The center will work first on CRISPR treatments for two genetic defects of the immune system: familial hemophagocytic lymphohistiocytosis (HLH), which causes immune cells to become overactive, damaging tissues and organs throughout the body; and Artemis-deficient severe combined immunodeficiency (ART-SCID), in which T and B lymphocytes fail to mature, making infants vulnerable to fatal infections.
The standard treatment for both conditions, a bone marrow transplant, is inadequate due to frequent complications.
“With CRISPR, we can speed up the development of improved therapies that can reach all the patients who need them,” said Jennifer Puck, MD, a pediatrics professor who directs the UCSF Jeffrey Modell Diagnostic Center for Primary Immunodeficiencies. “All patients deserve a sense of urgency – including those with rare diseases, many of whom are children.”
Since the CRISPR platform being created at IGI could, in theory, be reprogrammed to address any gene mutation, the goal is to use treatments for HLH and ART-SCID as models to develop a scalable approach from which new medicine for other genetic diseases can be rapidly developed.
“The unique nature of CRISPR makes it ideal for developing and deploying a platform capability for CRISPR cures on demand,” said Fyodor Urnov, IGI’s Director of Technology and Translation, who is overseeing the project along with Jennifer Doudna and IGI Executive Director Brad Ringeisen. “Danaher and the IGI are in a unique position to potentially create a first-of-its-kind CRISPR cures ‘cookbook’ that could be used by any team wishing to take on other diseases.”
ART-SCID and HLH are typical of many rare diseases in that they have small patient populations, making drug development challenging and cost prohibitive. On average, it takes 10 years for a single clinical trial.
HLH and ART-SCID are two examples of a class known as inborn errors of immunity or IEIs. Each IEI is very rare, but collectively there are about 500 such diseases affecting more than 112,000 patients.
“We can develop CRISPR cures in a laboratory, but at the end of the day we need a way to turn those into clinical products for thousands of patients,” says IGI founder Jennifer Doudna, PhD, a UC Berkeley biochemist who won the Nobel Prize for co-developing CRISPR.
Currently there are only a few hundred patients in clinical trials for CRISPR-based therapies; the IGI hopes its work will allow that number to ramp up ten-fold over the next decade.
After decades of research, Puck and UCSF Pediatrics Professor Mort Cowan, MD, successfully treated 14 children with ART-SCID, known colloquially as Bubble Baby Disease, by inserting a corrected version of the Artemis gene into the children’s own bone marrow stem cells using a delivery system known as a lentivirus. A CRISPR-based version of this treatment could more precisely target where the gene copies go, avoiding possible toxicity from lentiviral interference with genes near sites of insertion in the genome.
Both ART-SCID and HLH have extensive patient registries to facilitate enrollment in future clinical trials. Since both are diseases of blood-forming bone marrow stem cells that renew the immune system throughout the life span, targeting these cells can bypass challenges in delivering CRISPR molecules to tissues in other disorders.
“We know how to deliver the CRISPR molecules into the cells to fix them,” Cowan said. “We also know how to reach patients, because there is an existing registry and network of expert physicians. By focusing on ART-SCID and HLH first, we aim to create a roadmap through pre-clinical and clinical development and lead the way for other indications, whether they are rare or not.”
The IGI team includes UCSF physician-scientists Matthew Kan, MD, PhD, Puck and Cowan focusing on ART-SCID; and David Nguyen, MD, PhD, Michelle Hermiston, MD, PhD and Bryan Shy, MD, PhD, focusing on HLH. Petros Giannikopoulos, MD, director of IGI’s Clinical Laboratory, will be the center’s diagnostic and analytical lead. Donald Kohn, MD, of UCLA will be involved in translating the gene editing approaches developed at UCSF and UC Berkeley to clinical cell manufacturing in the UCLA Human Gene and Cell Therapy Facility.
Cowan, Kan, Kohn, Puck and Urnov are recipients of grants from the California Institute of Regenerative Medicine, CIRM, which have enabled them to reach the current stage of their work with the Beacon center.
About UCSF Health: UCSF Health is recognized worldwide for its innovative patient care, reflecting the latest medical knowledge, advanced technologies and pioneering research. It includes the flagship UCSF Medical Center, which is a top-ranked specialty hospital, as well as UCSF Benioff Children’s Hospitals, with campuses in San Francisco and Oakland, Langley Porter Psychiatric Hospital and Clinics, UCSF Benioff Children’s Physicians and the UCSF Faculty Practice. These hospitals serve as the academic medical center of the University of California, San Francisco, which is world-renowned for its graduate-level health sciences education and biomedical research. UCSF Health has affiliations with hospitals and health organizations throughout the Bay Area. Visit www.ucsfhealth.org. Follow UCSF Health on Facebook or on Twitter.
About the Innovative Genomics Institute: The Innovative Genomics Institute (IGI) is a joint effort between the Bay Area’s leading scientific research institutions, UC Berkeley and UC San Francisco, with affiliates at UC Davis, UCLA, Lawrence Berkeley National Laboratory, Lawrence Livermore National Laboratory, Gladstone Institutes, and other institutions. Founded by Nobel laureate Jennifer Doudna, the IGI’s mission is to bridge revolutionary genome-editing tool development to affordable and accessible solutions in human health, climate, and agriculture. We are working toward a world where genomic technology is routinely applied to treat genetic disease, enable sustainable agriculture, and help achieve a carbon-neutral economy. www.innovativegenomics.org
Source, UCSF News: New CRISPR Center Brings Hope for Rare and Deadly Genetic Diseases
