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du Rand A, Hunt J, Samson C, Loef E, Malhi C, Meidinger S, Chen CJ, Nutsford A, Taylor J, Dunbar R, Purvis D, Feisst V, Sheppard H. Highly efficient CRISPR/Cas9-mediated exon skipping for recessive dystrophic epidermolysis bullosa. Bioeng Transl Med 2024; 9:e10640. [PMID: 39036091 PMCID: PMC11256143 DOI: 10.1002/btm2.10640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/05/2023] [Accepted: 12/13/2023] [Indexed: 07/23/2024] Open
Abstract
Gene therapy based on the CRISPR/Cas9 system has emerged as a promising strategy for treating the monogenic fragile skin disorder recessive dystrophic epidermolysis bullosa (RDEB). With this approach problematic wounds could be grafted with gene edited, patient-specific skin equivalents. Precise gene editing using homology-directed repair (HDR) is the ultimate goal, however low efficiencies have hindered progress. Reframing strategies based on highly efficient non-homologous end joining (NHEJ) repair aimed at excising dispensable, mutation-harboring exons offer a promising alternative approach for restoring the COL7A1 open reading frame. To this end, we employed an exon skipping strategy using dual single guide RNA (sgRNA)/Cas9 ribonucleoproteins (RNPs) targeted at three novel COL7A1 exons (31, 68, and 109) containing pathogenic heterozygous mutations, and achieved exon deletion rates of up to 95%. Deletion of exon 31 in both primary human RDEB keratinocytes and fibroblasts resulted in the restoration of type VII collagen (C7), leading to increased cellular adhesion in vitro and accurate C7 deposition at the dermal-epidermal junction in a 3D skin model. Taken together, we extend the list of COL7A1 exons amenable to therapeutic deletion. As an incidental finding, we find that long-read Nanopore sequencing detected large on-target structural variants comprised of deletions up to >5 kb at a frequency of ~10%. Although this frequency may be acceptable given the high rates of intended editing outcomes, our data demonstrate that standard short-read sequencing may underestimate the full range of unexpected Cas9-mediated editing events.
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Affiliation(s)
- Alex du Rand
- School of Biological SciencesThe University of AucklandAucklandNew Zealand
| | - John Hunt
- School of Biological SciencesThe University of AucklandAucklandNew Zealand
| | - Christopher Samson
- School of Biological SciencesThe University of AucklandAucklandNew Zealand
| | - Evert Loef
- School of Biological SciencesThe University of AucklandAucklandNew Zealand
| | - Chloe Malhi
- School of Biological SciencesThe University of AucklandAucklandNew Zealand
| | - Sarah Meidinger
- School of Biological SciencesThe University of AucklandAucklandNew Zealand
| | | | - Ashley Nutsford
- School of Biological SciencesThe University of AucklandAucklandNew Zealand
| | - John Taylor
- School of Biological SciencesThe University of AucklandAucklandNew Zealand
| | - Rod Dunbar
- School of Biological SciencesThe University of AucklandAucklandNew Zealand
| | - Diana Purvis
- Te Whatu Ora Health New ZealandTe Toka TumaiAucklandNew Zealand
| | - Vaughan Feisst
- School of Biological SciencesThe University of AucklandAucklandNew Zealand
| | - Hilary Sheppard
- School of Biological SciencesThe University of AucklandAucklandNew Zealand
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Kubanov AA, Karamova AE, Chikin VV, Monchakovskaya ES, Nefedova MA. Efficacy Of Intradermal Allogeneic Fibroblast Injections In Junctional Epidermolysis Bullosa. RUSSIAN OPEN MEDICAL JOURNAL 2022. [DOI: 10.15275/rusomj.2022.0315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective — to assess the efficacy and safety of intradermal injections of allogeneic fibroblasts into non-healing wounds in a patient with junctional epidermolysis bullosa. Material and Methods — A 49-year-old patient with intermediate junctional epidermolysis bullosa was injected intradermally into the base of non-healing wounds with 1 mL suspension of allogeneic fibroblasts, which contained 5×106 cells/mL, 10×106 cells/mL, and 20×106 cells/mL. Immunofluorescence mapping exhibited reduced β3 chain of laminin 332 and collagen XVII expression in the basement membrane area. Paired erosions were injected with 2% albumin or saline solution. Results — At two weeks after treatment, wound areas reduced significantly, or 100% re-epithelialization occurred. Collagen XVII and β3 chain expression of laminin 332 increased at the dermal-epidermal junction. Conclusion — Our findings demonstrated that intradermal injections of allogeneic fibroblasts could be an effective therapeutic approach for treating small non-healing wounds in junctional epidermolysis bullosa.
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Affiliation(s)
- Alexey A. Kubanov
- State Research Center for Dermatovenereology and Cosmetology, Moscow, Russia
| | - Arfenya E. Karamova
- State Research Center for Dermatovenereology and Cosmetology, Moscow, Russia
| | - Vadim V. Chikin
- State Research Center for Dermatovenereology and Cosmetology, Moscow, Russia
| | | | - Mariya A. Nefedova
- State Research Center for Dermatovenereology and Cosmetology, Moscow, Russia
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Kubanov AA, Chikin VV, Karamova AE, Monchakovskaya ES. Topical treatment of inherited epidermolysis bullosa. VESTNIK DERMATOLOGII I VENEROLOGII 2021. [DOI: 10.25208/vdv1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Inherited epidermolysis bullosa is a group of genetic skin disorders characterized by skin erosions, ulceration, skin and mucosal blistering requiring topical treatment. This review demonstrates major clinical manifestations of epidermolysis bullosa and its mechanisms of development. According to these features the main principles of topical treatment and drug therapy were developed, including physical protection from trauma, moisturizing, improvement of wound healing, prevention and management of infection, itch and pain management. Drug therapy is outlined with dosage forms, drug routes of administration, age restrictions indicated in the instruction for medical use for the medications that could be used in epidermolysis bullosa patients. The authors provide indications for clinical use of antiseptics, disinfectants, antibiotics, antimicrobial agents, emollient cream and drugs reducing itch and pain.
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Shams F, Rahimpour A, Vahidnezhad H, Hosseinzadeh S, Moravvej H, Kazemi B, Rajabibazl M, Abdollahimajd F, Uitto J. The utility of dermal fibroblasts in treatment of skin disorders: A paradigm of recessive dystrophic epidermolysis bullosa. Dermatol Ther 2021; 34:e15028. [PMID: 34145697 DOI: 10.1111/dth.15028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/05/2021] [Accepted: 06/01/2021] [Indexed: 01/04/2023]
Abstract
Dermal fibroblasts are the most accessible cells in the skin that have gained significant attention in cell therapy. Applying dermal fibroblasts' regenerative capacity can introduce new patterns to develop cell-based therapies to treat skin disorders. Dermal fibroblasts originate from mesenchymal cells and are located within the dermis. These cells are mainly responsible for synthesizing glycosaminoglycans, collagens, and components of extracellular matrix supporting skin's structural integrity. Preclinical studies suggested that allogeneic and autologous dermal fibroblasts provide widespread and beneficial applications for wound healing, burn ulcers, and inherited skin disorders. In this regard, generating induced pluripotent stem cells (iPSCs) from fibroblasts and gene-edited fibroblasts are promising approaches for treating skin disorders. Here, we aimed to review literature about ongoing and completed clinical trials that applied fibroblasts and bioengineered fibroblasts as therapeutic agents for various skin disorders. This review explores cell therapy protocols from the earliest phase of allogeneic and autologous fibroblasts development in different benches to translating them into bedside-level treatment for skin disorders, particularly recessive dystrophic epidermolysis bullosa.
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Affiliation(s)
- Forough Shams
- Student Research Committee, Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azam Rahimpour
- Medical Nano-Technology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Vahidnezhad
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Simzar Hosseinzadeh
- Medical Nano-Technology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Moravvej
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Kazemi
- Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Rajabibazl
- Department of Clinical Biochemistry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Abdollahimajd
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Clinical Research Development Unit, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jouni Uitto
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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