REMEDY: REpair of heterozygous Mutations independent of Exogenous Donor template with high efficiency using allele specific CRISPR targeting and HDR enhancers

Sezgin, Y.; Snyder, G.; Saljoughian, N.; Maguire, C.; Erzurumluoglu Gokalp, E.; Jaganathan, D.; D'ambrossio, E. S.; Ozes, B.; Wheeler, G.; Kelly, B.; Hester, M.; Sahenk, Z.; Vaidyanathan, S.; Rashnonejad, A.; Mendell, J.; Saad, N. Y.; Abraham, R. S.; Bagaitkar, J.; Reynolds, S. D.; Bradbury, A.; Naeimi Kararoudi, M.

doi:10.1101/2025.05.29.641201

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bioRxiv · 10.1101/2025.05.29.641201

REMEDY: REpair of heterozygous Mutations independent of Exogenous Donor template with high efficiency using allele specific CRISPR targeting and HDR enhancers

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Abstract

We report the development of REMEDY (REpair of heterozygous Mutations independent of Exogenous Donor template with high efficiencY), a genome editing strategy that allows efficient repair of heterozygous mutations in human and mouse cells without necessitating an exogenous donor DNA template. Here, we used in-PAM or near-PAM CRISPR strategies to induce a double-strand break (DSB) in mutant alleles. Following the DSB, the wild-type homologous chromosome itself serves as an endogenous DNA donor template and initiates the correction of the mutant allele. Concurrently treating the cells with HDR enhancers, such as AZD7648, further improved the efficiency of the correction. We demonstrated the utility of REMEDY in the context of six different diseases with heterozygous mutations such as IBMPFD, cystic fibrosis, progeria, ITPR3-associated combined immunodeficiency, ACTA1, and TBCD in human patient derived primary cells and complementary mouse model cell lines. O_FIG O_LINKSMALLFIG WIDTH=91 HEIGHT=200 SRC="FIGDIR/small/641201v1_ufig1.gif" ALT="Figure 1"> View larger version (18K): org.highwire.dtl.DTLVardef@5f6c41org.highwire.dtl.DTLVardef@bc50d5org.highwire.dtl.DTLVardef@15edca2org.highwire.dtl.DTLVardef@e74ada_HPS_FORMAT_FIGEXP M_FIG Graphical Abstract C_FIG

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Sezgin, Y., Snyder, G., Saljoughian, N., Maguire, C., Erzurumluoglu Gokalp, E., Jaganathan, D., D'ambrossio, E. S., Ozes, B., Wheeler, G., Kelly, B., Hester, M., Sahenk, Z., Vaidyanathan, S., Rashnonejad, A., Mendell, J., Saad, N. Y., Abraham, R. S., Bagaitkar, J., Reynolds, S. D., Bradbury, A., Naeimi Kararoudi, M.. 2025-05-30. REMEDY: REpair of heterozygous Mutations independent of Exogenous Donor template with high efficiency using allele specific CRISPR targeting and HDR enhancers. https://doi.org/10.1101/2025.05.29.641201

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