- Cromer, M Kyle;
- Camarena, Joab;
- Martin, Renata M;
- Lesch, Benjamin J;
- Vakulskas, Christopher A;
- Bode, Nicole M;
- Kurgan, Gavin;
- Collingwood, Michael A;
- Rettig, Garrett R;
- Behlke, Mark A;
- Lemgart, Viktor T;
- Zhang, Yankai;
- Goyal, Ankush;
- Zhao, Feifei;
- Ponce, Ezequiel;
- Srifa, Waracharee;
- Bak, Rasmus O;
- Uchida, Naoya;
- Majeti, Ravindra;
- Sheehan, Vivien A;
- Tisdale, John F;
- Dever, Daniel P;
- Porteus, Matthew H
β-Thalassemia pathology is due not only to loss of β-globin (HBB), but also to erythrotoxic accumulation and aggregation of the β-globin-binding partner, α-globin (HBA1/2). Here we describe a Cas9/AAV6-mediated genome editing strategy that can replace the entire HBA1 gene with a full-length HBB transgene in β-thalassemia-derived hematopoietic stem and progenitor cells (HSPCs), which is sufficient to normalize β-globin:α-globin messenger RNA and protein ratios and restore functional adult hemoglobin tetramers in patient-derived red blood cells. Edited HSPCs were capable of long-term and bilineage hematopoietic reconstitution in mice, establishing proof of concept for replacement of HBA1 with HBB as a novel therapeutic strategy for curing β-thalassemia.