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The Strategies and Challenges of CCR5 Gene Editing in Hematopoietic Stem and Progenitor Cells for the Treatment of HIV

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Abstract

HIV infection continues to be a serious health issue with an alarming global spread, owing to the fact that attempts at developing an effective vaccine or a permanent cure remains futile. So far, the only available treatment for the clinical management of HIV is the combined Anti-Retroviral Therapy (cART), but the long-term cART is associated with metabolic changes, organ damages, and development and transmission of drug resistant HIV strains. Thus, there is a need for the development of one-time curative treatment for HIV infection. The allogeneic transplantation with the Hematopoietic Stem and Progenitor cells (HSPCs) having 32 bp deletion in Chemokine receptor 5 gene (CCR5 Δ32) demonstrated successful HIV remission in the Berlin and London patients, and highlighted that transplantation of CCR5 null HSPCs is a promising approach for a long- term HIV remission. The advent of gene editing technologies offers a new choice of generating ex vivo CCR5 ablated allogeneic or autologous HSPCs for stem cell transplantation into HIV patients. Many groups are attempting CCR5 disruption in HSPCs using various gene-editing strategies. At least two such studies, involving CCR5 gene editing in HSPCs have entered the clinical trials. This review aims to outline the strategies taken for CCR5 gene editing and discuss the challenges associated with the development of CCR5 manipulated HSPCs for the gene therapy of HIV infection.

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Abbreviations

cART:

combined Anti-Retroviral Therapy

HSPCs:

Hematopoietic Stem and Progenitor cells

CCR5:

Chemokine receptor 5

HIV-1:

Human Immunodeficiency Virus-1

AIDS:

Acquired Immunodeficiency Syndrome

AZT:

zidovudine

HAART:

Highly Activated Anti-retroviral therapy

AML:

Acute Myeloid Leukemia

TBI:

Total body irradiation

R5:

CCR5 utilizing HIV virus

X4:

CXCR4 utilizing HIV virus

gp:

glycoprotein

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Acknowledgements

This work was supported by Department of Biotechnology, Government of India. K.V.K is supported by fellowship from Department of Science and Technology- Innovation in Science Pursuit for Inspired Research - (IF180918) (DST-INSPIRE) and PB is supported by Junior Research Fellowship from Council of Scientific and Industrial Research (CSIR).

Funding

Department of Biotechnology, Ministry of Science and Technology, Government of India.

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  1. Centre for Stem Cell Research (A unit of inStem, Bengaluru), Christian Medical College, Vellore, Tamil Nadu, India

    Karthik V Karuppusamy, Prathibha Babu & Saravanabhavan Thangavel

  2. Manipal Academy of Higher Education, Manipal, Karnataka, India

    Karthik V Karuppusamy, Prathibha Babu & Saravanabhavan Thangavel

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  1. Karthik V Karuppusamy
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  2. Prathibha Babu
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  3. Saravanabhavan Thangavel
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K.V.K, P.B and ST drafted the study, executed the literature search and manuscript writing. This version of the manuscript is approved by all the three authors.

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Correspondence to Saravanabhavan Thangavel.

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Karuppusamy, K.V., Babu, P. & Thangavel, S. The Strategies and Challenges of CCR5 Gene Editing in Hematopoietic Stem and Progenitor Cells for the Treatment of HIV. Stem Cell Rev and Rep 17, 1607–1618 (2021). https://doi.org/10.1007/s12015-021-10145-7

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