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Therapeutic impact of CRISPR-corrected patient fibroblasts on CADASIL phenotype

Ascertain whether genetically corrected patient-derived fibroblasts produced via CRISPR-Cas9 base editing and reprogramming can modify the disease presentation of CADASIL, given that NOTCH3 mutations predominantly affect vascular smooth muscle cells.

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Background

A reported ex vivo approach corrects a common CADASIL-associated NOTCH3 single-nucleotide mutation in patient fibroblasts using adenine base editors during reprogramming. However, CADASIL pathophysiology primarily involves vascular smooth muscle cells, raising questions about the relevance and efficacy of fibroblast-based corrections for altering disease expression.

Determining whether corrected fibroblasts can impact CADASIL phenotypes is important for assessing the translational potential of fibroblast-targeted or fibroblast-derived therapeutic strategies.

References

It is also unclear whether the modified fibroblasts would change the disease presentation, as the NOTCH3 mutation typically most strongly affects VSMCs.

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL): Immunotherapy and Cell Therapy approaches (2506.09293 - Haile et al., 10 Jun 2025) in CADASIL as a Candidate for Cell and Gene Therapy