Inhibition of myostatin signaling is a potential method to enhance skeletal muscle growth and has been proposed as a strategy to treat muscle weakness associated with sarcopenia, cachexia, and muscular dystrophies. Current approaches under clinical investigation for inhibiting the myostatin pathway rely on systemic administration of soluble factors, including myostatin blocking antibodies and soluble myostatin receptors. Treatment with these protein-based inhibitors has led to enhanced muscle mass in mouse models of muscular dystrophy and cachexia, but has demonstrated limited efficacy and some adverse side effects in subsequent clinical trials. We hypothesized that a targeted gene regulation strategy to localize inhibition of the myostatin pathway to skeletal muscle fibers may increase the effectiveness and safety of this therapy. The RNA-guided CRISPR/Cas9 system has emerged as a promising platform for targeted gene regulation. Fusion of catalytically inactive, “dead” Cas9 (dCas9) to the Kruppel-associated box (KRAB) domain generates a synthetic repressor capable of highly specific silencing of target genes. dCas9-KRAB repressors can be employed in gene therapy to silence detrimental gene products, repress oncogenes, inhibit viral replication, and treat dominant negative diseases. However, gene delivery of dCas9-KRAB to skeletal muscle in vivo is challenging because the size of the S. pyogenes dCas9 and KRAB domain fusion exceeds the packaging limit of standard AAV vectors. Recently, a smaller Cas9 protein derived from S. aureus was described for AAV delivery and in vivo gene editing. We generated a S. aureus dCas9-KRAB fusion and targeted the myostatin receptor, Acvr2b, for silencing. In cultured mouse myoblasts, S. aureus dCas9-KRAB potently repressed Acvr2b expression by qPCR and resulted in reduced myotube formation following differentiation compared to controls. The S. aureus dCas9-KRAB repressor was packaged into AAV vectors and expressed efficiently in vitro in cultured myoblasts and in vivo following direct injection into the mouse tibialis anterior muscle. Ongoing studies will determine the effects of transcriptional silencing of Acvr2b on myotube diameter in vitro and the efficiency of Acvr2b silencing achieved by engineered dCas9-KRAB repressors in vivo. These studies establish how transcriptional modulation with the CRISPR/Cas9 system can be used to investigate potential therapeutic gene targets for treating neuromuscular disorders.
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