Prime Editing for p47<sup>phox</sup>-Deficient Chronic Granulomatous Disease.

Gori, Jennifer L; Haddad, Elie; Frangoul, Haydar; Kohn, Donald B; Morris, Emma C; Martin, Bradley N; Deary, Briana A; Nickerson, McKinley et al. · N Engl J Med · 2025

case_series · Level IV

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Abstract

Chronic granulomatous disease (CGD) is a severe monogenic immunodeficiency caused by damaging variants in genes required for microbicidal NADPH oxidase activity. Autosomal recessive p47<sup>phox</sup>-deficient CGD (p47-CGD) is predominantly caused by a two-nucleotide deletion in exon 2 (delGT) of <i>NCF1</i>. We developed PM359, an autologous CD34+ hematopoietic stem-cell therapy in which prime editing is used to correct delGT. Two participants received PM359 after myeloid conditioning with busulfan: neutrophils and platelets engrafted promptly in both patients. Adverse events were consistent with myeloid conditioning with busulfan. NADPH oxidase activity was observed in neutrophils within 1 month and was maintained for 6 months and 4 months as of the last follow-up visit in Participants 1 and 2, respectively. These results support further investigation of prime editing of CD34+ cells to treat p47-CGD. (Funded by Prime Medicine; ClinicalTrials.gov number, NCT06559176.).