CNS-targeted base editing of the major late-onset Tay-Sachs mutation alleviates disease in mice

Maria L Allende; Mari Kono; Y. Terry Lee; Samantha M. Olmsted; Vienna Huso; Jenna Y. Bakir; Florencia Pratto; Cuiling Li; Colleen Byrnes; Galina Tuymetova; Hongling Zhu; Cynthia J. Tifft; Richard L. Proia

doi:10.1172/JCI183434

¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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¹Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, United States of America

²Medical Genetics Branch, National Human Genome Research Institute, Bethesda, United States of America

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J Clin Invest. https://doi.org/10.1172/JCI183434.
Copyright © 2025, Allende et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

Published June 17, 2025 - Version history

Late-onset Tay-Sachs (LOTS) disease is a lysosomal storage disorder most commonly caused by a point mutation (c.805G>A) in the HEXA gene encoding the α-subunit of the lysosomal enzyme β-hexosaminidase A. LOTS manifests as a range of gradually worsening neurological symptoms beginning in young adulthood. Here, we explored the efficacy of an adenine base editor (ABE) programmed with a small guide RNA (sgRNA) to correct the HEXA c.805G>A mutation. Base editing in LOTS patient fibroblasts successfully converted the pathogenic HEXA c.805A to G and partially restored β-hexosaminidase activity, with minimal genome-wide off-target editing. We generated a LOTS mouse model in which the mice exhibited decreased β-hexosaminidase activity, accumulation of GM2 ganglioside in the brain, progressive neurological manifestations, and reduced lifespan. Treatment of LOTS mice with the neurotropic virus AAV-PHP.eB carrying the ABE and an sgRNA targeting the LOTS point mutation partially corrected the c.805G>A mutation in the CNS, significantly increased brain β-hexosaminidase activity, and substantially reduced GM2 ganglioside accumulation in the brain. Moreover, the therapy delayed symptom onset and significantly extended median lifespan. These findings highlight the potential of base editing as an effective treatment for LOTS and its broader applicability to other lysosomal storage disorders.

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CNS-targeted base editing of the major late-onset Tay-Sachs mutation alleviates disease in mice

Maria L Allende,¹ Mari Kono,¹ Y. Terry Lee,¹ Samantha M. Olmsted,¹ Vienna Huso,¹ Jenna Y. Bakir,¹ Florencia Pratto,¹ Cuiling Li,¹ Colleen Byrnes,¹ Galina Tuymetova,¹ Hongling Zhu,¹ Cynthia J. Tifft,² and Richard L. Proia¹

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CNS-targeted base editing of the major late-onset Tay-Sachs mutation alleviates disease in mice

Maria L Allende,1 Mari Kono,1 Y. Terry Lee,1 Samantha M. Olmsted,1 Vienna Huso,1 Jenna Y. Bakir,1 Florencia Pratto,1 Cuiling Li,1 Colleen Byrnes,1 Galina Tuymetova,1 Hongling Zhu,1 Cynthia J. Tifft,2 and Richard L. Proia1

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Maria L Allende,¹ Mari Kono,¹ Y. Terry Lee,¹ Samantha M. Olmsted,¹ Vienna Huso,¹ Jenna Y. Bakir,¹ Florencia Pratto,¹ Cuiling Li,¹ Colleen Byrnes,¹ Galina Tuymetova,¹ Hongling Zhu,¹ Cynthia J. Tifft,² and Richard L. Proia¹