Mol Ther Nucleic Acids. 2024 Sep 10. 35(3): 102257
Ju Hyuen Cha,
Seok-Hoon Lee,
Yejin Yun,
Won Hoon Choi,
Hansol Koo,
Sung Ho Jung,
Ho Byung Chae,
Dae Hee Lee,
Seok Jae Lee,
Dong Hyun Jo,
Jeong Hun Kim,
Jae-Jin Song,
Jong-Hee Chae,
Jun Ho Lee,
Jiho Park,
Jin Young Kang,
Sangsu Bae,
Sang-Yeon Lee.
Mutations in nuclear genes regulating mitochondrial DNA (mtDNA) replication are associated with mtDNA depletion syndromes. Using whole-genome sequencing, we identified a heterozygous mutation (c.272G>A:p.Arg91Gln) in single-stranded DNA-binding protein 1 (SSBP1), a crucial protein involved in mtDNA replisome. The proband manifested symptoms including sensorineural deafness, congenital cataract, optic atrophy, macular dystrophy, and myopathy. This mutation impeded multimer formation and DNA-binding affinity, leading to reduced efficiency of mtDNA replication, altered mitochondria dynamics, and compromised mitochondrial function. To correct this mutation, we tested two adenine base editor (ABE) variants on patient-derived fibroblasts. One variant, NG-Cas9-based ABE8e (NG-ABE8e), showed higher editing efficacy (≤30%) and enhanced mitochondrial replication and function, despite off-target editing frequencies; however, risks from bystander editing were limited due to silent mutations and off-target sites in non-translated regions. The other variant, NG-Cas9-based ABE8eWQ (NG-ABE8eWQ), had a safer therapeutic profile with very few off-target effects, but this came at the cost of lower editing efficacy (≤10% editing). Despite this, NG-ABE8eWQ-edited cells still restored replication and improved mtDNA copy number, which in turn recovery of compromised mitochondrial function. Taken together, base editing-based gene therapies may be a promising treatment for mitochondrial diseases, including those associated with SSBP1 mutations.
Keywords: MT: RNA/ DNA editing; NG-ABE8e; NG-ABE8eWQ; NG-Cas9-based ABE8e; NG-Cas9-based ABE8eWQ; SSBP1; editing efficacy; mitochondrial diseases; myopathy; off-target effects; optic atrophy; sensorineural deafness; single-stranded binding protein 1