- McAuley, Grace E;
- Yiu, Gloria;
- Chang, Patrick C;
- Newby, Gregory A;
- Campo-Fernandez, Beatriz;
- Fitz-Gibbon, Sorel T;
- Wu, Xiaomeng;
- Kang, Sung-Hae L;
- Garibay, Amber;
- Butler, Jeffrey;
- Christian, Valentina;
- Wong, Ryan L;
- Everette, Kelcee A;
- Azzun, Anthony;
- Gelfer, Hila;
- Seet, Christopher S;
- Narendran, Aru;
- Murguia-Favela, Luis;
- Romero, Zulema;
- Wright, Nicola;
- Liu, David R;
- Crooks, Gay M;
- Kohn, Donald B
CD3δ SCID is a devastating inborn error of immunity caused by mutations in CD3D, encoding the invariant CD3δ chain of the CD3/TCR complex necessary for normal thymopoiesis. We demonstrate an adenine base editing (ABE) strategy to restore CD3δ in autologous hematopoietic stem and progenitor cells (HSPCs). Delivery of mRNA encoding a laboratory-evolved ABE and guide RNA into a CD3δ SCID patient's HSPCs resulted in a 71.2% ± 7.85% (n = 3) correction of the pathogenic mutation. Edited HSPCs differentiated in artificial thymic organoids produced mature T cells exhibiting diverse TCR repertoires and TCR-dependent functions. Edited human HSPCs transplanted into immunodeficient mice showed 88% reversion of the CD3D defect in human CD34+ cells isolated from mouse bone marrow after 16 weeks, indicating correction of long-term repopulating HSCs. These findings demonstrate the preclinical efficacy of ABE in HSPCs for the treatment of CD3δ SCID, providing a foundation for the development of a one-time treatment for CD3δ SCID patients.