Patient-Specific In Vivo Gene Editing to Treat a Rare Genetic Disease.

Document Type

Article

Publication Date

6-12-2025

Keywords

JMG, Humans, Infant, Infant, Newborn, Male, Gene Editing, Genetic Therapy, Nanoparticles, Rare Diseases, Carbamoyl-Phosphate Synthase I Deficiency Disease, Carbamoyl-Phosphate Synthase (Ammonia), Liposomes, Hepatocytes, Hyperammonemia, Ammonia, Treatment Outcome

JAX Source

N Engl J Med. 2025;392(22):2235-43.

ISSN

1533-4406

PMID

40373211

DOI

https://doi.org/10.1056/NEJMoa2504747

Abstract

Base editors can correct disease-causing genetic variants. After a neonate had received a diagnosis of severe carbamoyl-phosphate synthetase 1 deficiency, a disease with an estimated 50% mortality in early infancy, we immediately began to develop a customized lipid nanoparticle-delivered base-editing therapy. After regulatory approval had been obtained for the therapy, the patient received two infusions at approximately 7 and 8 months of age. In the 7 weeks after the initial infusion, the patient was able to receive an increased amount of dietary protein and a reduced dose of a nitrogen-scavenger medication to half the starting dose, without unacceptable adverse events and despite viral illnesses. No serious adverse events occurred. Longer follow-up is warranted to assess safety and efficacy. (Funded by the National Institutes of Health and others.).

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