Engineered CRISPR-Base Editors as a Permanent Treatment for Familial Dysautonomia

Familial dysautonomia (FD) is a fatal autosomal recessive sensory and autonomic neuropathy. FD is caused by a T-to-C point mutation in intron 20 of the Elongator acetyltransferase complex subunit 1 (ELP1) gene, which results in tissue-specific skipping of exon 20 to cause a premature termination codon and thus redues ELP1 protein levels. Here, we developed a CRISPR-Cas-based cytosine base editing strategy to permanently correct the disease-causing mutation and restore canonical mRNA splicing. Through systematic engineering of base editors and guide RNAs, we identified an optimal editor configuration capable of achieving up to 70% on-target correction in human cells and that restored ELP1 exo