Hematopoietic Stem Cell Gene-Addition/Editing Therapy in Sickle Cell Disease

Autologous hematopoietic stem cell (HSC)-targeted gene therapy provides a one-time cure for various genetic diseases including sickle cell disease (SCD) and beta-thalassemia. SCD is caused by a point mutation (20A > T) in the beta-globin gene. Since SCD is the most common single-gene disorder, curing SCD is a primary goal in HSC gene therapy. beta-thalassemia results from either the absence or the reduction of beta-globin expression, and it can be cured using similar strategies. In HSC gene-addition therapy, patient CD34+ HSCs are genetically modified by adding a therapeutic beta-globin gene with lentiviral transduction, followed by autologous transplantation. Alternatively, novel gene-editing therapies allow for the correction of the mutated beta-globin gene, instead of addition. Furthermore, these diseases can be cured by gamma-globin induction based on gene addition/editing in HSCs. In this review, we discuss HSC-targeted gene therapy in SCD with gene addition as well as gene editing.