Abstract
The development of new revolutionary technologies for directed gene editing has made it possible to thoroughly model and study NgAgo human diseases at the cellular and molecular levels. Gene editing tools like ZFN, TALEN, CRISPR-based systems, NgAgo and SGN can introduce different modifications. In gene sequences and regulate gene expression in different types of cells including induced pluripotent stem cells (iPSCs). These tools can be successfully used for Huntington’s disease (HD) modeling, for example, to generate isogenic cell lines bearing different numbers of CAG repeats or to correct the mutation causing the disease. This review presents common genome editing technologies and summarizes the progress made in using them in HD and other hereditary diseases. Furthermore, we will discuss prospects and limitations of genome editing in understanding HD pathology.
Keywords
INTRODUCTION
Huntington’s disease (HD) is a severe neurodegenerative disorder caused by the autosomal dominant mutation in the first exon of the
Although the mutation was identified more than 20 years ago, disease pathways are not fully elucidated and only symptomatic treatment is available. One reason for the slow progress was the lack of an efficient tool to study the effects of mutant huntingtin on cellular and molecular processes and the role of other genes in the progression of the disease.
Transcriptome analysis, bioinformatic assays and RNAi are usually used to explore the mechanisms of disease development. Nevertheless such methods can’t fully reveal all connections and interactions between genes, proteins and cellular organelles during disease progression. Modern gene editing approaches such as ZFN (zinc finger nuclease) [3], TALEN (transcription activator-like effector nuclease) [4], CRISPR-based systems (clustered regularly interspaced short palindromic repeats [5–7], NgAgo-gDNA (DNA-guided endonuclease Argonaute
Here, we review modern molecular tools for gene editing, recent results and future directions of using them in HD studies.
GENOME EDITING TOOLS
Gene editing tools have been widely used in recent years. The use of these tools has facilitated knockout or knock-in of target loci, and thus, to study the function of genes and gene networks and regulatory sequences, to create models of hereditary diseases, and to develop methods for their treatment. These tools have various structures which mediate functional parameters such as specificity, efficiency of delivery and gene editing, sequence limitations, assembly cost, etc (Fig. 1). This section briefly describes the main components of such tools, as well as the advantages and disadvantages to edit genes.
ZFN
ZFN was constructed by Kim and colleagues in 1996 as a chimeric nuclease consisting of two parts [3]. The first part is a DNA-binding box consisting of 3-4 zinc finger domains (ZFPs). Each ZFP binds to 3 nucleotides so a set of 3-4 ZFPs in each subunit provides sufficient specificity for site-specific DNA binding. The second part is the nuclease domain of endonuclease
TALEN
Transcription activator-like effector nuclease (TALEN) has an artificial DNA-binding domain and DNA-cleavage domain endonuclease
CRISPR-based systems
Clustered regularly interspaced short palindromic repeats/ CRISPR associated protein 9 (CRISPR/Cas9) was firstly reported in 2012 [17]. Originally it is a bacterial analog of the immune system against phage infection but researchers adapted it for directed modification of eukaryotic genomes. All CRISPR/Cas systems are divided into three main types (I-III), and at least 10 subtypes. In genome engineering II-A type system is currently the most widely used from
CRISPR/Cas9 allows genome editing with high efficiency but can make unwanted modifications at off-target sites [27]. The off-target effects may cause genomic instability and disrupt the functionality of otherwise normal genes, and this reason restricts application of CRISPR/Cas9 in biomedicine and the clinic [28]. In January 2016, it was reported that a new modified Cas9 nuclease had been created [6]. Specificity of Cas9 was improved by substitutions in Cas9 sequence which blocked some hydrogen bonds between Cas9 and target DNA strand. Such modifications altered energetics of the Cas9-sgRNA complex and thus reduced off-target binding and subsequently off-target effects that were confirmed by next-generation sequencing.
Another direction to increase the specificity of CRISPR system is the application of Cas9 orthologs, which require other PAM-sequences and have higher cleavage specificity and smaller size of nuclease encoding genes. Such orthologs were found in
NgAgo
The next gene editing tool was developed by Gao and colleagues in 2016 [8]. It is endonuclease Argonaute derived from
SGN
Also in 2016 a promising structure-guided nuclease (SGN) was engineered consisting of flap endonuclease-1 (FEN-1) that recognizes DNA-DNA 3’-flap structures and nuclease domain
As NgAgo and SGN are the most recent technologies and only two reports were published further studies are needed to confirm applicability for gene editing in cells.
POSSIBLE APPLICATIONS OF GENOME EDITING TOOLS IN HD STUDIES
Gene editing tools are indispensable components for the generation of targeted DSBs that are repaired through one of two major DNA-repair pathways –nonhomologous end-joining (NHEJ) in the absence of homologous donor template or homology-directed repair (HDR) in the presence of the donor template (plasmids, single stranded oligonucleotides). NHEJ pathway is error-prone and leads to the generation of insertion and/or deletions (indels) in the target DNA sequence. So targeted DSBs repaired by NHEJ can be used to disrupt desired gene sequences and to shift reading frame resulting in the synthesis of nonfunctional protein. Alternatively, in HDR artificial exogenous homologous sequence serves as a template for the recovery of native DNA structure and DSBs can stimulate this process [32]. HDR allows inserting any sequence in the target site, for example, restriction site, reporter gene. Moreover it allows correcting or introducing certain mutations that enable modeling hereditary diseases.
Correction/insertion of mutation causing disease
Initially, cells from healthy individuals were used as a negative control in studying the disease and experimental results obtained in such studies were not fully reliable. Targeted gene editing enables the generation of isogenic cell lines which provide an ideal healthy control for disease modeling, drug-screening and searching for new mutations involved in disease pathogenesis. Additionally, corrected patient-derived cells can be used in cell replacement therapy. A promising cell source for both approaches is iPSCs. On one hand, these cells can be generated by the reprogramming of somatic cells and can be further differentiated into various cell types that enable comprehensive disease study and drug-screening. On the other hand, iPSCs can be obtained during a patient’s life, “corrected” and transplanted in the damaged tissue. The first patient-specific iPSC line of HD containing 72 CAG repeats was obtained in 2008 by Park and colleagues [33] and since this publication, the number of HD patient-derived iPSC lines has been expanded [34].
In an unprecedented study performed by An et al., mutant
The first successful study using genome editing tool for gene correction was published in 2007 [36]. Researchers used ZFNs and donor sequence to correct a point mutation in hematopoietic stem cells in the
In order to obtain isogenic cell lines from healthy cells, a disease causing mutation may be inserted into the genome of these cells. CRISPR/Cas9 was applied to create a set of isogenic HD cell lines bearing various length CAG tracts (21, 72, 97 CAG) (Fig. 2) [37]. It should be noted that donor plasmids with expanded CAG repeats were generated using PCR-products of mutant
Another study was reported by Malakhova and colleagues in 2016 [38]. The feature of this study is the donor plasmid bearing 215 CAG repeats which was built by the Golden Gate cloning method [39]. PCR-product from normal
One of the most important aspects in genome editing is the structure of target site nucleotide sequence. It is known that the promoter region and the first exon of
Disruption or deletion of mutant allele
Mutant allele inactivation can benefit dominantly inherited disorders, particularly HD. TALEN was used for allele-specific
Although such contraction of the mutant allele are appropriate, it was found that DSBs caused both contractions and expansions of CAG tracts when researchers used ZFN and CRISPR/Cas9 targeted to the CAG repeat tract [44]. In contrast, Cas9 D10A mutant (Cas9 nickase) induced single strand breaks within the CAG tract which resulted in mainly repeat contractions due to the activation of an alternative mechanism of DNA repair. Authors proposed that the type of DNA damage plays a key role in determining direction of DNA repair. Thus these results pave the way for shortening expansions in polyglutamine diseases and a possible path for therapy.
Another strategy to inactivate the mutant allele used haplotype-specific CRISPR/Cas9 [45]. The strategy was based on using mutant allele-specific single-nucleotide polymorphisms (SNPs) for PAM of CRISPR/Cas9. Researchers simultaneously used two sgRNAs that depend on PAM sites generated by SNPs in the mutant allele. This resulted in excision of ∼44 kb sequence including promoter region, transcription start site, and expanded CAG tract in the mutant
Inactivation of the mutant allele is more attractive due to the need of only gene editing tool delivery. Moreover, it is much easier to introduce DSBs that are repaired by more efficient NHEJ compared to homologous recombination. Genome editing tools based on the CRISPR system and NgAgo are most suitable for this purpose because they have high efficiency. However, it is necessary to take into account the specificity of the tools so careful selection of target site and more accurate molecular tools (high-fidelity CRISPR/Cas9, CRISPR-Cpf1, NgAgo) are required.
Modification of genes involved in disease pathogenesis
HD is a monogenic Mendelian neurodegenerative disorder and genetic risk of HD entirely depends on the length of the expanded repeat. However, it is known that HD patients carrying CAG repeat tracts with equal length have a variable age of disease onset indicating the considerable epistatic effects of genetic background [46]. So identification of modifier genes can reveal or confirm molecular pathways implicated in pathophysiological processes in HD. Moreover, confirmed modifier genes provide new targets for disease therapy.
More than 100 genes are known to be involved in disease progression [47, 48] which were identified using transcriptome, proteome and bioinformatic analyses. There are several potential HD modifiers such as huntingtin-associated protein 1 (
In order to study how these genes influence HD pathogenesis, gene editing tools can be used in two directions. The first way is the generation of isogenic cell lines that differ from each other by a specific SNP in the gene modifier. These SNPs can be introduced or corrected like expanded CAG repeats. Therefore such isogenic cell lines could provide the platform for studies of the effects of SNPs in gene modifiers on disease pathogenesis and candidates for new drug targets in disease therapy.
The second way is to knockout the modifier gene to show how deletion of the gene protein influences the course of the disease. Any of the molecular tools can be used for this purpose. Special attention should be paid to the CRISPR-system. Due to the simplicity of programming the CRISPR in order to modify almost any genomic locus, this tool can be used to study gene function on a genome-wide scale. Researchers from Cambridge University created a genome-scale library of sgRNAs (64,751 unique sgRNAs) targeting 18,080 genes for genome-scale CRISPR/Cas9 knockout (GeCKO) to identify genes essential for cell viability and drug-resistance in cancer [23]. Indeed, such an approach could easily and efficiently reveal functions of multiple genes and determine the role of each of them in HD in a short time.
In both cases, the most useful is the CRISPR-system. The advantage of this system is that sgRNA can be integrated into the genome using lentiviruses and transcribed when it is needed. However given the problem of off-target effects, a new system for multiplex gene editing based of NgAgo-gDNA may soon be developed. But here the problem of delivering gDNA is worth considering. A possible solution to this problem is the delivery of complexes NgAgo-gDNA into cells.
REGULATION OF GENE EXPRESSION AND EPIGENOME EDITING
Regulation of gene expression by up- or down-regulation is an alternative way of interrogation of gene function. Moreover it can be useful for treatment by repression of mutant protein production and activation of genes combating pathological processes. There are several regulators of gene expression based on genome editing tools. Their DNA-binding domains serve for targeted regulation. Nuclease domains are inactive and replaced by different effectors such as transcription activators and repressors and chromatin modifiers.
Gene expression effectors
ZFPs can be repressors of transcription in the absence of additional effector domains. In 2012, Garriga-Canut and colleagues demonstrated excellent results using ZFPs as mutant
There are several effectors based on the TALEN system. For targeted activation of gene expression, DNA-binding TALE-domain fused with VP64 (transcription activator domain) is used (TALE-TF) that attracts endogenous activators, and KRAB (Krüppel associated box) and SRDX (ethylene-responsive element binding factor-associated amphiphilic repression motif repressor) domains are used for repression of the targeted gene [57].
Transcription repression of the mutant
Another therapeutic application is the up-regulation of genes involved in ablation misfolding proteins. It is known that heat shock proteins (HSPs) provide a first line of defense against aberrant proteins in such diseases as Alzheimer’s, Parkinson’s and Huntington’s disease and gain-of-function of these genes could reverse disease phenotype at least at the early stages of the disease [60]. More research is required in order to understand exactly which HSPs improve neuroprotection and through what mechanisms they act.
In 2014, Konermann and colleagues developed a genome-scale transcriptional activation system based on CRISPR/Cas9 complex (synergistic activation mediator, SAM) [61]. They created a system, which consisted of catalytically inactive Cas9 (dCas9)-VP64 fusion protein and MS2-p65-HSF1 transcription activator domain and upgraded sgRNA containing aptamers to facilitate the recruitment of effector domains to the Cas9 complex. Like the GeCKO system it is also possible to create a library of sgRNAs targeting multiple genes. So, the CRISPR-system can be successfully used for multiplex activation (SAM) or repression (dCas9-KRAB) [62], particularly repression of the mutant
Targeted epigenetic editing
The emergence of gene editing tools allows not only manipulation of the genome, but also modifications of the epigenome. Epigenome editing tools are built upon nucleotide sequence recognition (DNA-binding domains and sgRNAs) and effector domains responsible for DNA or histone modifications (DNA (de)methylation, DNA hydroxymethylation, histone (de)acetylation, (de)methylation and (de)phosphorylation). There are several ZFN, TALE and CRISPR-based tools fused with effectors of DNA methylation (DNMT3A), demethylation (TDG) and hydroxymethylation (Tet1) (Table 1) [63].
The first epigenome editing tool was ZFN-based and was a popular instrument due to efficient target binding and small size [69–71]. However, a new system relying on TALEs was developed, which received greater interest due to simplicity of design and targeting [72, 74]. But this system has also a limitation, namely, sensitivity to CpG methylation and thus it became unsuitable for promoter region modifications in mammalian cells [81]. Further, a new platform for DNA methylation based on CRISPR was constructed, which combines the positive features such as ease of targeting sgRNAs and insensitivity to CpG methylation [76, 82].
DNA methylation is known to regulate a myriad of cellular processes in mammalian cells and alterations in DNA methylation are frequently involved in psychiatric and neurological diseases such as schizophrenia, Alzheimer’s and Huntington’s disease. For example, DNA hypermethylation underlies fragile X-chromosome syndrome caused by the expansion of trinucleotide repeat CGG in the promoter region of
Histone modifications are also important regulators of gene expression thus affecting such processes as development, cell-fate decision, epigenetic inheritance and pathogenesis of neurological and psychiatric diseases [89]. There are many types of histone modifications –histone acetylation, methylation, phosphorylation, etc. –which directly (gene) or indirectly (enhancer) influence gene expression. Previously, it was not possible to precisely modify histones and combine such modifications which consequently limited our understanding of functional relationships of histone modifications. To address this problem programmable histone TALE-modifiers have been developed that specifically and efficiently reverse the expression of target genes (Table 1) [78, 79]. Furthermore, a CRISPR-based tool for targeted histone acetylation was designed leading to directed acetylation and subsequent target-gene activation [80].
Direct histone modification can be very useful for studying causal relationships between epigenetic changes and development of neurodegenerative diseases, particularly histone hypoacetylation which is the most frequent alteration in these disorders. Histone hypoacetylation is found in amyotrophic lateral sclerosis, Parkinson’s and Huntington’s disease and Friedreich’s ataxia. Moreover, many other changes of histone profiles in neurological diseases have been reported such as histone acetylation and phosphorylation alterations in Alzheimer’s disease and epilepsy, and H3K9 hypertrimethylation in Huntington’s disease and Friedreich’s ataxia [90]. It suggests the idea that targeted epigenetic editing can also be a promising therapeutic agent for the treatment of neurodegenerative disorders.
Comparing the prospects of the two platforms based on TALEs and CRISPR it is easy to see that CRISPR-based epigenome editing tools are much more promising. The first advantage is guide RNA programming almost any genome site whereas the design of DNA-binding domains for TALE-based editing is more difficult. Another advantage is the possibility to simultaneously modify DNA or histones in different loci and thus to carry out multiplex epigenome editing.
CONCLUSION
In recent years, significant progress in the study of molecular mechanisms and modeling of genetic diseases has been achieved. An important role was played by the rapid development of tools for directed genome editing, and ease of construction and low cost have made them widely used. It is worth noting that the choice of the tool depends on goals of researchers, as each tool has its own specific characteristics and functional features. First artificial nucleases ZFN and TALEN are inferior to the CRISPR system in many aspects such as design simplicity, high efficiency and specificity and ease of delivery. However, the latest tools NgAgo and SGN have not yet been proven, and perhaps in the future will be able to compete with the CRISPR system.
The contributions that genome editing technologies can make particularly to the HD field are substantial and may impact on our understanding of HD and the therapeutic directions being pursued. Although, there are still few researchers using these tools in the study of HD, the potential of these tools is just beginning to unfold for mutant
FUNDING
The funding for this research was provided by the Russian Science Foundation project No 16-15-10128.
CONFLICT OF INTEREST
The authors have no conflict to declare.
