PROJECT SUMMARY/ABSTRACT – OVERALL
The genome editing community is celebrating the ten-year anniversary of landmark CRISPR papers in 2022.
What is notable to many in the field is tremendous technological advances in editing precision and versatility,
along with a Nobel Prize and billions of dollars of investment. However, there is a palpable sense that these
advances have not been translated into valuable drugs at a sufficient rate. In vivo gene editing still faces
substantial challenges, especially when it comes to safety, efficacy, and delivery. While the development of
EDIT-101, a viral vector carrying Cas9 to treat a rare retinal disorder (BRILLIANCE trial), provided a clear path
to the clinic for a genome editing therapeutic program, this path can be challenging to follow for others in the
field interested in developing human therapeutics. Viral strategies have several limitations involving an immune
response to vector elements and prolonged expression of the editor for the lifetime of the patient, heightening
off-target concerns. Newer editors like base editors cannot be readily packaged into common viral vectors, plus
there is a challenging supply chain for viral vector manufacturing. We seek to overcome the limitations with viral
delivery systems by using novel nonviral delivery systems termed the Silica NanoCapsule (SNC) and Target
Active Gene Editors (TAGE). They can efficiently deliver genome editors to the retina with high efficiency,
reaching levels of 10-70% that are among the best for nonviral delivery of editors to the eye and comparable to
viral delivery systems. Based on our strong published and preliminary data we propose to develop nonviral gene
editing products to treat Best Disease (BD) and Leber Congenital Amaurosis (LCA), two diseases affecting
ion channels of the retinal pigment epithelium (i.e., RPE channelopathies). Our team, spanning academia and
industry, will pursue the following aims. In Overall Aim 1, we evaluate the clinical readiness of a genome editor
targeting a post-mitotic cell through transient, localized, and nonviral delivery. To date, outside of the liver, only
viral editors have reached an IND for in vivo editing. Here, we rigorously evaluate the potential of our SNC and
TAGE nonviral delivery systems for the treatment of LCA and BD. We invest our most significant effort into the
Lead Project 1 that develops a base editor within a SNC. This project will reach an IND within five years and
provide synergy for other projects. In Overall Aim 2, we create a platform that can address many rare diseases
of the eye by streamlined manufacturing of different guides with a simple pipeline for preclinical testing. In Overall
Aim 3, we provide the SCGE Consortium and broader genome editing field a set of regulatory interactions that
clarifies development path to the clinic for new gene editing therapies. Finally, through our experience with BD,
we expect to learn about the regulatory path in developing somatic cell genome editors for scenarios when no
suitable animal model exists. Because the majority of known pathological mutations in the eye have no suitable
animal models, sharing this knowledge will have a large impact on subsequent genome editing leads.