CRISP(R)- Y GENETICS.
CRISPR Cas9:
Editing genes, Solving mysteries.
In the amazing and surprisingly accurate, Sci-film
Gattaca, a geneticist explains to two parents that an embryo that he has
programmed to never have any ‘prejudicial conditions, such as alcoholism and
obesity is ‘simply the best of you. [They] could conceive naturally a thousand
times and never get such a result’. Whilst the idea of creating a child to be
exactly what you would want them to be is a concept that appears to belong to
Marvel movies, the potential of CRISPR Cas9 can make the future depicted in
Gattaca a reality.
CRISPR Cas-9 describes a natural system found in bacteria, that has been utilized for genetic engineering and may be the future of genetics and genomics. In 2020, Jennifer Doudna and Emmanuelle Charpentier, were awarded the Nobel Prize in Chemistry for their work in developing CRISPR.
Jennifer
Doudna and Emmanuelle Charpentier.
The winners of the 2020 Nobel Prize in Chemistry- for their work in developing CRISPR. Multiple other scientists have contributed to CRISPR including, but not limited to: Francisco Mojica, Gilles Vergnaud and Christine Pourcel, Alexander Bolotin, Luciano Marraffini and Erik Sontheimer, and Sylvain Moineau
In 2025, CPRISR is still making waves. In May this year, CRISPR was first used as a personalised therapy for an infant born with a metabolic disorder. Casgevy, the first CRISPR-based gene therapy has now been approved for use in treating sickle cell disorder and beta thalassemia, has been approved and is now treating patients across 50 sites worldwide.
But it appears that CRISPR is not only for the future; it is also for solving the past. Despite the multiple experiments conducted and discoveries made, the genome is still full of many mysteries that have never been solved.
In September 2021, Daniel M.Sapozhnikov and Moshe Szyf made their own contribution to the work done to understand the genome by using CRISPR Cas9. After four decades of research, the relationship between DNA methylation and gene expression is still unknown. DNA methylation is known to be associated with transcriptional regulation and has been for almost half a century- but it was unclear whether DNA methylation is the force behind the transcriptional change or whether it is the transcriptional change that causes the methylation.
The beginner’s guide to DNA methylation.
DNA methylation is a form of epigenetics; these are changes in activity or the function of the genes. It is common misconception that every gene that the DNA codes for is constantly active and constantly producing protein. Actually, a gene can be active or non-active, based on what proteins are actually required. Lung cells may need different proteins than muscle cells for example. DNA methylation is used to turn genes 'On' or 'Off'. When a methyl group - a carbon with three hydrogens is added to the DNA sequence, the gene is turned off. It is important to remember that the DNA sequence itself does not change. I always think of it like adding charms to a charm bracelet. The unwound DNA resembles a chain -this does not change, but charms- the methyl groups are added.
How DNA
Methylation works.
Now imagine that in the charm bracelet, charms can only be added to certain links. These certain links start off as 4 links apart but then become close and closer, giving regions where there are several charms hanging of the chains but other regions where there are barely any. These regions are the CpG islands -or CGI.
In mammalian genomes, regions of high guanine and cytosine content contain a high amount of CpG nucleotides. The methyl groups would only be binding to a cytosine located next to a guanine. In between them will be a phosphate molecule.
These islands tend to be located in gene promotor and enhancer regions. These are areas of DNA that control whether a gene can produce a protein in a process called transcription. But they can also be found within genes themselves. Typically, they are maintained in an unmethylated state and play a role in control of gene expression.
What was unknown was whether the DNA methylation was actually CAUSING the transcriptional change or the DNA methylation was just indicating that a transcriptional change was occurring
In other words, in a variation of the old chicken and the egg debate- what came first- DNA methylation or the transcriptional change- the turning on or off of the gene or the subsequent transcription? Multiple studies indicated it was the later with the transcriptional factor (a protein needed to kickstart transcription) binding to the DNA sequence before methyl groups bind to the DNA sequence.
This would make it possible that the state of DNA methylation is a marker for a particular condition. If proteins are being expressed correctly and causing a disorder, the absence or presence of methyl groups can tell you what proteins are being overexpressed or under expressed and can also help devise new treatments. For example, techniques to add or remove the methyl groups or techniques to reduce the impact of the protein.
However, it is also possible that the methylation of DNA plays a critical role
in the pathophysiological mechanism in transcription. This basically would mean that methyl groups binding or not binding to the DNA sequence would set off a chain reaction, affecting the transcription of proteins - potentially causing disease.
So what does this actually have to do with CRISPR?
CRISPR Cas9: The molecular biologist’s dream team.
CRISPR stands
for clustered regularly interspaced short palindromic repeats and was first discovered in the E.coli genome in 1987. It refers to an immune system that bacteria species use for defence against re-infection. Essentially, the bacteria can use CRISPR to create a memory of the infection, stopping it from being infected again. Unlike the human immune
system, the ‘memory’ created by CRISPR is passed onto the next generation.
It is made up of the following components- the Cas9 nuclease, a type of enzyme that cleaves DNA and RNA, and noncoding guide RNA (gRNA). RNA is similar to DNA but it is single stranded, whilst DNA is double-stranded, and contains a different sugar in its make-up. Its most important role is to get information transferred from DNA to its required location. It's often referred to as a messenger.
This guide RNA has a target-specific CRISPR RNA (crRNA) and a trans-activating
RNA (tracrRNA). The crRNA consists of a 20-nucleotide (a nucleotide is an individual component of a DNA molecule) guide sequence and a
partial direct repeat.
The guide RNA directs the Cas9 nuclease to a specific place in the genome- and causes a double stranded break (DBS) at the selected location. In other words, this is a cut in both strands of the DNA- at the same location.
But why would
we want to induce double stranded breaks in the DNA?
Inducing a DBS causes DNA repair systems to kick in to repair the double stranded break. It is possible to exploit these repair pathways to manipulate the genome at the selected locus. The broken strands will undergo one of two major pathways to repair the DNA damage: Non Homologous End Joining (NHEJ) or Homologous end repair (HDR).This repair pathways can lead to the insertion or deletion of DNA- otherwise known as 'indels'.
Genome
Editing using CRISPR Cas9.
This has multiple applications for healthcare. Being able to induce an indel into DNA can result in a disease-causing gene being knocked out. Due to the nature of DNA always using triplet nucleotides to generate a protein, adding in extra DNA or removing DNA gives extra or less nucleotides. This ruins the sequence of triplets, stopping the protein from being produced. This is known as a protective mutation. CRISPR also shows use in treating disease caused by viruses by being able to cleave viral DNA. Viruses rely on certain sequences of DNA being able to hijack human DNA to create more copies of itself, causing disease. Cleaving the viral DNA stops it from entering the human DNA and stops the disease.
It is also
possible to use CRISPR to introduce desired characteristics. In 2018, He
Jiankui announced that he had used CRISPR Cas9 to edit two human embryos,
making the babies less susceptible HIV- the CRISPR cas9 disrupted a gene that
codes a protein which allows HIV to enter immune cells. He Jiankui was
sentenced to three years in prison in 2020.
But the technique is not just for genetic engineering. This is seen by Sapozhnikov and Szyf using CRISPR cas9 to find the answer to a question that has been plaguing molecular biologists for decades.
The ultimate
showdown: CRISPR against the gang- TALEN, ZFN and RNAi
TALENs–transcription activator like effector nucleases are able to cut DNA sequences of interest, producing a DBS with high frequency and are derived from bacterial proteins. A similar nuclease, ZFN or Zinc finger nucleases are derived from a transcription factor found in Xenopus oocytes. These aren’t as efficient or specific as TALENS but work in a similar way; a nonspecific domain of DNA is fused to a sequence-specific DNA binding domain, generating double stranded breaks.
With both ZFNs and TALENs, it is possible to customise the DNA binding domain, meaning it can recognise virtually any sequence. DNA is full of highly specific sequences, with each one meaning a different thing. Being able to programme the DNA binding domains means the ZFN and TALENs can cut anywhere. CRISPR on the other hand relies on PAM sequences. PAM refers a short sequence that Cas9 has to bind to before it can cleave DNA.
However, what gives CRISPR an advantage over ZFN or TALEN is how simple and quick it is. When using TALEN, a new complex clone has to be designed for each DNA target, whilst if using ZFN, artificial proteins with customizable sequence specific domains have to be generated. This is not an issue with CRISPR; one invariant Cas9 nuclease can be targeted to a large variety of DNA motifs.
Meanwhile, RNA interference (RNAi) was the ‘magic bullet’ for gene targeting, provided the DNA sequence was known first. As the mechanisms for this became apparent, it was soon used in human cells to inhibit genes. However, an issue with RNAi is that it didn't always cause a complete knockout- the gene could still be active, just at a lower level. This is not an issue with CRISPR Cas9 as it usually allow for a complete knockout of genes.
Dead but not
necessarily inactive.
What Sapozhnikov
and Szyf did slightly differently was to use a nuclease-dead Cas9, along with
the guide RNA. This is also known as a nuclease-deficient Cas9 or dCas9. This basically meant that it didn't have the nuclease enzyme. This is actually a lentiviral system created by Liu
et al in 2016 to determine whether an inactive nuclease would
cause or erase DNA methylation.
The use of a dead Cas9 is a slight variation on the classic CRISPR /Cas9 system that prevents the formation of the double stranded break but still allows for RNA-guided targeting. As a result, Sapozhnikov and Szyf did not actually alter the DNA sequence- as is commonly seen in CRISPR.
CRISPR vs TET.
Of course, what was also important in their experiment was the decision not to use of TET-based epigenetic editors. TET enzymes can either inhibit methylation by replacing a methylated cytosine with a unmethylated cytosine.
However, Sapozhnikov and Szyf chose not to use TET. They instead used CRISPR/dcas9 for targeted methylation- i.e. using the system to add methyl groups. They proved that Cas9 can add methyl groups to DNA itself .
However, they did decide to assess the efficacy and specificity of the Liu et al system. This was to give them an accurate idea of the limitations of available targeted DNA methylation editing technology. So, Sapozhnikov and Szyf fused a dead Cas9 to the catalytic domain of a TET enzyme; TET1- which promotes active DNA demethylation.
CRISP(R)-ing
up the Methylation.
Sapozhnikov and
Szyf used the dead nuclease and guide RNA to target specific sites in the DNA.
The DNA they chose to use was the interleukin-33 (Il33) gene, due to the
presence and location of the CpG islands.
By removing a
methyl group, a gene can thus be un-silenced and can be transcribed.
What they found
out is as follows:
Cells that were
exposed to the TET enzyme were more demethylated but did not have an adequate
guide RNA. In comparison, the cells that were not exposed to the TET were less
demethylated but had a better guide RNA. This basically mean that using TET didn't cause a complete 'on-switching' off the gene but did make the system more accurate.
The
demethylation caused by using a dead Cas9 and TET1 was spread along a ‘substantial’ genetic
distance. For example, in some cells, CPGs located 700 bp away from the target
region were demethylated. This suggested that demethylation is not a
tightly regulated process, raising questions about the role of methylation in
transcriptional changes. Transcription has to be incredibly accurate and accurate, so anything involved in causing it would also have to be accurate.
Using a dead Cas9 along with dead TET resulted in demethylation and transactivation of the Il33 gene to comparable levels with dCas9 TET. This meant that the IL33 gene became activated to the same extent in both of these systems. But the system with the dead Cas9 and dead TER lacked any capacity to initiate the active DNA methylation process. This means it is not clear how the transcription of the Ill33 took place, considering that the methylation should not have been possible.
They were also able to determine that demethylation is not the only epigenetic change conferred by dCas9-TET- this was as an increase of 5-hydroxylmethylcystoine was detected when the promotor was exposed to dCas9-TET but not when exposed to dCas9-deadTET. 5-hydroxylmethylcytosine refers to the molecule formed when the 5-methylcytosine is oxidised by TET enzymes and it is believed to be linked to the control of DNA methylation.
As it has been found that dcas9-dead TET is capable of activating transcription, this means catalytic 5-hydroxylmethylcytosine is not necessary to begin transcriptional induction. This raises questions on what is actually needed to begin transcription.
CRISP(R)-y Ethics.
Anything involving
genetic engineering will have ethical concerns that will need to be addressed
and CRISPR is no exception to this.
One ethical concern that has to be addressed is the morality of enhancing the germline-i.e. the cells that will be passed down to future generations. It is entirely possible to use CRISPR to make the next generation ‘better’ than the first- as seen in the film Gattaca.
He Jiankui:
the creator of the CRISPR babies.
He Jiankui, a
Chinese scientist, edited the DNA of two babies to protect them against HIV. If
this is allowed, will parents wish to ‘protect’ their children against other conditions?
Will this bring us closer to the future seen in Gattaca?
It has also been
noted that CRISPR can have negative impacts. In a recent study conducted at
Kathy Niakan of the Francis Crick Institute, 22% of genome-edited embryos had
unwanted changes- including DNA rearrangements and large deletions of thousands
of DNA letters. Dieter Elgi in New York City also led a study where CRISPR
resulted in large segments of the relevant chromosome being lost. These changes
were completely unpredictable. This seems to indicate that there
is still quite a bit that needs to be understood about the CRISPR technique-
perhaps it is not as accurate as hoped. So it has to be asked whether it is
ethical to alter the genome when there is still so much that is not quite fully
understood.
However, the potential of CRISPR Cas9 in curing disease must also raise the question whether it is ethical and moral to deny the life-saving work of CRISPR. For example, CRISPR Cas9 can be used to treat melanoma, sarcoma, and myeloma, by expressing and switching off receptors associated with the immune system and the cancer cells. There is also no doubt that CRISPR can be used to treat genetic disorders, such as Cystic Fibrosis and Sickle cell disease. Could CRISPR be the only hope for many people?
CRISP(R)-y
Methylation: The future.
Sapozhnikov and
Szyf have potentially raised valuable questions about the relationship between
DNA methylation and transcriptional genomics but may also have validated the
use of CRISPR to control transcriptional regulation and expression.
If it is
possible to control methylation, using the system that Sapozhnikov and Szyf adapted
from Liu et al, why not use it as a form of genetic engineering? For example, if
DNA demethylation can activate a gene previously silenced, could this result in
a transcriptional change that could protect against disease? A benefit with DNA
methylation is that it is possible to reverse the changes made- for example, using
TET enzymes.
This is why it
is important to determine what causes methylation and whether methylation is responsible
for transcriptional changes. It provides
an alternative form of genetic engineering that many may consider to be more
ethical than CRISPR/cas9 would be.
As for the
future of CRISPR Cas9 itself, CRISPR appears to one of the most advanced and
most brilliant techniques currently available for genomic editing. However, it
is not impossible that more advanced genomic editing technologies will be
developed. Many would not have believed that something more advanced than RNAi
could ever be theorized.
There is little
doubt that genome editing will become more accessible and more acceptable as
understanding of the genome and the increases. Whether it is CRISPR that will
take to us the best possible embryos as seen in Gattaca remains to be seen.