CRISPR gene therapy: a review

Authors

  • Sanjeyan N. Department of Pharmacy Practice, JKKMMRF’s Annai JKK Sampoorani Ammal College of Pharmacy, Komarapalayam, Namakkal District, Tamil Nadu, India
  • Gobika G. JKKMMRF’s Annai JKK Sampoorani Ammal College of Pharmacy, Komarapalayam, Namakkal District, Tamil Nadu, India
  • Harshini Reethu S. JKKMMRF’s Annai JKK Sampoorani Ammal College of Pharmacy, Komarapalayam, Namakkal District, Tamil Nadu, India
  • Renuka A. JKKMMRF’s Annai JKK Sampoorani Ammal College of Pharmacy, Komarapalayam, Namakkal District, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20262885

Keywords:

CRISPR-Cas9, Gene editing, Gene therapy, Genome engineering, Genetic diseases, Off-target effects

Abstract

The adaptive immune system of prokaryotes is the source of CRISPR-Cas9, a ground-breaking genome editing technique that uses RNA-guided nucleases to precisely alter DNA sequences. An summary of CRISPR/Cas9's discovery, structural elements, mode of action, therapeutic uses, and present limitations is given in this article. The Cas9 nuclease and guide RNA work together to identify particular DNA targets and cause double-strand breaks in the system. Cellular processes like homology-directed repair or non-homologous end joining fix these defects, allowing for gene disruption or correction. Numerous genetic abnormalities, such as hemoglobinopathies including sickle cell disease and β-thalassemia, hereditary retinal diseases, muscular dystrophies, liver metabolic disorders, congenital lung diseases, and genetic deafness, have showed great potential for treatment with CRISPR/Cas9. Clinical applicability is limited by issues such off-target effects, PAM sequence restrictions, DNA damage-induced toxicity, and immunological responses to Cas proteins, despite its wide therapeutic potential. These obstacles are being addressed by improvements in delivery methods and high-fidelity Cas9 variations. All things considered, CRISPR/Cas9 is a revolutionary development in molecular medicine and gene therapy, providing strong prospects for accurate genome engineering and upcoming clinical uses in personalized medicine.

References

Jinek M, Chylinski K, Fonfara I, Hauer M, Doudna JA, Charpentier E. A programmable dual-RNA-guided DNA endonuclease in adaptive bacterial immunity. Science. 2012;337(6096):816-21.

Cong L, Ran FA, Cox D, Lin S, Barretto R, Habib N, et al. Multiplex genome engineering using CRISPR/Cas systems. Science. 2013;339(6121):819-23.

Mali P, Yang L, Esvelt KM, Aach J, Guell M, DiCarlo JE, et al. RNA-guided human genome engineering via Cas9. Science. 2013;339(6121):823-6.

Doudna JA, Charpentier E. The new frontier of genome engineering with CRISPR-Cas9. Science. 2014;346(6213):1258096.

Hsu PD, Lander ES, Zhang F. Development and applications of CRISPR-Cas9 for genome engineering. Cell. 2014;157(6):1262-78.

Barrangou R, Fremaux C, Deveau H, Richards M, Boyaval P, Moineau S, et al. CRISPR provides acquired resistance against viruses in prokaryotes. Science. 2007;315(5819):1709-12.

Ishino Y, Shinagawa H, Makino K, Amemura M, Nakata A. Nucleotide sequence of the iap gene, responsible for alkaline phosphatase isozyme conversion in Escherichia coli, and identification of a new repeated sequence motif. J Bacteriol. 1987;169(12):5429-33.

Mojica FJ, Díez-Villaseñor C, García-Martínez J, Soria E. Intervening sequences of regularly spaced prokaryotic repeats derive from foreign genetic elements. J Mol Evol. 2005;60(2):174-82.

Komor AC, Kim YB, Packer MS, Zuris JA, Liu DR. Programmable editing of a target base in genomic DNA without double-stranded DNA cleavage. Nature. 2016;533(7603):420-4.

Anzalone AV, Randolph PB, Davis JR, Sousa AA, Koblan LW, Levy JM, et al. Search-and-replace genome editing without double-strand breaks or donor DNA. Nature. 2019;576(7785):149-57.

Frangoul H, Altshuler D, Cappellini MD, Chen YS, Domm J, Eustace BK, et al. CRISPR-Cas9 gene editing for sickle cell disease and β-thalassemia. N Engl J Med. 2021;384(3):252-60.

Gillmore JD, Gane E, Taubel J, Kao J, Fontana M, Maitland ML, et al. CRISPR-Cas9 in vivo gene editing for transthyretin amyloidosis. N Engl J Med. 2021;385(6):493-502.

Maeder ML, Stefanidakis M, Wilson CJ, et al. Development of a gene-editing approach to restore vision loss in Leber congenital amaurosis type 10. Nat Med. 2019;25(2):229-33.

Long C, Amoasii L, Mireault AA. Postnatal genome editing partially restores dystrophin expression in a mouse model of muscular dystrophy. Science. 2016;351(6271):400-3.

Kleinstiver BP, Pattanayak V, Prew MS, Tsai SQ, Nguyen NT, Zheng Z, et al. High-fidelity CRISPR-Cas9 nucleases with no detectable genome-wide off-target effects. Nature. 2016;529(7587):490-5.

Haapaniemi E, Botla S, Persson J, Schmierer B, Taipale J. CRISPR-Cas9 genome editing induces a p53-mediated DNA damage response. Nat Med. 2018;24(7):927-30.

Charlesworth CT, Deshpande PS, Dever DP. Identification of preexisting adaptive immunity to Cas9 proteins in humans. Nat Med. 2019;25(2):249-54.

Yang H, Qin C, Li YH, Tao L, Zhou J, Yu CY, et al. Therapeutic genome editing: prospects and challenges. Nat Med. 2022;28(10):2064-76.

Pickar-Oliver A, Gersbach CA. The next generation of CRISPR-Cas technologies and applications. Nat Rev Mol Cell Biol. 2019;20(8):490-507.

Doudna JA. The promise and challenge of therapeutic genome editing. Nature. 2020;578(7794):229-36.

Downloads

Published

2026-08-24

How to Cite

N., S., G., G., S., H. R., & A., R. (2026). CRISPR gene therapy: a review. International Journal of Basic & Clinical Pharmacology, 15(5), 1089–1094. https://doi.org/10.18203/2319-2003.ijbcp20262885