1. Introduction
CRISPR/Cas9 technology is expected to offer novel therapies of genome editing for various diseases including cancer, and inherited and infectious diseases [
1,
2,
3]. Using this technique, viral vectors are expected to become effective curative agents for patients for whom effective therapies are not currently available [
4,
5].
E1- and E3-deleted adenovirus vector (AdV), also called replication-incompetent AdV, is widely used both in basic studies and in applied fields including gene therapy [
6]. AdVs show high-level expression, infect a wide variety of cells and tissues, and transfer an expression unit to both dividing and non-dividing cells. Their large-scale production can also be achieved. These features are advantageous for practical application for promising drugs. Furthermore, AdVs possess a large capacity, up to approximately 8 kilobases (kb) in length. However, a major drawback of AdVs is their high immunogenicity and short duration of the expression limits their application specifically for the gene therapy of inherited diseases.
AAV vectors are currently particularly prominent in the field of gene therapy mainly because of their low immunogenicity and the maintenance of their expression for over 10 years when the cells do not divide. Therefore, several gene therapy drugs using AAV vectors have been approved for clinical use [
7]. The maximum capacity of an AAV vector is 4.7 kb. This size is often sufficient for gene therapy but is not necessarily sufficient for genome editing therapies because Cas9 derived from Streptococcus pyogenes (spCas9), the most commonly used Cas9, is very large. The coding region of Cas9 is 4.2 kb, so the size of its expression unit normally exceeds the capacity of AAV. Additionally, not only the expression unit(s) of guide RNA (gRNA, hereafter) but also a donor DNA for correction of a mutated gene are required. For this reason, AAV vectors must employ a shorter Cas9 derived from Staphylococcus aureus (saCas9), which is 1.6 kb in length [
8,
9]. However, this Cas9 cannot be used for the safer double-nicking strategy, as explained below.
Off-target effects are the most serious problem in genome editing therapy. A strategy to combat this called double nicking is available, which uses Cas9 nickase (Cas9n), a variant of spCas9, introducing a nick instead of a cleavage and reduces off-target effects by up to 1,500-fold [
10]. In this strategy, two nicks are introduced by Cas9n using two gRNAs, and the length between the 5′-terminals of the two gRNAs present in the top and bottom strands must be between nucleotides (nt) 30 and −5 for efficient cleavage. Because one gRNA specifies 20-nt sequences, with 40-nt sequences in total, the cleavage specificity is doubled. In addition, off-target nicks produced by Cas9n are immediately repaired [
11]. Therefore, the double-nicking strategy can, at least in part, solve the problem of off-target effects. Although double-nicking cleavages cause chromosomal rearrangements similarly to native Cas9, double-nicking strategy is preferable because it reduces the formation of insertions/deletions (indels) at off-target sites, which is inevitable for native Cas9.
However, the double-nicking strategy is not currently widely used because two gRNAs are required for one cleavage. If the same promoter is used for the expression of two gRNA units, deletion of the unit due to homologous recombination is normally unavoidable in the steps of both vector construction in E. coli and viral vector amplification in human cells. Another reason for the unpopularity of the double-nicking strategy is that AAV vectors cannot use a double-nicking strategy because they must use saCas9 owing to the size limitation. The PAM sequence, essential for Cas9 cleavage, must be present within 1 nt from the 20-nt target sequence. The PAM sequence of spCas9 consists only of dinucleotides of 5′-NGG-3′ and, because the dinucleotide “GG” is frequently present in the cell genome, a possible cleavage site of double nicking, where two GGs in the different strands are by chance present within 30 nt, is often available. Meanwhile, the PAM sequence of saCas9 used in the AAV vector is 5′-NNG(A/G)(A/G)T-3′, so possible cleavage sites are rare. Consequently, AAV vectors can hardly use the double-nicking strategy.
We have shown that multiplex eight guide RNA units are stably maintained in the AdV genome without deletion, even though the units are completely identical, only with the exception of the 20-nt target sequences [
12]. Therefore, surprisingly, homologous recombination causing deletion of the units hardly occurs, although AdV genomes are replicated to 10 million copies in a single 293 cell. Thus the limiting step in the construction of AdVs possessing eight multiple gRNA units is, unexpectedly, not the viral replication step in 293 cells, but the step of replication of large plasmids carrying the AdV genome in
E. coli. We routinely obtain large plasmids (called cosmids) with no deletion of the eight units by using in vitro packaging of lambda phage, where deleted plasmids of smaller sizes are removed through size selection. We also developed a “tetraplex tandem” method that allows the construction of cosmids possessing AdV genomes bearing four and eight multiplex gRNA units in a single step [
13,
14].
AdVs simultaneously expressing four and eight gRNAs (4g AdVs and 8g AdVs, respectively, hereafter) are particularly desirable. Using two gRNAs, the double-nicking method can be employed and, additionally, simultaneous cleavage at two sites and subsequent end-joining cause an irreversible deletion, resulting in complete gene disruption in one step. Therefore, 4g AdVs can safely and efficiently destroy the target gene, as shown by Nakanishi et al. [
14]. However, an unavoidable problem with the strategy of 4g AdVs is that, if the activity of one gRNA is low, this strategy using four gRNAs does not work well. Moreover, a mismatch of only 1 nt in 80 nt target sequences of four gRNAs in total abolishes this strategy, which often occurs in practical applications. In this context, 8g AdVs, which can be constructed in one step using the tetraplex tandem method, solve this problem and are clearly more effective than 4g AdVs. The 8g AdVs are particularly useful for the therapy of infectious diseases because genome sequences of pathogens are generally heterogeneous. In fact, we showed that an 8g AdV effectively disrupted the hepatitis B virus genome, where four gRNAs could not cleave the genome because of mismatches, but the remaining four gRNAs efficiently cleaved the genome through irreversible deletion [
12].
In genome editing experiments, AAV vectors and AdVs generally employ a co-infection strategy to account for size limitations or technical difficulty, as explained below. In the co-infection strategy, a cleavage occurs only when both gRNA-expressing vector and Cas9-expressing vector are simultaneously introduced into a single cell. In particular, under conditions where the two vectors are diluted, such as in vivo, the number of cells infected with both vectors will exponentially decrease. In contrast, if an all-in-one vector is used, the Cas9(n) enzyme and gRNAs are always present at the same time. Therefore, it is expected that all-in-one AdV is more effective than co-infecting AdVs.
All-in-one AdV expressing eight multiplex gRNAs (8g all-in-one AdV, hereafter) is attractive, but construction of the vector has been considered challenging. To date, very few reports of all-in-one type AdVs have been published [
15,
16], and the maximum number of guides expressed was two [
15]. Besides E1- and E3-deleted AdVs, a helper-dependent (HD) AdV lacking all of the adenovirus genes has been reported, which is an all-in-one type and possesses both three gRNA units and a Cas9 expression unit [
17,
18,
19]. However, the construction of an HD vector is not simple because it requires a helper AdV supplying all viral gene products in trans, and the large-scale production necessary for therapeutic application is difficult.
The production of all-in-one AdV containing even four gRNA units (4g all-in-one AdV, hereafter) is expected to be difficult because, although all four gRNA units can be maintained under the normal amplification conditions in 293 cells in the co-infection strategy, extremely large amounts of Cas9 nickase and gRNAs are produced from 10 million copies of the AdV genome in the all-in-one strategy. The genome of 293 cells may be damaged by off-target cleavages, which induce homologous recombination and deletion of the units. The 8g all-in-one AdVs are associated with an additional difficulty: the size of the Cas9-nickase expression unit and eight gRNA units in total exceeds the capacity of the normal AdV backbone currently available. Therefore, we must develop a new vector with a larger capacity.
We here describe that 4g and 8g all-in-one AdVs could actually be constructed. The U6 promoters were shortened to obtain smaller expression units of eight multiplex gRNAs. Also, E4/E3 deletion in the AdV backbone was enlarged to increase AdV capacity. The all-in-one AdVs were successfully obtained and cleaved the expected two and four double-nicking target sites, although, unexpectedly, the efficiencies of deletion of both AdVs were not higher than those of co-infecting AdVs using this vector backbone. Possible reasons for this are discussed.
3. Discussion
We here showed that all-in-one AdVs simultaneously expressing four and eight gRNAs can be successfully constructed. Because the AdV genome was amplified at 10
9 copies per cell in 293 cells and vast amounts of both gRNA and Cas9n were produced, we expected that the cell genome was probably damaged by off-target cleavages, leading to the activation of repair systems and enhancement of homologous recombination. We thought that four gRNA units in the all-in-one AdV would possibly be deleted and successful construction would probably be difficult. Although we used a double-nicking strategy, which was reported to reduce off-target effects caused by native Cas9 by up to 1/1500-fold in transfection experiments [
10], the reduction in off-target effects that we observed was actually only three orders of magnitude and appeared insufficient to completely prevent activation of the repair systems. However, contrary to our expectations, the results obtained using 4g all-in-one AdV showed that, although the full lysis in the amplification of AdV was delayed from 2 to 3 weeks, no significant deletion of multiple gRNA units was observed. This suggests that, unexpectedly, the induction of homologous recombination by off-target cleavage of the 293 cell genome did not occur.
It is currently unclear why homologous recombination was not induced in this setting. However, a simple and plausible possibility is that, even when very large amounts of the enzyme and gRNAs were present at high concentrations, Cas9n caused much less off-target cleavage than we expected. If so, nicks produced by Cas9n were very immediately repaired, so Cas9n may be much safer than we imagined. Another possible mechanism for the deletion is that, when the AdV genome replicates, the progressing 5′end dissociates and hybridizes to the next or a more distant gRNA unit, resulting in deletions between them. However, no deletions were actually observed, indicating that this process did not occur, at least in the 4g all-in-one AdV. Because four multiplex gRNA units in 4g all-in-one AdV were unexpectedly stable, 4g vectors can be used for applications where four gRNAs are sufficient.
We also showed that an 8g all-in-one AdV, Ax8sg-mNTCP-oCBNC9, can be obtained, although deletions were observed in contrast to the case for 4g all-in-one AdV. However, we previously reported that, in cases of co-infection when Cas9n was absent, eight multiplex gRNA units were stably maintained in the AdV genome [
12]. Two different reasons for this can be considered. One obvious reason is that, in the presence of Cas9n, one of the two conditions mentioned above could have occurred because eight units is too many to be stably maintained. If this is the reason, it may be difficult to construct an 8g all-in-one AdV possessing eight multiplex units. The other reason is that the genome size of this particular 8g all-in-one AdV was approximately the same or slightly larger than the reported packaging limit of the AdV genome. If this is the reason for the instability, this problem should be resolved when the size of the AdV genome is further reduced. The total size of the 8g all-in-one AdV presented here is 37.87 kb in length (105.4% of the wild-type adenovirus genome). Bett et al. [
21] reported that the upper limit is 37.7 kb (105% of the AdV genome) based on the result that an AdV, AdLacZ, of 37.87 kb (105.4%) showed deletion; this size is the same as that of the 8g all-in-one AdV described here. However, Ghosh-Choudhury reported that Ad5in52 of 38.0 kb, corresponding to 105.7% of the AdV genome, was stably produced [
26]. Therefore, it is currently unclear which explanation for the instability observed in the case of the 8g all-in-one AdV is valid.
Upon using 4g all-in-one AdVs of Axda4g-mH2Aa-oCBNC9 and Axda4g-mH2Aa-iCBNC9 at MOI of 300, the efficiency of destruction targeting the mouse
H2-Aa gene in MEF cells was 55% and 47%, respectively (
Figure 5b), and all four gRNAs were active. However, the observed efficiency was unexpectedly low compared with that upon co-infection. Ax4g-mH2Aa is the parent AdV containing the same four gRNA units, but lacks a Cas9n expression unit, and 81% efficiency was reported upon co-infection with Cas9n-expressing AdV, both at an MOI of 100 [
13]. Therefore, the destruction efficiency of 4g all-in-one AdV was much lower than that of co-infection with Ax4g-mH2Aa and AxCBNC9. The structural difference between the two methods is that 4g all-in-one vectors used the AdV backbone lacking the E3 region: the 5′position of the E3 deletion of g4 all-in-one AdV starts at position 27,980 shown in
Figure 3a (second row, AxdA), while that of Ax4g-mH2Aa starts at position 28,593 (outside of
Figure 3a), covering the whole of the 12.4K gene. Because deletion of 153 bp between AxdA and AxdB caused low genome editing efficiency (
Figure 3c), the difference in genome editing efficiency between the all-in-one AdV and co-infecting AdVs can probably be explained in the same way. Therefore, we could not show expression efficiency of all-in-one AdV that was higher than that of co-infection, probably because of low efficiency caused by deletion of the N-terminal half of the 12.4K gene. The mechanism behind the low efficiency is currently unclear because the function of the 12.4K gene has not been reported. It is desirable to develop a vector backbone that avoids the low efficiency and increases the capacity to construct 8g all-in-one AdVs. (We later succeeded in solving the problem of this low efficiency while further enlarging the E3 deletion, but the results will be published elsewhere.) Mizuguchi et al. reported a higher-capacity AdV possessing an L4/E3 deletion 292 bp larger than that of the AxdA [
27]. This vector solves the size limitation problem to construct 8g AdV, but our results may suggest that deletion of the whole of the 12.4K gene could cause low efficiency of genome editing similarly to our vectors using the AxdA backbone, if an all-in-one AdV is constructed using their L4/E3 backbone..
In conclusion, we successfully constructed a 4g all-in-one AdV simultaneously containing four multiplex gRNA units and a Cas9n expression unit, and demonstrated that this vector can be amplified to levels sufficient for in vivo experiments with no deletion of the units. We also constructed an 8g all-in-one AdV, although the amount of intact AdV retaining all eight gRNA units was approximately one-third in the purified stock. Both g4 and g8 all-in-one AdVs showed all expected cleavages in vitro and in vivo to disrupt target genes by double nicking. However, we could not show higher genome editing efficiency of all-in-one AdV than that of co-infecting AdVs in this study. The results described here provide a basis for the development of effective and safe all-in-one AdVs that can be valuable for genome editing therapy.