Treatment of autosomal dominant hearing loss by in vivo delivery of genome editing agents

Nature. 2018 Jan 11;553(7687):217-221. doi: 10.1038/nature25164. Epub 2017 Dec 20.


Although genetic factors contribute to almost half of all cases of deafness, treatment options for genetic deafness are limited. We developed a genome-editing approach to target a dominantly inherited form of genetic deafness. Here we show that cationic lipid-mediated in vivo delivery of Cas9-guide RNA complexes can ameliorate hearing loss in a mouse model of human genetic deafness. We designed and validated, both in vitro and in primary fibroblasts, genome editing agents that preferentially disrupt the dominant deafness-associated allele in the Tmc1 (transmembrane channel-like gene family 1) Beethoven (Bth) mouse model, even though the mutant Tmc1Bth allele differs from the wild-type allele at only a single base pair. Injection of Cas9-guide RNA-lipid complexes targeting the Tmc1Bth allele into the cochlea of neonatal Tmc1Bth/+ mice substantially reduced progressive hearing loss. We observed higher hair cell survival rates and lower auditory brainstem response thresholds in injected ears than in uninjected ears or ears injected with control complexes that targeted an unrelated gene. Enhanced acoustic startle responses were observed among injected compared to uninjected Tmc1Bth/+ mice. These findings suggest that protein-RNA complex delivery of target gene-disrupting agents in vivo is a potential strategy for the treatment of some types of autosomal-dominant hearing loss.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acoustic Stimulation
  • Alleles
  • Animals
  • Animals, Newborn
  • Auditory Threshold
  • Base Sequence
  • CRISPR-Associated Proteins / administration & dosage*
  • CRISPR-Associated Proteins / metabolism
  • CRISPR-Associated Proteins / therapeutic use
  • CRISPR-Cas Systems
  • Cell Survival
  • Cochlea / cytology
  • Cochlea / metabolism
  • Disease Models, Animal
  • Evoked Potentials, Auditory, Brain Stem
  • Female
  • Fibroblasts
  • Gene Editing / methods*
  • Genes, Dominant / genetics*
  • Genetic Therapy / methods*
  • Hair Cells, Auditory / cytology
  • Hearing Loss / genetics*
  • Hearing Loss / physiopathology
  • Hearing Loss / prevention & control
  • Humans
  • Liposomes
  • Male
  • Membrane Proteins / genetics
  • Mice
  • Reflex, Startle


  • CRISPR-Associated Proteins
  • Liposomes
  • Membrane Proteins
  • TMC1 protein, mouse