[HTML][HTML] Reprogramming metabolic pathways in vivo with CRISPR/Cas9 genome editing to treat hereditary tyrosinaemia

FP Pankowicz, M Barzi, X Legras, L Hubert, T Mi… - Nature …, 2016 - nature.com
FP Pankowicz, M Barzi, X Legras, L Hubert, T Mi, JA Tomolonis, M Ravishankar, Q Sun…
Nature communications, 2016nature.com
Many metabolic liver disorders are refractory to drug therapy and require orthotopic liver
transplantation. Here we demonstrate a new strategy, which we call metabolic pathway
reprogramming, to treat hereditary tyrosinaemia type I in mice; rather than edit the disease-
causing gene, we delete a gene in a disease-associated pathway to render the phenotype
benign. Using CRISPR/Cas9 in vivo, we convert hepatocytes from tyrosinaemia type I into
the benign tyrosinaemia type III by deleting Hpd (hydroxyphenylpyruvate dioxigenase) …
Abstract
Many metabolic liver disorders are refractory to drug therapy and require orthotopic liver transplantation. Here we demonstrate a new strategy, which we call metabolic pathway reprogramming, to treat hereditary tyrosinaemia type I in mice; rather than edit the disease-causing gene, we delete a gene in a disease-associated pathway to render the phenotype benign. Using CRISPR/Cas9 in vivo, we convert hepatocytes from tyrosinaemia type I into the benign tyrosinaemia type III by deleting Hpd (hydroxyphenylpyruvate dioxigenase). Edited hepatocytes (Fah−/−/Hpd−/−) display a growth advantage over non-edited hepatocytes (Fah−/−/Hpd+/+) and, in some mice, almost completely replace them within 8 weeks. Hpd excision successfully reroutes tyrosine catabolism, leaving treated mice healthy and asymptomatic. Metabolic pathway reprogramming sidesteps potential difficulties associated with editing a critical disease-causing gene and can be explored as an option for treating other diseases.
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