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Cells edited using CRISPR–Cas9 injected into a person for the first time

nature.com

11–20 of 55 posts

Re: Cells edited using CRISPR–Cas9 injected into a person for the first time

#11
post #9

I think the best (or worst?) part is that CRISPR can be used with a 'gene drive' it keeps the changes active on on-going it's not a one shot thing. GATTACA?

Can't CRISPR achieve stable transfection through pathways like AAV, though? If that's the case, can't the cell lines carry on the changes without any need for on-going therapy?

Re: Cells edited using CRISPR–Cas9 injected into a person for the first time

#12
So this title is a bit misleading; something like, "cells edited with CRISPR injected into a person for the first time" would be better. While CRISPR is promising for topological treatments, that's not what happened here.

The team took white blood cells out of a patient's body, used CRISPR to knock out a gene which suppresses immune response, then injected those same cells back into the patient, hoping that they would attack the cancer without that inhibiting gene.

If this were a live CRISPR treatment in a human, it would probably make more sense to just knock out the activated oncogene(s) in the patient's cancer cells and/or repair the deactivated tumor suppressant gene(s).

Re: Cells edited using CRISPR–Cas9 injected into a person for the first time

#13

So this title is a bit misleading; something like, "cells edited with CRISPR injected into a person for the first time" would be better. While CRISPR is promising for topological treatments, that's not what happened here. The team took white blood cells out of a patient's body, used CRISPR to knock out a gene which suppresses immune response, then injected those same cells back into the patient, hoping that they woul…

> it would probably make more sense to just knock out the activated oncogene(s) in the patient's cancer

I've been wondering about that for the past couple of years, since I heard of CRISPR basically. Who is working on this aspect most seriously right now? Is there any interesting published progress? I understand it will take a while to make real progress, but mostly I'm just curious as an outsider to the industry.

Re: Cells edited using CRISPR–Cas9 injected into a person for the first time

#14
>"The researchers removed immune cells from the recipient’s blood and then disabled a gene in them using CRISPR–Cas9, which combines a DNA-cutting enzyme with a molecular guide that can be programmed to tell the enzyme precisely where to cut. The disabled gene codes for the protein PD-1, which normally puts the brakes on a cell’s immune response: cancers take advantage of that function to proliferate.

Lu’s team then cultured the edited cells, increasing their number, and injected them back into the patient, who has metastatic non-small-cell lung cancer. The hope is that, without PD-1, the edited cells will attack and defeat the cancer."

Or maybe it was this:

>"The researchers removed immune cells from the recipient’s blood and then selectively killed most cells containing a certain sequence using CRISPR–Cas9, which combines a DNA-cutting enzyme with a molecular guide that can be programmed to tell the enzyme precisely where to cut. The targeted gene codes for the protein PD-1, which normally puts the brakes on a cell’s immune response: cancers take advantage of that function to proliferate.

Lu’s team then cultured the surviving cells, increasing their number, and injected them back into the patient, who has metastatic non-small-cell lung cancer. The hope is that, without PD-1, the selected-for cell population will attack and defeat the cancer."

Since there is no paper (only press release) we can't say much more about which explanation is most plausible in this case.

Re: Cells edited using CRISPR–Cas9 injected into a person for the first time

#15

So this title is a bit misleading; something like, "cells edited with CRISPR injected into a person for the first time" would be better. While CRISPR is promising for topological treatments, that's not what happened here. The team took white blood cells out of a patient's body, used CRISPR to knock out a gene which suppresses immune response, then injected those same cells back into the patient, hoping that they woul…

> it would probably make more sense to just knock out the activated oncogene(s) in the patient's cancer I've been wondering about that for the past couple of years, since I heard of CRISPR basically. Who is working on this aspect most seriously right now? Is there any interesting published progress? I understand it will take a while to make real progress, but mostly I'm just curious as an outsider to the industry.

I don't think anyone is; it's still too far out there. I'm sure that there's plenty of research building towards it, but I couldn't name any names. I'm also an outsider to the industry, but CRISPR is actually a simple protocol that doesn't require much advanced equipment, and I've been looking into using it for some home science projects.

The problem as I understand it is that right now, CRISPR requires some manual steps in the lab to make it work well. You can design the protein and guide RNA and spacers until you're blue in the face, but if you can't find a specific enough cutting site on the genome, or one that is close enough to your target, or something like that, you'll wind up with a lack of specificity in that cut, which can lead to unwanted mutations. And since the CRISPR system was originally a sort of bacterial immune system, it's really geared towards 'knocking out' specific genes by (I think, but I'm really shaky on this part) introducing a bunch of extra mutations when the cut it makes in the DNA gets repaired. But there are two kinds of repair mechanisms, and apparently there's a way to encourage the more accurate one, although this is really an area I need to read more about.

Anyways, the technique has also been used to introduce entirely new genes, but I think that involves using modified CRISPR proteins called 'nickase's to make single-stranded cuts in the DNA, rather than double-stranded ones. You introduce plasmid DNA with your genes to match up with the cleavage sites, and ideally it gets taken up.

Whatever the approach, you still aren't going to get 100% expression or transfection, and stable transfection either requires invasive techniques like biolistics (shooting DNA through membranes on accelerated nanoparticles) or delivery by viruses, which has a lot of potential, comparatively minimal side effects, and can even be targeted somewhat to certain types of cells. But I think the FDA is nervous about, especially in humans.

Again though, I'm a layman here too, so someone please correct me where I'm wrong :)

Re: Cells edited using CRISPR–Cas9 injected into a person for the first time

#16
post #14

>"The researchers removed immune cells from the recipient’s blood and then disabled a gene in them using CRISPR–Cas9, which combines a DNA-cutting enzyme with a molecular guide that can be programmed to tell the enzyme precisely where to cut. The disabled gene codes for the protein PD-1, which normally puts the brakes on a cell’s immune response: cancers take advantage of that function to proliferate. Lu’s team then…

Luckily the article linked to the clinical trials.gov record for this trial [1] which suggests that the first approach (editing vs selection) is being used.

1. https://clinicaltrials.gov/ct2/show/NCT02793856?term=crispr&...

Re: Cells edited using CRISPR–Cas9 injected into a person for the first time

#17
This makes me feel that i.e. looking for bone marrow donors may become obsolete in some cases, if we know the gene sequence responsible for the disease. Instead of looking for donors, it may actually be possible to repair bone marrow cells and inject them back, fixing the problem. Am I missing something here?

Re: Cells edited using CRISPR–Cas9 injected into a person for the first time

#18

Earlier quoted context omitted.

> it would probably make more sense to just knock out the activated oncogene(s) in the patient's cancer I've been wondering about that for the past couple of years, since I heard of CRISPR basically. Who is working on this aspect most seriously right now? Is there any interesting published progress? I understand it will take a while to make real progress, but mostly I'm just curious as an outsider to the industry.

I don't think anyone is; it's still too far out there. I'm sure that there's plenty of research building towards it, but I couldn't name any names. I'm also an outsider to the industry, but CRISPR is actually a simple protocol that doesn't require much advanced equipment, and I've been looking into using it for some home science projects. The problem as I understand it is that right now, CRISPR requires some manual s…

Project idea: The death cap mushroom is really tasty according to people who are now dead. Disable the poison.

Re: Cells edited using CRISPR–Cas9 injected into a person for the first time

#19
post #14

>"The researchers removed immune cells from the recipient’s blood and then disabled a gene in them using CRISPR–Cas9, which combines a DNA-cutting enzyme with a molecular guide that can be programmed to tell the enzyme precisely where to cut. The disabled gene codes for the protein PD-1, which normally puts the brakes on a cell’s immune response: cancers take advantage of that function to proliferate. Lu’s team then…

Luckily the article linked to the clinical trials.gov record for this trial [1] which suggests that the first approach (editing vs selection) is being used. 1. https://clinicaltrials.gov/ct2/show/NCT02793856?term=crispr&...

That seems to be the favorite interpretation. We need to see what data they present that favors it (ie % survival of the treated cells, number of initial cells, % mutants at that location detected in control cells). Also, this is kind of weird, because they say it is non-randomized:

  Study Design: 	
  Allocation: Non-Randomized
  Endpoint Classification: Safety Study
  Intervention Model: Parallel Assignment
  Masking: Open Label
  Primary Purpose: Treatment
But later it says:

  Progression free survival - PFS [ Time Frame: From date of randomization until 
  the date of first documented progression or date of death from any cause, whichever
  came first, assessed up to average 10 months ] [ Designated as safety issue: No ]

  Overall Survival - OS [ Time Frame: The time from randomization to death from any
  cause, assessed up to 2 years ] [ Designated as safety issue: No ]
So is the treatment randomized or not? The info on that site may not be reliable... maybe it makes sense somehow though.

Re: Cells edited using CRISPR–Cas9 injected into a person for the first time

#20

So this title is a bit misleading; something like, "cells edited with CRISPR injected into a person for the first time" would be better. While CRISPR is promising for topological treatments, that's not what happened here. The team took white blood cells out of a patient's body, used CRISPR to knock out a gene which suppresses immune response, then injected those same cells back into the patient, hoping that they woul…

The headline seems fine to me. Your complaint seems to be that you think "CRISPR gene-editing" should only refer to editing of cells while they are still inside a live body. But I don't see why that specific type of therapy should claim full ownership of the term "CRISPR gene-editing". Grammatically, any therapy that uses CRISPR modified genes would qualify.
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