Predictable and precise template-free CRISPR editing of pathogenic variants

MW Shen, M Arbab, JY Hsu, D Worstell, SJ Culbertson… - Nature, 2018 - nature.com
MW Shen, M Arbab, JY Hsu, D Worstell, SJ Culbertson, O Krabbe, CA Cassa, DR Liu
Nature, 2018nature.com
Following Cas9 cleavage, DNA repair without a donor template is generally considered
stochastic, heterogeneous and impractical beyond gene disruption. Here, we show that
template-free Cas9 editing is predictable and capable of precise repair to a predicted
genotype, enabling correction of disease-associated mutations in humans. We constructed a
library of 2,000 Cas9 guide RNAs paired with DNA target sites and trained inDelphi, a
machine learning model that predicts genotypes and frequencies of 1-to 60-base-pair …
Abstract
Following Cas9 cleavage, DNA repair without a donor template is generally considered stochastic, heterogeneous and impractical beyond gene disruption. Here, we show that template-free Cas9 editing is predictable and capable of precise repair to a predicted genotype, enabling correction of disease-associated mutations in humans. We constructed a library of 2,000 Cas9 guide RNAs paired with DNA target sites and trained inDelphi, a machine learning model that predicts genotypes and frequencies of 1- to 60-base-pair deletions and 1-base-pair insertions with high accuracy (r = 0.87) in five human and mouse cell lines. inDelphi predicts that 5–11% of Cas9 guide RNAs targeting the human genome are ‘precise-50’, yielding a single genotype comprising greater than or equal to 50% of all major editing products. We experimentally confirmed precise-50 insertions and deletions in 195 human disease-relevant alleles, including correction in primary patient-derived fibroblasts of pathogenic alleles to wild-type genotype for Hermansky–Pudlak syndrome and Menkes disease. This study establishes an approach for precise, template-free genome editing.
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