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Published on: May 23, 2025
Exon skipping induced by CRISPR-directed gene editing regulates the response to chemotherapy in non-small cell lung
Kelly Banas1, Shirin Modarai1, Natalia Rivera-Torres1
1Gene Editing Institute, ChristianaCare, Newark, DE, USA.
Abstract:
We have been developing CRISPR-directed gene editing as an augmentative therapy for the treatment of non-small cell lung carcinoma (NSCLC) by genetic disruption of Nuclear Factor Erythroid 2-Related Factor 2 (NRF2). NRF2 promotes tumor cell survival in response to therapeutic intervention and thus its disablement should restore or enhance effective drug action. Here, we report how NRF2 disruption leads to collateral damage in the form of CRISPR-mediated exon skipping. Heterogeneous populations of transcripts and truncated proteins produce a variable response to chemotherapy, dependent on which functional domain is missing. We identify and characterize predicted and unpredicted transcript populations and discover that several types of transcripts arise through exon skipping; wherein one or two NRF2 exons are missing. In one specific case, the presence or absence of a single nucleotide determines whether an exon is skipped or not by reorganizing Exonic Splicing Enhancers (ESEs). We isolate and characterize the diversity of clones induced by CRISPR activity in a NSCLC tumor cell population, a critical and often overlooked genetic byproduct of this exciting technology. Finally, gRNAs must be designed with care to avoid altering gene expression patterns that can account for variable responses to solid tumor therapy.
Insights
CRISPR gene editing for non-small cell lung cancer (NSCLC) disrupts NRF2, but causes unintended exon skipping. This leads to varied transcript and protein products, impacting chemotherapy effectiveness and requiring careful guide RNA design.
Area of Science:
- Oncology
- Molecular Biology
- Gene Editing
Background:
- Non-small cell lung carcinoma (NSCLC) cells utilize Nuclear Factor Erythroid 2-Related Factor 2 (NRF2) for survival against therapies.
- Disrupting NRF2 is a strategy to enhance anti-cancer drug efficacy.
Purpose of the Study:
- To investigate the consequences of CRISPR-mediated NRF2 disruption in NSCLC.
- To characterize the resulting transcript and protein variations.
- To assess the impact on therapeutic response.
Main Methods:
- CRISPR-directed gene editing targeting NRF2 in NSCLC cells.
- Transcriptome analysis to identify and characterize diverse RNA populations.
- Protein analysis to detect truncated forms.
- Investigation of splicing regulatory elements like Exonic Splicing Enhancers (ESEs).
Main Results:
- NRF2 disruption induced CRISPR-mediated exon skipping, creating heterogeneous transcripts.
- Exon skipping resulted in variable functional domains and truncated proteins.
- A single nucleotide change influenced exon skipping by reorganizing ESEs.
- CRISPR activity generated diverse clones with altered gene expression patterns.
Conclusions:
- CRISPR-mediated NRF2 disruption in NSCLC can cause unintended exon skipping, leading to variable therapeutic responses.
- Careful guide RNA design is crucial to avoid unintended genetic alterations and ensure consistent treatment outcomes.
- Understanding these off-target effects is vital for the clinical application of CRISPR in solid tumor therapy.
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