US2022235347A1PendingUtilityA1

Compositions and methods for treating hemoglobinopathies

Assignee: BEAM THERAPEUTICS INCPriority: Feb 13, 2019Filed: Feb 13, 2020Published: Jul 28, 2022
Est. expiryFeb 13, 2039(~12.6 yrs left)· nominal 20-yr term from priority
C07K 2319/00C12N 2310/315C12N 2310/321C12N 15/113C12N 9/22C12Y 305/04004C12N 9/78C12N 2800/80C12N 15/907A61K 38/465C07K 2319/80C12N 2310/20C12N 2510/00A61K 35/28A61K 35/18C12N 15/102C12N 15/11A61P 7/00A61K 31/7088C07K 2319/09C07K 14/805C07K 14/4717C12N 5/0641A61P 7/06C12N 2506/11A61K 38/50A61K 35/15
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Claims

Abstract

The present invention features compositions and methods for editing deleterious mutations associated with hemoglobinopathies, such as sickle cell disease (SCD). In particular embodiments, the invention provides methods for correcting mutations in a beta globin polynucleotide using modified adenosine base editors termed “ABE8” having unprecedented levels (e.g., >60-70%) of efficiency.

Claims

exact text as granted — not AI-modified
1 . A method of editing a beta globin (HBB) polynucleotide comprising a single nucleotide polymorphism (SNP) associated with sickle cell disease, the method comprising contacting a beta globin polynucleotide with one or more guide RNAs and a fusion protein comprising a polynucleotide programmable DNA binding domain and at least one base editor domain that is an adenosine deaminase variant comprising a T166R alteration in the following amino acid sequence and having at least 85% sequence identity to the following amino acid sequence MSEVEFSHEYWMRHALTLAKRARDEREVPVGAVLVLNNRVIGEGWNRAIGLHDPTAHAEIMALRQGGLVMQNY RLIDATLYVTFEPCVMCAGAMIHSRIGRVVFGVRNAKTGAAGSLMDVLHYPGMNHRVEITEGILADECAALLC YFFRMPRQVFNAQKKAQSSTD (SEQ ID NO: 2), wherein said guide RNA targets said base editor domain to effect an alteration of the SNP associated with sickle cell disease. 
     
     
         2 . The method of  claim 1 , wherein the adenosine deaminase variant comprises alterations at amino acid positions 82 and 166. 
     
     
         3 - 4 . (canceled) 
     
     
         5 . The method of  claim 1 , wherein the adenosine deaminase variant comprises V82S and T166R alterations. 
     
     
         6 . (canceled) 
     
     
         7 . The method of  claim 1 , wherein the adenosine deaminase variant comprises a combination of alterations selected from the group consisting of: Y147T+Q154R; Y147T+Q154S; Y147R+Q154S; V82S+Q154S; V82S+Y147R; V82S+Q154R; V82S+Y123H; I76Y+V82S; V82S+Y123H+Y147T; V82S+Y123H+Y147R; V82S+Y123H+Q154R; Y147R+Q154R+Y123H; Y147R+Q154R+176Y; Y147R+Q154R+T166R; Y123H+Y147R+Q154R+I76Y; V82S+Y123H+Y147R+Q154R; and I76Y+V82S+Y123H+Y147R+Q154R. 
     
     
         8 - 17 . (canceled) 
     
     
         18 . A method of editing a beta globin (HBB) polynucleotide comprising a single nucleotide polymorphism (SNP) associated with sickle cell disease, the method comprising contacting a beta globin polynucleotide with one or more guide RNAs and a fusion protein comprising a polynucleotide programmable DNA binding domain comprising the following 
       
         
           
                 
               
                   (SEQ ID NO: 3) 
                 
                   
                     EIGKATAKYFFYSNIMNFFKTEITLANGEIRKRPLIETNGETGEIVWDK 
                   
                 
                     
                 
                   
                     GRDFATVRKVLSMPQVNIVKKTEVQTGGFSKESILPKRNSDKLIARKKD 
                   
                 
                     
                 
                   
                     WDPKKYGGFMQPTVAYSVLVVAKVEKGKSKKLKSVKELLGITIMERSSF 
                   
                 
                     
                 
                   
                     EKNPIDFLEAKGYKEVKKDLIIKLPKYSLFELENGRKRMLASAKFLQKG 
                   
                 
                     
                 
                   
                     NELALPSKYVNFLYLASHYEKLKGSPEDNEQKQLFVEQHKHYLDEIIEQ 
                   
                 
                     
                 
                   
                     ISEFSKRVILADANLDKVLSAYNKHRDKPIREQAENIIHLFTLTNLGAP 
                   
                 
                     
                 
                   
                     RAFKYFDTTIARKEYRSTKEVLDATLIHQSITGLYETRIDLSQLGGD 
                     GG 
                   
                 
                     
                 
                   
                     SGGSGGSGGSGGSGGSGGM 
                     DKKYSIGLAIGTNSVGWAVITDEYKVPSKK 
                   
                 
                     
                 
                   
                     FKVLGNTDRHSIKKNLIGALLFDSGETAEATRLKRTARRRYTRRKNRIC 
                   
                 
                     
                 
                   
                     YLQEIFSNEMAKVDDSFFHRLEESFLVEEDKKHERHPIFGNIVDEVAYH 
                   
                 
                     
                 
                   
                     EKYPTIYHLRKKLVDSTDKADLRLIYLALAHMIKFRGHFLIEGDLNPDN 
                   
                 
                     
                 
                   
                     SDVDKLFIQLVQTYNQLFEENPINASGVDAKAILSARLSKSRRLENLIA 
                   
                 
                     
                 
                   
                     QLPGEKKNGLFGNLIALSLGLTPNFKSNFDLAEDAKLQLSKDTYDDDLD 
                   
                 
                     
                 
                   
                     NLLAQIGDQYADLFLAAKNLSDAILLSDILRVNTEITKAPLSASMIKRY 
                   
                 
                     
                 
                   
                     DEHHQDLTLLKALVRQQLPEKYKEIFFDQSKNGYAGYIDGGASQEEFYK 
                   
                 
                     
                 
                   
                     FIKPILEKMDGTEELLVKLNREDLLRKQRTFDNGSIPHQIHLGELHAIL 
                   
                 
                     
                 
                   
                     RRQEDFYPFLKDNREKIEKILTFRIPYYVGPLARGNSRFAWMTRKSEET 
                   
                 
                     
                 
                   
                     ITPWNFEEVVDKGASAQSFIERMTNFDKNLPNEKVLPKHSLLYEYFTVY 
                   
                 
                     
                 
                   
                     NELTKVKYVTEGMRKPAFLSGEQKKAIVDLLFKTNRKVTVKQLKEDYFK 
                   
                 
                     
                 
                   
                     KIECFDSVEISGVEDRFNASLGTYHDLLKIIKDKDFLDNEENEDILEDI 
                   
                 
                     
                 
                   
                     VLTLTLFEDREMIEERLKTYAHLFDDKVMKQLKRRRYTGWGRLSRKLIN 
                   
                 
                     
                 
                   
                     GIRDKQSGKTILDFLKSDGFANRNFMQLIHDDSLTFKEDIQKAQVSGQG 
                   
                 
                     
                 
                   
                     DSLHEHIANLAGSPAIKKGILQTVKVVDELVKVMGRHKPENIVIEMARE 
                   
                 
                     
                 
                   
                     NQTTQKGQKNSRERMKRIEEGIKELGSQILKEHPVENTQLQNEKLYLYY 
                   
                 
                     
                 
                   
                     LQNGRDMYVDQELDINRLSDYDVDHIVPQSFLKDDSIDNKVLTRSDKNR 
                   
                 
                     
                 
                   
                     GKSDNVPSEEVVKKMKNYWRQLLNAKLITQRKFDNLTKAERGGLSELDK 
                   
                 
                     
                 
                   
                     AGFIKRQLVETRQITKHVAQILDSRMNTKYDENDKLIREVKVITLKSKL 
                   
                 
                     
                 
                   
                     VSDFRKDFQFYKVREINNYHHAHDAYLNAVVGTALIKKYPKLESEFVYG 
                   
                 
                     
                 
                     DYKVYDVRKMIAKSEQ   EGADKRTADGSEFESPKKKRKV *, 
                 
             
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
               
            
           
         
         wherein the bold sequence indicates sequence derived from Cas9, the italics sequence denotes a linker sequence, and the underlined sequence denotes a bipartite nuclear localization sequence, and at least one base editor domain comprising an adenosine deaminase variant comprising a T166R alteration in the following amino acid sequence and having at least 85% sequence identity to the following amino acid sequence: 
       
       
         
           
                 
               
                   (SEQ ID NO: 2) 
                 
                   MSEVEFSHEYWMRHALTLAKRARDEREVPVGAVLVLNNRVIGEGWNRAI 
                 
                     
                 
                   GLHDPTAHAEIMALRQGGLVMQNYRLIDATLYVTFEPCVMCAGAMIHSR 
                 
                     
                 
                   IGRVVFGVRNAKTGAAGSLMDVLHYPGMNHRVEITEGILADECAALLCY 
                 
                     
                 
                   FFRMPRQVFNAQKKAQSSTD. 
                 
             
                
                
                
                
                
                
                
                
               
            
           
         
       
     
     
         19 . The method of  claim 18 , wherein adenosine deaminase variant comprises alterations at amino acid positions 82 and 166. 
     
     
         20 - 23 . (canceled) 
     
     
         24 . The method of  claim 18 , wherein the adenosine deaminase variant comprises a combination of alterations selected from the group consisting of: Y147T+Q154R; Y147T+Q154S; Y147R+Q154S; V82S+Q154S; V82S+Y147R; V82S+Q154R; V82S+Y123H; I76Y+V82S; V82S+Y123H+Y147T; V82S+Y123H+Y147R; V82S+Y123H+Q154R; Y147R+Q154R+Y123H; Y147R+Q154R+176Y; Y147R+Q154R+T166R; Y123H+Y147R+Q154R+I76Y; V82S+Y123H+Y147R+Q154R; and I76Y+V82S+Y123H+Y147R+Q154R. 
     
     
         25 - 43 . (canceled) 
     
     
         44 . The method of  claim 1 , wherein the SNP associated with sickle cell disease results in expression of an HBB polypeptide having a valine at amino acid position 6. 
     
     
         45 - 59 . (canceled) 
     
     
         60 . A base editing system comprising the fusion protein of  claim 1  and a guide RNA comprising a nucleic acid sequence selected from the group consisting of 
       
         
           
                 
                 
               
                     
                   (SEQ ID NO: 4) 
                 
                     
                   CUUCUCCACAGGAGUCAGAU; 
                 
                     
                     
                 
                     
                   (SEQ ID NO: 5) 
                 
                     
                   ACUUCUCCACAGGAGUCAGAU; 
                 
                     
                   and 
                 
                     
                     
                 
                     
                   (SEQ ID NO: 6) 
                 
                     
                   GACUUCUCCACAGGAGUCAGAU. 
                 
             
                
                
                
                
                
                
                
                
                
               
            
           
         
       
     
     
         61 . The base editing system of  claim 60 , wherein the gRNA further comprises a nucleic acid sequence 
       
         
           
                 
               
                   (SEQ ID NO: 7) 
                 
                   GUUUUUGUACUCUCAAGAUUUAAGUAACUGUACAACGAAACUUACACAG 
                 
                     
                 
                   UUACUUAAAUCUUGCAGAAGCUACAAAGAUAAGGCUUCAUGCCGAAAUC 
                 
                     
                 
                   AACACCCUGUCAUUUUAUGGCAGGGUG. 
                 
             
                
                
                
                
                
                
               
            
           
         
       
     
     
         62 . The base editing system of  claim 60 , wherein the gRNA comprises a nucleic acid sequence selected from 
       
         
           
                 
               
                   (SEQ ID NO: 8) 
                 
                   CUUCUCCACAGGAGUCAGAUGUUUUUGUACUCUCAAGAUUUAAGUAACU 
                 
                     
                 
                   GUACAACGAAACUUACACAGUUACUUAAAUCUUGCAGAAGCUACAAAGA 
                 
                     
                 
                   UAAGGCUUCAUGCCGAAAUCAACACCCUGUCAUUUUAUGGCAGGGUG; 
                 
                     
                 
                   (SEQ ID NO: 9) 
                 
                   ACUUCUCCACAGGAGUCAGAUGUUUUUGUACUCUCAAGAUUUAAGUAAC 
                 
                     
                 
                   UGUACAACGAAACUUACACAGUUACUUAAAUCUUGCAGAAGCUACAAAG 
                 
                     
                 
                   AUAAGGCUUCAUGCCGAAAUCAACACCCUGUCAUUUUAUGGCAGGGUG; 
                 
                   and 
                 
                     
                 
                   (SEQ ID NO: 10) 
                 
                   GACUUCUCCACAGGAGUCAGAUGUUUUUGUACUCUCAAGAUUUAAGUAA 
                 
                     
                 
                   CUGUACAACGAAACUUACACAGUUACUUAAAUCUUGCAGAAGCUACAAA 
                 
                     
                 
                   GAUAAGGCUUCAUGCCGAAAUCAACACCCUGUCAUUUUAUGGCAGGGUG. 
                 
             
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
               
            
           
         
       
     
     
         63 . A cell produced by introducing into the cell, or a progenitor thereof:
 a base editor, a polynucleotide encoding said base editor, to said cell, wherein said base editor comprises a polynucleotide programmable DNA binding domain and an adenosine deaminase domain described in  claim 1 ; and   one or more guide polynucleotides that target the base editor to effect an A•T to G•C alteration of the SNP associated with sickle cell disease.   
     
     
         64 - 87 . (canceled) 
     
     
         88 . A method of treating sickle cell disease in a subject comprising administering to said subject a cell of  claim 63 . 
     
     
         89 . The method of  claim 88 , wherein said cell is autologous or allogenic to said subject. 
     
     
         90 .- 91 . (canceled) 
     
     
         92 . A method of producing a red blood cell, or progenitor thereof, comprising:
 (a) introducing into a red blood cell progenitor comprising an SNP associated with sickle cell disease,   a base editor, or a polynucleotide encoding said base editor, wherein said base editor comprises a polynucleotide-programmable nucleotide-binding domain and an adenosine deaminase variant domain described in  claim 1 ; and   one or more guide polynucleotides, wherein said one or more guide polynucleotides target said base editor to effect an A•T to G•C alteration of the SNP associated with sickle cell disease; and   (b) differentiating the red blood cell progenitor into an erythrocyte.   
     
     
         93 - 114 . (canceled) 
     
     
         115 . A method for treating sickle cell disease (SCD) in a subject, the method comprising: administering to the subject a fusion protein comprising an adenosine deaminase variant inserted within a Cas9 or a Cas12 polypeptide, or a polynucleotide encoding the fusion protein thereof; and one or more guide polynucleotides to target the fusion protein to effect an A•T to G•C alteration of a single nucleotide polymorphism (SNP) associated with SCD, thereby treating SCD in the subject. 
     
     
         116 . A method of treating sickle cell disease (SCD) in a subject, the method comprising: administering to the subject an adenosine base editor 8 (ABE8), or a polynucleotide encoding said base editor, wherein the ABE8 comprises an adenosine deaminase variant inserted within a Cas9 or Cas12 polypeptide; and one or more guide polynucleotides that target the ABE8 to effect an A•T to G•C alteration of a SNP associated with SCD, thereby treating SCD in the subject. 
     
     
         117 - 118 . (canceled) 
     
     
         119 . The method of  claim 116 , wherein the adenosine deaminase variant comprises an alteration at amino acid position 166. 
     
     
         120 . (canceled) 
     
     
         121 . The method of  claim 119 , wherein the adenosine deaminase variant further comprises one of the following combinations of alterations: Y147T+Q154R; Y147T+Q154S; Y147R+Q154S; V82S+Q154S; V82S+Y147R; V82S+Q154R; V82S+Y123H; I76Y+V82S; V82S+Y123H+Y147T; V82S+Y123H+Y147R; V82S+Y123H+Q154R; Y147R+Q154R+Y123H; Y147R+Q154R+176Y; Y147R+Q154R+T166R; Y123H+Y147R+Q154R+I76Y; V82S+Y123H+Y147R+Q154R; and I76Y+V82S+Y123H+Y147R+Q154R. 
     
     
         122 - 171 . (canceled) 
     
     
         172 . A pharmaceutical composition comprising a base editing system comprising the fusion protein of  claim 1 , and a pharmaceutically acceptable carrier, vehicle, or excipient. 
     
     
         173 . The pharmaceutical composition of  claim 172 , further comprising a guide RNA comprising a nucleic acid sequence selected from the group consisting of 
       
         
           
                 
                 
               
                     
                   (SEQ ID NO: 4) 
                 
                     
                   CUUCUCCACAGGAGUCAGAU; 
                 
                     
                     
                 
                     
                   (SEQ ID NO: 5) 
                 
                     
                   ACUUCUCCACAGGAGUCAGAU; 
                 
                     
                   and 
                 
                     
                     
                 
                     
                   (SEQ ID NO: 6) 
                 
                     
                   GACUUCUCCACAGGAGUCAGAU. 
                 
             
                
                
                
                
                
                
                
                
                
               
            
           
         
       
     
     
         174 - 175 . (canceled) 
     
     
         176 . A pharmaceutical composition comprising a base editor or a polynucleotide encoding the base editor, wherein the base editor comprises a polynucleotide programmable DNA binding domain and an adenosine deaminase domain described in  claim 1 ; and one or more guide polynucleotides that target the base editor to effect an A•T to G•C alteration of the SNP associated with sickle cell disease, and a pharmaceutically acceptable carrier, vehicle or excipient. 
     
     
         177 . A pharmaceutical composition comprising the cell of  claim 63 , and a pharmaceutically acceptable carrier, vehicle or excipient. 
     
     
         178 . A kit comprising a base editing system comprising the fusion protein of  claim 1 . 
     
     
         179 . (canceled) 
     
     
         180 . A kit comprising a base editor or a polynucleotide encoding the base editor, wherein the base editor comprises a polynucleotide programmable DNA binding domain and an adenosine deaminase domain described in  claim 1 ; and one or more guide polynucleotides that target the base editor to effect an A•T to G•C alteration of the SNP associated with sickle cell disease. 
     
     
         181 . A kit comprising the cell of  claim 63 . 
     
     
         182 - 183 . (canceled) 
     
     
         184 . A base editor system comprising a polynucleotide programmable DNA binding domain and at least one base editor domain that comprises an adenosine deaminase variant comprising an alteration at amino acid position 166 of 
       
         
           
                 
               
                   (SEQ ID NO: 2) 
                 
                   MSEVEFSHEYWMRHALTLAKRARDEREVPVGAVLVLNNRVIGEGWNRAI 
                 
                     
                 
                   GLHDPTAHAEIMALRQGGLVMQNYRLIDATLYVTFEPCVMCAGAMIHSR 
                 
                     
                 
                   IGRVVFGVRNAKTGAAGSLMDVLHYPGMNHRVEITEGILADECAALLCY 
                 
                     
                 
                   FFRMPRQVFNAQKKAQSSTD 
                 
             
                
                
                
                
                
                
                
                
               
            
           
         
         and a guide RNA, wherein said guide RNA targets said base editor to effect an alteration of the SNP associated with alpha-1 antitrypsin deficiency. 
       
     
     
         185 . The base editor system of  claim 184 , wherein the adenosine deaminase variant comprises a T166R alteration. 
     
     
         186 . The base editor system of  claim 185 , wherein the adenosine deaminase variant further comprises one or more of the following alterations: Y147T, Y147R, Q154S, Y123H, and Q154R. 
     
     
         187 - 193 . (canceled) 
     
     
         194 . A base editor system comprising one or more guide RNAs and a fusion protein comprising a polynucleotide programmable DNA binding domain comprising the following sequence: 
       
         
           
                 
               
                   (SEQ ID NO: 3) 
                 
                   
                     EIGKATAKYFFYSNIMNFFKTEITLANGEIRKRPLIETNGETGEIVWDK 
                   
                 
                     
                 
                   
                     GRDFATVRKVLSMPQVNIVKKTEVQTGGFSKESILPKRNSDKLIARKKD 
                   
                 
                     
                 
                   
                     WDPKKYGGFMQPTVAYSVLVVAKVEKGKSKKLKSVKELLGITIMERSSF 
                   
                 
                     
                 
                   
                     EKNPIDFLEAKGYKEVKKDLIIKLPKYSLFELENGRKRMLASAKFLQKG 
                   
                 
                     
                 
                   
                     NELALPSKYVNFLYLASHYEKLKGSPEDNEQKQLFVEQHKHYLDEIIEQ 
                   
                 
                     
                 
                   
                     ISEFSKRVILADANLDKVLSAYNKHRDKPIREQAENIIHLFTLTNLGAP 
                   
                 
                     
                 
                   
                     RAFKYFDTTIARKEYRSTKEVLDATLIHQSITGLYETRIDLSQLGGD 
                     GG 
                   
                 
                     
                 
                   
                     SGGSGGSGGSGGSGGSGGM 
                     DKKYSIGLAIGTNSVGWAVITDEYKVPSKK 
                   
                 
                     
                 
                   
                     FKVLGNTDRHSIKKNLIGALLFDSGETAEATRLKRTARRRYTRRKNRIC 
                   
                 
                     
                 
                   
                     YLQEIFSNEMAKVDDSFFHRLEESFLVEEDKKHERHPIFGNIVDEVAYH 
                   
                 
                     
                 
                   
                     EKYPTIYHLRKKLVDSTDKADLRLIYLALAHMIKFRGHFLIEGDLNPDN 
                   
                 
                     
                 
                   
                     SDVDKLFIQLVQTYNQLFEENPINASGVDAKAILSARLSKSRRLENLIA 
                   
                 
                     
                 
                   
                     QLPGEKKNGLFGNLIALSLGLTPNFKSNFDLAEDAKLQLSKDTYDDDLD 
                   
                 
                     
                 
                   
                     NLLAQIGDQYADLFLAAKNLSDAILLSDILRVNTEITKAPLSASMIKRY 
                   
                 
                     
                 
                   
                     DEHHQDLTLLKALVRQQLPEKYKEIFFDQSKNGYAGYIDGGASQEEFYK 
                   
                 
                     
                 
                   
                     FIKPILEKMDGTEELLVKLNREDLLRKQRTFDNGSIPHQIHLGELHAIL 
                   
                 
                     
                 
                   
                     RRQEDFYPFLKDNREKIEKILTFRIPYYVGPLARGNSRFAWMTRKSEET 
                   
                 
                     
                 
                   
                     ITPWNFEEVVDKGASAQSFIERMTNFDKNLPNEKVLPKHSLLYEYFTVY 
                   
                 
                     
                 
                   
                     NELTKVKYVTEGMRKPAFLSGEQKKAIVDLLFKTNRKVTVKQLKEDYFK 
                   
                 
                     
                 
                   
                     KIECFDSVEISGVEDRFNASLGTYHDLLKIIKDKDFLDNEENEDILEDI 
                   
                 
                     
                 
                   
                     VLTLTLFEDREMIEERLKTYAHLFDDKVMKQLKRRRYTGWGRLSRKLIN 
                   
                 
                     
                 
                   
                     GIRDKQSGKTILDFLKSDGFANRNFMQLIHDDSLTFKEDIQKAQVSGQG 
                   
                 
                     
                 
                   
                     DSLHEHIANLAGSPAIKKGILQTVKVVDELVKVMGRHKPENIVIEMARE 
                   
                 
                     
                 
                   
                     NQTTQKGQKNSRERMKRIEEGIKELGSQILKEHPVENTQLQNEKLYLYY 
                   
                 
                     
                 
                   
                     LQNGRDMYVDQELDINRLSDYDVDHIVPQSFLKDDSIDNKVLTRSDKNR 
                   
                 
                     
                 
                   
                     GKSDNVPSEEVVKKMKNYWRQLLNAKLITQRKFDNLTKAERGGLSELDK 
                   
                 
                     
                 
                   
                     AGFIKRQLVETRQITKHVAQILDSRMNTKYDENDKLIREVKVITLKSKL 
                   
                 
                     
                 
                   
                     VSDFRKDFQFYKVREINNYHHAHDAYLNAVVGTALIKKYPKLESEFVYG 
                   
                 
                     
                 
                     DYKVYDVRKMIAKSEQ   EGADKRTADGSEFESPKKKRKV *, 
                 
             
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
               
            
           
         
         wherein the bold sequence indicates sequence derived from Cas9, the italics sequence denotes a linker sequence, and the underlined sequence denotes a bipartite nuclear localization sequence, and at least one base editor domain comprising an adenosine deaminase variant comprising an alteration at amino acid position 166 of MSEVEFSHEYWMRHALTLAKRARDEREVPVGAVLVLNNRVIGEGWNRAIGLHDPTAH AEIMALRQGGLVMQNYRLIDATLYVTFEPCVMCAGAMIHSRIGRVVFGVRNAKTGAA GSLMDVLHYPGMNHRVEITEGILADECAALLCYFFRMPRQVFNAQKKAQSSTD (SEQ ID NO: 2), and wherein the one or more guide RNAs target said base editor to effect an alteration of the SNP associated with alpha-1 antitrypsin deficiency. 
       
     
     
         195 . A cell comprising the base editor system of  claim 194 . 
     
     
         196 - 197 . (canceled)

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