Emerging clinical applications of ADAR based RNA editing

RNA editing via adenosine deaminases acting on RNA (ADARs) offers precise and reversible modifications at the RNA level, complementing traditional DNA-targeting therapies. ADAR enzymes catalyze the conversion of adenosine to inosine within double-stranded RNA, influencing critical cellular processes such as translation, splicing, and RNA stability. Utilizing endogenous ADARs guided by exogenous guide RNAs enables site-specific RNA editing without the need for transgenic editor expression, minimizing immunogenicity, and enhancing control over gene expression. Towards addressing the challenges in ensuring specificity, optimizing delivery methods, and navigating regulatory landscapes, ongoing innovations in guide RNA design, delivery technologies, and computational modeling are propelling the field forward. Already, initial clinical advancements are demonstrating the potential of ADAR-mediated RNA editing in treating human diseases. Collaborative efforts among researchers, clinicians, and industry partners are overcoming existing hurdles, progressively positioning ADAR-mediated RNA editing to revolutionize personalized medicine and provide effective treatments for a wide array of historically intractable diseases.