Evidence map›Paper›PMID 40605271›Full record

ReviewMolecular therapy : the journal of the American Society of Gene Therapy2025

Peeling back the layers of immunogenicity in Cas9-based genomic medicine.

Virpi Stigzelius, Anna Lina Cavallo, Rakesh Kantilal Chandode, Roberto Nitsch

Abstract readReview
In one paragraph

Review in Molecular therapy : the journal of the American Society of Gene Therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

  1. Review
  2. Review
  3. Treatment of Huntington's disease with a pan-HTT-targeting CRISPR nuclease.Molecular therapy : the journal of the American Society of Gene Therapy · 2026
    Article
  4. Decoding Undesirable Inflammatory Responses of Nucleic Acid-Delivering Lipid Nanoparticles.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026
    Review
  5. Review
  6. Review
  7. Review
  8. Article
  9. Review
  10. Review
  11. Article
  12. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Virpi StigzeliusCell Therapy Safety, Clinical and Pharmacological Safety Sciences, AstraZeneca R&D, 431 83 Mölndal, Sweden; Drug Research Program, Faculty of Pharmacy, University of Helsinki, Helsinki 00014, Finland.
Anna Lina CavalloImmune Analytics & CGT Dx Bioanalysis, Clinical Pharmacology and Safety Sciences, AstraZeneca R&D, 431 83 Mölndal, Sweden.
Rakesh Kantilal ChandodeImmunology Safety, Safety Sciences, Clinical Pharmacology and Safety Sciences, AstraZeneca R&D, 431 83 Mölndal, Sweden.
Roberto NitschCell Therapy Safety, Clinical and Pharmacological Safety Sciences, AstraZeneca R&D, 431 83 Mölndal, Sweden. Electronic address: roberto.nitsch@astrazeneca.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The CRISPR-Cas9 genome editing system is rewriting the treatment of genetic disorders, offering unprecedented potential for detrimental and previously untreatable diseases. As this technology advances toward wider utilization in clinical applications, the immunogenicity of Cas9 nuclease has emerged as a potential challenge for in vivo therapies. Immune recognition of CRISPR-Cas9 components can trigger both innate and adaptive responses. The complex interactions between Cas9, delivery vectors, and host immune reactivity play a crucial role in determining the safety and efficacy of CRISPR-based treatments. Recent advances in mitigating Cas9 immunogenicity include epitope engineering, optimized delivery systems, and nucleic acid modifications. These strategies, explored across various tissue contexts and delivery methods, show promise in enhancing the tolerability of CRISPR-based therapies. However, pre-existing immunity to Cas9 and the potential for long-term adaptive immune responses remain important considerations. Addressing these immunological challenges requires an integrated approach, combining insights from immunology with innovative engineering solutions. As the field progresses, overcoming Cas9 immunogenicity will be crucial for realizing the full therapeutic potential of the CRISPR-Cas9 system in diverse clinical applications.

Indexed as

CRISPR-Associated Protein 9CRISPR-Cas SystemsGene EditingGenetic TherapyGenomicsAnimalsHumansCRISPR-Associated Protein 9CRISPR-Cas9genetic diseasesgenomic medicinehost immune responseimmunogenicity

Identifiers

PMID40605271
PMCPMC12848201

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.