Treatment of sickle cell anemia using CRISPR and prime editing

Hongwei Yang
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Abstract

Sickle cell disease is a hereditary blood disease caused by an invisible genetic mutation on the autosome, caused by a transversion mutation in which the 6th amino acid of the -peptide chain, glutamate, is replaced by valine, resulting in the formation of sickle hemoglobin, instead of normal hemoglobin. Due to genetic mutations leading to structural abnormalities in hemoglobin and morphological changes in red blood cells, red blood cells lose their deformability in hypoxic environments, leading to vascular blockage, causing severe pain and partial tissue ischemia in patients. Oxygen needs to be transported to various parts of the body through red blood cells, thereby affecting the transportation of oxygen in the body. In general, red blood cells are circular and elastic, making them easy to move in blood vessels. However, in sickle cells, these red blood cells are compressed and deformed, causing the transportation of oxygen in the blood to become stiff and viscous, potentially slowing or blocking blood flow. The most common complication of SCA is blockage of blood vessels, which leads to pain. Although this is a complex phenomenon, HbS aggregation is a fundamental pathological physiological phenomenon in SCA. HbS aggregation can lead to malignant changes in the shape and physical properties of red blood cells, leading to hemolytic anemia and preventing blood flow, especially in small blood vessels, which may damage some organs. Clinical manifestations include anemia, immunodeficiency, multiple organ damage, severe acute and chronic pain, and premature death. The quality of life of the patients was seriously affected.
利用 CRISPR 和基因编辑技术治疗镰状细胞性贫血
镰状细胞病是一种遗传性血液病,是由于常染色体上的隐形基因突变引起的,这种基因突变是由于-肽链的第6个氨基酸谷氨酸被缬氨酸取代,从而形成镰状血红蛋白,而不是正常血红蛋白。由于基因突变导致血红蛋白结构异常和红细胞形态变化,红细胞在缺氧环境中失去变形能力,导致血管堵塞,引起患者剧烈疼痛和部分组织缺血。氧气需要通过红细胞运输到身体的各个部位,从而影响体内氧气的运输。一般来说,红细胞呈圆形,富有弹性,易于在血管中移动。然而,在镰状细胞患者体内,这些红细胞被压缩变形,导致血液中氧气的运输变得僵硬和粘稠,有可能减缓或阻碍血液流动。镰状红细胞症最常见的并发症是血管堵塞,从而导致疼痛。虽然这是一个复杂的现象,但 HbS 聚集是 SCA 的基本病理生理现象。HbS 聚集会导致红细胞的形状和物理性质发生恶性变化,导致溶血性贫血,阻碍血液流动,尤其是小血管内的血液流动,从而可能损害某些器官。临床表现包括贫血、免疫缺陷、多器官损伤、严重的急性和慢性疼痛以及过早死亡。患者的生活质量受到严重影响。
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