of Maryland, Baltimore County (UMBC) have discovered what may be the scariest virus of all—the Vampire Virus. It’s a term that may inspire “Walking Dead” level horror in the wake of the COVID-19 pandemic, and though virologists and microbiologists might be tempted to dismiss them as imaginary, they are all too real. Even more apropos to the Dracula saga, the UM scientists found them in a soil sample. Yikes!

Happily, this ghoulish discovery could have positive implications for gene editing, gene therapy, and the development of new antiviral medications, according to The Conversation. In turn, these positive implications may eventually trigger the need to create new diagnostic tests that clinical laboratories can offer to physicians.

The UMBC scientists published their findings in the journal ISME, a publication of the International Society for Microbial Ecology, titled, “Simultaneous Entry as an Adaptation to Virulence in a Novel Satellite-Helper System Infecting Streptomyces Species.”

Vampire-like virus photo

The image above, taken from a University of Maryland news release, shows the satellite virus “latched onto its helper virus.” Discovery of vampire-like viruses that attach at the “neck” of other viruses may lead to important discoveries in the development of gene editing and antiviral therapies. Might clinical laboratories one day collect samples for pharmaceutical developers engaged in combating antiviral drug resistance? (Photo copyright: University of Maryland.)

Spotting a Vampire Virus

According to IFLScience, these tiny vampire viruses were first discovered by undergraduates who believed they were looking at sample contamination when analyzing sequences of bacteriophages from environmental soil samples. But upon repeating the experiment they realized it was no mistake.

In the UMBC news release, bioinformatician Ivan Erill, PhD, Professor of Biological Sciences at the University of Maryland, noted that “some viruses, called satellites, depend not only on their host organism to complete their life cycle, but also on another virus, known as a helper.

“The satellite virus needs the helper either to build its capsid, a protective shell that encloses the virus’ genetic material, or to help it replicate its DNA,” he added. “These viral relationships require the satellite and the helper to be in proximity to each other at least temporarily, but there were no known cases of a satellite actually attaching itself to a helper—until now.”

Although scientists have witnessed viruses working together before, this is the first known instance of a virus directly latching onto another virus’ capsid—rather like a vampire going for the neck.

“When I saw it, I was like, I can’t believe this,” said Tagide deCarvalho, PhD, Assistant Director of Natural and Mathematical Sciences at the University of Maryland and first author of the study, in a UM news release, “No one has ever seen a bacteriophage—or any other virus—attach to another virus.”

Visualizing the tiny viruses was only possible through the use of the transmission electron microscope (TEM) at UMBC’s Keith R. Porter Imaging Facility (KPIF), to which deCarvalho had access.

“Not everyone has a TEM at their disposal. [With the TEM] I’m able to follow up on some of these observations and validate them with imaging. There’s elements of discovery we can only make using the TEM,” said deCarvalho in the UMBC news release.

Using Vampire Viruses to Develop Better Gene Therapies

Spookily, the comparisons to Dracula and his parasitic brethren do not stop with their freeloading tendencies. The researchers found that some viruses without a satellite attached still showed signs of having been leeched onto before. Those viruses had the equivalent of “bite marks” showing evidence of encountering vampiric viruses in the past.

“It’s possible that a lot of the bacteriophages that people thought were contaminated were actually these satellite-helper systems,” said deCarvalho in the ISME paper.

But what does UMBC’s breakthrough mean for the greater scientific and medical community? Do we need to arm host viruses with silver crosses and necklaces of garlic? Jokes aside, this discovery could lead to further development in research of how to genetically alter viruses and deliver therapeutic elements into cells.

According to Healthline, some gene therapy or “gene editing” already involves the use of viruses. Scientists switch out the programming on a virus and trick it into healing, instead of harming the cells it infiltrates. Therefore, UMBC’s discovery could lead to new breakthroughs battling deadly viruses by using their own parasitic tricks to infiltrate other viruses.

Although groundbreaking and extremely interesting, the research is still in early stages. Any developments from this discovery aren’t likely to impact clinical laboratories any time soon. But after the past few years of battling the COVID-19 variants, this exciting discovery could help find new ways to prevent the next pandemic.  

—Ashley Croce

Related Information:

Vampire Viruses Prey on Other Viruses to Replicate Themselves and May Hold the Key to New Antiviral Therapies

Virus Seen Latching onto Another Virus (Like A Tiny Vampire) for First Time

UMBC Team Makes First-Ever Observation of a Virus Attaching to Another Virus

The First Discovered Vampire Virus Hooks Onto other Viruses—Meet the ‘MiniFlayer’

Simultaneous Entry as an Adaptation to Virulence in a Novel Satellite-Helper System infecting Streptomyces Species

Your Guide to Gene Therapy: How It Works and What It Treats

Bizarre First: Viruses Seen ‘Biting’ onto Other Viruses Like Tiny Vampires

Another Milestone for CRISPR-Cas9 Technology: First Trial Data for Treatment Delivered Intravenously

Unlike most other CRISPR/Cas-9 therapies that are ex vivo treatments in which cells are modified outside the body, this study was successful with an in vivo treatment

Use of CRISPR-Cas9 gene editing technology for therapeutic purposes can be a boon for clinical laboratories. Not only is this application a step forward in the march toward precision medicine, but it can give clinical labs the essential role of sequencing a patient’s DNA to help the referring physician identify how CRISPR-Cas9 can be used to edit the patient’s DNA to treat specific health conditions.

Most pathologists and medical lab managers know that CRISPR-Cas9 gene editing technology has been touted as one of the most significant advances in the development of therapies for inherited genetic diseases and other conditions. Now, a pair of biotech companies have announced a milestone for CRISPR-Cas9 with early clinical data involving a treatment delivered intravenously (in vivo).

The therapy, NTLA-2001, was developed by Intellia Therapeutics (NASDAQ:NTLA) and Regeneron Pharmaceuticals (NASDAQ:REGN) for treatment of hereditary ATTR (transthyretin) amyloidosis, a rare and sometimes fatal liver disease.  

As with other therapies, determining which patients are suitable candidates for specific treatments is key to the therapy’s success. Therefore, clinical laboratories will play a critical role in identifying those patients who would most likely benefit from a CRISPR-delivered therapy.

Such is the goal of precision medicine. As methods are refined that can correct unwelcome genetic mutations in a patient, the need to do genetic testing to identify and diagnose whether a patient has a specific gene mutation associated with a specific disease will increase.

The researchers published data from a Phase 1 clinical trial of NTLA-2001 in the New England Journal of Medicine (NEJM), titled, “CRISPR-Cas9 In Vivo Gene Editing for Transthyretin Amyloidosis.” They also presented their findings at the Peripheral Nerve Society (PNS) Annual Meeting.

What is NTLA-2001 and Why Is It Important?

Cleveland Clinic describes ATTR amyloidosis as a “protein misfolding disorder” involving transthyretin (TTR), a protein made in the liver. The disease leads to deposits of the protein in the heart, nerves, or other organs.

According to Intellia and Regeneron, NTLA-2001 is designed to inactivate the gene that produces the protein.

The interim clinical trial data indicated that one 0.3 mg per kilogram dose of the therapy reduced serum TTR by an average of 87% at day 28. A smaller dose of 0.1 mg per kilogram reduced TTR by an average of 52%. The researchers reported “few adverse events” in the six study patients, “and those that did occur were mild in grade.”

Current treatments, the companies stated, must be administered regularly and typically reduce TTR by about 80%.

“These are the first ever clinical data suggesting that we can precisely edit target cells within the body to treat genetic disease with a single intravenous infusion of CRISPR,” said Intellia President and CEO John Leonard, MD, in a press release. “The interim results support our belief that NTLA-2001 has the potential to halt and reverse the devastating complications of ATTR amyloidosis with a single dose.”

He added that “solving the challenge of targeted delivery of CRISPR-Cas9 to the liver, as we have with NTLA-2001, also unlocks the door to treating a wide array of other genetic diseases with our modular platform, and we intend to move quickly to advance and expand our pipeline.”

Daniel Anderson, PhD

“It’s an important moment for the field,” MIT biomedical engineer Daniel Anderson, PhD (above), told Nature. Anderson is Professor, Chemical Engineering and Institute for Medical Engineering and Science at the Koch Institute for Integrative Cancer Research at MIT. “It’s a whole new era of medicine,” he added. Advances in the use of CRISPR-Cas9 for therapeutic purposes will create the need for clinical laboratories to sequence patients’ DNA to help physicians determine the best uses for a CRISPR-Cas9 treatment protocol. (Photo copyright: Massachusetts Institute of Technology.)

In Part 2 of the Phase 1 trial, Intellia plans to evaluate the new therapy at higher doses. After the trial is complete, “the company plans to move to pivotal studies for both polyneuropathy and cardiomyopathy manifestations of ATTR amyloidosis,” the press release states.

Previous clinical trials reported results for ex vivo treatments in which cells were removed from the body, modified with CRISPR-Cas9 techniques, and then reinfused. “But to be able to edit genes directly in the body would open the door to treating a wider range of diseases,” Nature reported.

How CRISPR-Cas9 Works

On its website, CRISPR Therapeutics, a company co-founded by Emmanuelle Charpentier, PhD, a director at the Max Planck Institute for Infection Biology in Berlin, and inventor of CRISPR-Cas9 gene editing, explained that the technology “edits genes by precisely cutting DNA and then letting natural DNA repair processes take over.” It can remove fragments of DNA responsible for causing diseases, as well as repairing damaged genes or inserting new ones.

The therapies have two components: Cas9, an enzyme that cuts the DNA, and Guide RNA (gRNA), which specifies where the DNA should be cut.

Charpentier and biochemist Jennifer Doudna, PhD, Nobel Laureate, Professor of Chemistry, Professor of Biochemistry and Molecular Biology, and Li Ka Shing Chancellor’s Professor in Biomedical and Health at the University of California Berkeley, received the 2020 Nobel Prize in Chemistry for their work on CRISPR-Cas9, STAT reported.

It is important to pathologists and medical laboratory managers to understand that multiple technologies are being advanced and improved at a remarkable pace. That includes the technologies of next-generation sequencing, use of gene-editing tools like CRISPR-Cas9, and advances in artificial intelligence, machine learning, and neural networks.

At some future point, it can be expected that these technologies will be combined and integrated in a way that allows clinical laboratories to make very early and accurate diagnoses of many health conditions.

—Stephen Beale

Related Information

Intellia and Regeneron Announce Landmark Clinical Data Showing Deep Reduction in Disease-Causing Protein After Single Infusion of NTLA-2001, an Investigational CRISPR Therapy for Transthyretin (ATTR) Amyloidosis

CRISPR-Cas9 In Vivo Gene Editing for Transthyretin Amyloidosis

Landmark CRISPR Trial Shows Promise Against Deadly Disease

CRISPR Milestone Pushes Gene Editing Toward Its Promise

CRISPR Clinical Trials: A 2021 Update

CRISPR Gene Therapy: Applications, Limitations, and Implications for the Future

Diseases CRISPR Could Cure: Latest Updates on Research Studies and Human Trials

Faster, Better, Cheaper: The Rise of CRISPR in Disease Detection

The Potential of CRISPR-Based Diagnostic Assays and Treatment Approaches Against COVID-19

Two Female CRISPR Scientists Make History, Winning Nobel Prize in Chemistry for Genome-Editing Discovery

EBRC Report Offers a 20-Year Synthetic Biology Roadmap That Could Lead to New Diagnostic Technologies for Clinical Laboratories, Pathologists

The 80 scientists and engineers that comprise the consortium believe synthetic biology can address key challenges in health and medicine, but technical hurdles remain

Synthetic biology now has a 20-year development roadmap. Many predict this fast-moving field of science will deliver valuable products that can be used in diagnostics—including clinical laboratory tests, therapeutics, and other healthcare products.

Eighty scientists from universities and companies around the world that comprise the Engineering Biology Research Consortium (EBRC) recently published the 20-year roadmap. They designed it to “provide researchers and other stakeholders (including government funders)” with what they hope will be “a go-to resource for engineering/synthetic biology research and related endeavors,” states the EBRC Roadmap website.

The EBRC is “a public-private partnership partially funded by the National Science Foundation and centered at the University of California, Berkeley,” a Berkeley news release states.

Medical laboratories and clinical pathologists may soon have new tools and therapies for targeting specific diseases. The EBRC defines synthetic biology as “the design and construction of new biological entities such as enzymes, genetic circuits, and cells or the redesign of existing biological systems. Synthetic biology builds on the advances in molecular, cell, and systems biology and seeks to transform biology in the same way that synthesis transformed chemistry and integrated circuit design transformed computing.”

Synthetic biology is an expanding field and there are predictions that it may produce research findings that can be adapted for use in clinical pathology diagnostics and treatment for chronic diseases, such as cancer.

Another goal of the roadmap is to encourage federal government funding for synthetic biology.

“The question for government is: If all of these avenues are now open for biotechnology development, how does the US stay ahead in those developments as a country?” said Douglas Friedman, EBRC’s Executive Director, in a news release. “This field has the ability to be truly impactful for society and we need to identify engineering biology as a national priority, organize around that national priority, and take action based on it.”

Designing or Redesigning Life Forms for Specific Applications

Synthetic biology is an interdisciplinary field that combines elements of engineering, biology, chemistry, and computer science. It enables the design and construction of new life forms—or redesign of existing ones—for a multitude of applications in medicine and other fields.

Dark Daily reported on one such breakthrough by researchers in Cambridge, England, that involved the creation of synthetic E. coli. They were studying the potential use of synthetic genomics in clinical laboratory medicine. (See, “Scientists in United Kingdom Manipulate DNA to Create a Synthetic Bacteria That Could Be Immune to Infections,” September 27, 2019.)

Another recent example comes from the Wyss Institute at Harvard. Scientist there developed a direct-to-consumer molecular diagnostics platform called INSPECTR that, they say, uses programmable synthetic biosensors to detect infectious pathogens or host cells.

The Wyss Institute says on its website that the platform can be packaged as a low-cost, direct-to-consumer test similar to a home pregnancy test. “This novel approach combines the specificity, rapid development, and broad applicability of a molecular diagnostic with the low-cost, stability, and direct-to-consumer applicability of lateral flow immunoassays.”

In March, Harvard announced that it had licensed the technology to Sherlock Biosciences.

Howard Salis, PhD (above), Associate Professor of biological engineering and chemical engineering at Pennsylvania State University (Penn State), co-chaired the EBRC Roadmapping Working Group that produced the roadmap. In a Penn State news story, Salis explained synthetic biology’s potential. “There are both traditional and startup companies leveraging synthetic biology technologies to develop novel biotech products,” he said. “Organisms that produce biorenewable materials; diagnostics to detect the Zika virus, Ebola and tuberculosis; and soil bacteria that fix nitrogen into ammonia for improved plant growth.” (Photo copyright: Twitter.)

Fundamental Challenges with Synthetic Biology

The proponents of synthetic biology hope to make it easier to design and build these systems, in much the same way computer engineers design integrated circuits and processors. The EBRC Roadmap may help scientist worldwide achieve this goal.

However, in “What is Synthetic/Engineering Biology?” the EBRC also identifies the fundamental challenges facing the field. Namely, the complexity and unpredictability inherent in biology, and a limited understanding of how biological components interact.

The EBRC roadmap report, “Engineering Biology: A Research Roadmap for the Next-Generation Bioeconomy,” covers five categories of applications:

Health and medicine are of primary interest to pathologists.

Synthetic Biology in Health and Medicine

The Health and Medicine section of the report identifies four broad societal challenges that the EBRC believes can be addressed by synthetic biology. For each, the report specifies engineering biology objectives, including efforts to develop new diagnostic technologies. They include:

  • Existing and emerging infectious diseases: Objectives include development of tools for treating infections, improving immunity, reducing dependence on antibiotics, and diagnosing antimicrobial-resistant infections. The authors also foresee tools for rapid characterization and response to “known and unknown pathogens in real time at population scales.”
  • Non-communicable diseases and disorders, including cancer, heart disease, and diabetes: Objectives include development of biosensors that will measure metabolites and other biomolecules in vivo. Also: tools for identifying patient-specific drugs; tools for delivering gene therapies; and genetic circuits that will foster tissue formation and repair.
  • Environmental health threats, such as toxins, pollution, and injury: Objectives include systems that will integrate wearable tech with living cells, improve interaction with prosthetics, prevent rejection of transplanted organs, and detect and repair of biochemical damage.
  • Healthcare access and personalized medicine: The authors believe that synthetic biology can enable personalized treatments and make new therapies more affordable.

Technical Themes

In addition to these applications, the report identifies four “technical themes,” broad categories of technology that will spur the advancement of synthetic biology:

  • Gene editing, synthesis, and assembly: This refers to tools for producing chromosomal DNA and engineering whole genomes.
  • Biomolecule, pathway, and circuit engineering: This “focuses on the importance, challenges, and goals of engineering individual biomolecules themselves to have expanded or new functions,” the roadmap states. This theme also covers efforts to combine biological components, both natural and non-natural, into larger, more-complex systems.
  • Host and consortia engineering: This “spans the development of cell-free systems, synthetic cells, single-cell organisms, multicellular tissues and whole organisms, and microbial consortia and biomes,” the roadmap states.
  • Data Integration, modeling, and automation: This refers to the ability to apply engineering principles of Design, Build, Test and Learn to synthetic biology.

The roadmap also describes the current state of each technology and projects likely milestones at two, five, 10, and 20 years into the future. The 2- and 5-year milestones are based on “current or recently implemented funding programs, as well as existing infrastructure and facilities resources,” the report says.

The longer-term milestones are more ambitious and may require “significant technical advancements and/or increased funding and resources and new and improved infrastructure.”

Synthetic biology is a significant technology that could bring about major changes in clinical pathology diagnostics and treatments. It’s well worth watching.

—Stephen Beale

Related Information:

Engineering Biology: A Research Roadmap for the Next-Generation Bioeconomy

What Is Synthetic/Engineering Biology?

Scientists Chart Course Toward A New World of Synthetic Biology

INSPECTR: A Synthetic Biology-Based Molecular Diagnostics Platform to Empower Patients and Consumers with Low-Cost, Self-Diagnostic Tests

Penn State Professor Co-Chairs Roadmap to Guide Synthetic Biology Investments

Scientists in United Kingdom Manipulate DNA to Create a Synthetic Bacteria That Could Be Immune to Infections

CRISPR-Cas9 DNA Editing Possibly Linked to Cancer, But CRISPR-Cas13d RNA Editing Could Offer New Avenues for Treatment

CRISPR-Cas9 connection to cancer prompts research to investigate different approaches to gene editing

Dark Daily has covered CRISPR-Cas9 many times in previous e-briefings. Since its discovery, CRISPR, or Clustered Regularly Interspaced Short Palindromic Repeats, has been at the root of astonishing breakthroughs in genetic research. It appears to fulfill precision medicine goals for patients with conditions caused by genetic mutations and has anatomic pathologists, along with the entire scientific world, abuzz with the possibilities such a tool could bring to diagnostic medicine.

All of this research has contributed to a deeper understanding of how cells function. However, as is often the case with new technologies, unforeseen and problematic questions also have arisen.

CRISPR-Cas9 Connection to Cancer

Research conducted at the Wellcome Sanger Institute in the United Kingdom (UK) and published in Nature Biotechnology, examined potential damage caused by CRISPR-Cas9 editing.

“Here we report significant on-target mutagenesis, such as large deletions and more complex genomic rearrangements at the targeted sites in mouse embryonic stem cells, mouse hematopoietic progenitors, and a human differentiated cell line,” wrote the authors in their introduction.

Another study, this one conducted by biomedical researches at Cambridge, Mass., and published in Nature, describes possible toxicity caused by Cas9.

“Our results indicate that Cas9 toxicity creates an obstacle to the high-throughput use of CRISPR-Cas9 for genome engineering and screening in hPSCs [human pluripotent stem cells]. Moreover, as hPSCs can acquire P53 mutations, cell replacement therapies using CRISPR-Cas9-enginereed hPSCs should proceed with caution, and such engineered hPSCs should be monitored for P53 function.”

Essentially what both groups of researchers found is that CRISPR-Cas9 cuts through the double helix of DNA, which the cell responds to as it would any injury. A gene called p53 then directs a cellular “first-aid kit” to the “injury” site that either initiates self-destruction of the cell or repairs the DNA.

Therefore, in some instances, CRISPR-Cas9 is inefficient because the repaired cells continue to function. And, the repair process involves the p53 gene. P53 mutations have been implicated in ovarian, colorectal, lung, pancreatic, stomach, liver, and breast cancers.

Though important, some experts are downplaying the significance of the findings.

Erik Sontheimer, PhD (above), Professor, RNA Therapeutics Institute, at the University of Massachusetts Medical School, told Scientific American that the two studies are important, but not show-stoppers. “This is something that bears paying attention to, but I don’t think it’s a deal-breaker,” he said. (Photo copyright: University of Massachusetts.)

“It’s something we need to pay attention to, especially as CRISPR expands to more diseases. We need to do the work and make sure edited cells returned to patients don’t become cancerous,” Sam Kulkarni, PhD, CEO of CRISPR Therapeutics, told Scientific American.

Both studies are preliminary. The implications, however, is in how genes that have become corrupted are used.

“It is unclear if the findings translate into cells actually used in clinical studies,” Bernhard Schmierer, PhD, co-author of a paper titled, “CRISPR-Cas9 Genome Editing Induces a p53-mediated DNA Damage Response,” told Scientific American.

Nevertheless, the cancer-cat is out of the bag.

Targeting RNA Instead of DNA with CRISPR-Cas13d

A team from the Salk Institute may have found a solution. They are investigating a different enzyme—Cas13d—which, in conjunction with CRISPR would target RNA rather than DNA. “DNA is constant, but what’s always changing are the RNA messages that are copied from the DNA. Being able to modulate those messages by directly controlling the RNA has important implications for influencing a cell’s fate,” Silvana Konermann, PhD, a Howard Hughes Medical Institute (HHMI) Hanna Gray Fellow and member of the research team at Salk, said in a news release.

The Salk team published their findings in the journal Cell. The paper describes how “scientists from the Salk Institute are reporting for the first time the detailed molecular structure of CRISPR-Cas13d, a promising enzyme for emerging RNA-editing technology. They were able to visualize the enzyme thanks to cryo-electron microscopy (cryo-EM), a cutting-edge technology that enables researchers to capture the structure of complex molecules in unprecedented detail.”

The researchers think that CRISPR-Cas13d may be a way to make the process of gene editing more effective and allow for new strategies to emerge. Much like how CRISPR-Cas9 led to research into recording a cell’s history and to tools like SHERLOCK (Specific High-sensitivity Enzymatic Reporter unLOCKing), a new diagnostic tool that works with CRISPR and changed clinical laboratory diagnostics in a foundational way.

Dark Daily reported on this breakthrough last year. (See, “CRISPR-Related Tool Set to Fundamentally Change Clinical Laboratory Diagnostics, Especially in Rural and Remote Locations,” August 4, 2017.)

Each discovery will lead to more branches of inquiry and, hopefully, someday it will be possible to cure conditions like sickle cell anemia, dementia, and cystic fibrosis. Given the high expectations that CRISPR and related technologies can eventually be used to treat patients, pathologists and medical laboratory professionals will want to stay informed about future developments.

—Dava Stewart

Related Information:

Repair of Double-Strand Breaks Induced by CRISPR-Cas9 Leads to Large Deletions and Complex Rearrangements

P53 Inhibits CRISPR-Cas9 Engineering in Human Pluripotent Stem Cells

CRISPR-Edited Cells Linked to Cancer Risk in 2 Studies

CRISPR-Cas9 Genome Editing Induces a p53-Mediated DNA Damage Response

Decoding the Structure of an RNA-Based CRISPR System

Structural Basis for the RNA-Guided Ribonuclease Activity of CRISPR-Cas13d

CRISPR Timeline

What Are Genome Editing and CRISPR-Cas9?

Federal Court Sides with Broad in CRISPR Patent Dispute

Top Biologists Call for Moratorium on Use of CRISPR Gene Editing Tool for Clinical Purposes Because of Concerns about Unresolved Ethical Issues

CRISPR-Related Tool Set to Fundamentally Change Clinical Laboratory Diagnostics, Especially in Rural and Remote Locations

Researchers at Several Top Universities Unveil CRISPR-Based Diagnostics That Show Great Promise for Clinical Laboratories

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