WEBVTT 00:00:01.286 --> 00:00:05.317 The most important gift your mother and father ever gave you 00:00:05.341 --> 00:00:08.061 was the two sets of three billion letters of DNA 00:00:08.085 --> 00:00:09.649 that make up your genome. 00:00:10.014 --> 00:00:12.491 But like anything with three billion components, 00:00:12.515 --> 00:00:13.915 that gift is fragile. 00:00:14.815 --> 00:00:18.355 Sunlight, smoking, unhealthy eating, 00:00:18.379 --> 00:00:21.371 even spontaneous mistakes made by your cells, 00:00:21.395 --> 00:00:23.318 all cause changes to your genome. 00:00:24.942 --> 00:00:28.220 The most common kind of change in DNA 00:00:28.244 --> 00:00:32.473 is the simple swap of one letter, or base, such as C, 00:00:32.497 --> 00:00:35.738 with a different letter, such as T, G or A. 00:00:36.744 --> 00:00:40.117 In any day, the cells in your body will collectively accumulate 00:00:40.141 --> 00:00:44.977 billions of these single-letter swaps, which are also called "point mutations." NOTE Paragraph 00:00:46.147 --> 00:00:48.678 Now, most of these point mutations are harmless. 00:00:48.702 --> 00:00:49.860 But every now and then, 00:00:49.884 --> 00:00:53.877 a point mutation disrupts an important capability in a cell 00:00:53.901 --> 00:00:57.256 or causes a cell to misbehave in harmful ways. 00:00:58.099 --> 00:01:01.098 If that mutation were inherited from your parents 00:01:01.122 --> 00:01:03.782 or occurred early enough in your development, 00:01:03.806 --> 00:01:06.772 then the result would be that many or all of your cells 00:01:06.796 --> 00:01:08.708 contain this harmful mutation. 00:01:09.153 --> 00:01:12.423 And then you would be one of hundreds of millions of people 00:01:12.447 --> 00:01:14.058 with a genetic disease, 00:01:14.082 --> 00:01:17.085 such as sickle cell anemia or progeria 00:01:17.109 --> 00:01:20.230 or muscular dystrophy or Tay-Sachs disease. NOTE Paragraph 00:01:22.225 --> 00:01:25.407 Grievous genetic diseases caused by point mutations 00:01:25.431 --> 00:01:27.424 are especially frustrating, 00:01:27.448 --> 00:01:30.352 because we often know the exact single-letter change 00:01:30.376 --> 00:01:34.576 that causes the disease and, in theory, could cure the disease. 00:01:35.268 --> 00:01:38.117 Millions suffer from sickle cell anemia 00:01:38.141 --> 00:01:41.212 because they have a single A to T point mutations 00:01:41.236 --> 00:01:43.597 in both copies of their hemoglobin gene. 00:01:45.529 --> 00:01:48.661 And children with progeria are born with a T 00:01:48.685 --> 00:01:50.853 at a single position in their genome 00:01:50.877 --> 00:01:52.276 where you have a C, 00:01:53.125 --> 00:01:56.564 with the devastating consequence that these wonderful, bright kids 00:01:56.588 --> 00:02:00.564 age very rapidly and pass away by about age 14. 00:02:02.358 --> 00:02:04.041 Throughout the history of medicine, 00:02:04.065 --> 00:02:07.125 we have not had a way to efficiently correct point mutations 00:02:07.149 --> 00:02:08.918 in living systems, 00:02:08.942 --> 00:02:12.142 to change that disease-causing T back into a C. 00:02:13.482 --> 00:02:15.450 Perhaps until now. 00:02:15.474 --> 00:02:19.664 Because my laboratory recently succeeded in developing such a capability, 00:02:19.688 --> 00:02:21.488 which we call "base editing." NOTE Paragraph 00:02:23.277 --> 00:02:25.301 The story of how we developed base editing 00:02:25.325 --> 00:02:27.999 actually begins three billion years ago. 00:02:29.055 --> 00:02:31.715 We think of bacteria as sources of infection, 00:02:31.739 --> 00:02:35.053 but bacteria themselves are also prone to being infected, 00:02:35.077 --> 00:02:36.984 in particular, by viruses. 00:02:37.871 --> 00:02:40.022 So about three billion years ago, 00:02:40.046 --> 00:02:43.926 bacteria evolved a defense mechanism to fight viral infection. 00:02:45.649 --> 00:02:48.434 That defense mechanism is now better known as CRISPR. 00:02:49.008 --> 00:02:51.833 And the warhead in CRISPR is this purple protein 00:02:51.857 --> 00:02:55.635 that acts like molecular scissors to cut DNA, 00:02:55.659 --> 00:02:58.087 breaking the double helix into two pieces. 00:02:59.323 --> 00:03:03.299 If CRISPR couldn't distinguish between bacterial and viral DNA, 00:03:03.323 --> 00:03:05.562 it wouldn't be a very useful defense system. NOTE Paragraph 00:03:06.315 --> 00:03:09.100 But the most amazing feature of CRISPR 00:03:09.124 --> 00:03:14.161 is that the scissors can be programmed to search for, 00:03:14.185 --> 00:03:16.608 bind to and cut 00:03:16.632 --> 00:03:19.370 only a specific DNA sequence. 00:03:20.911 --> 00:03:24.308 So when a bacterium encounters a virus for the first time, 00:03:24.332 --> 00:03:27.705 it can store a small snippet of that virus's DNA 00:03:27.729 --> 00:03:31.373 for use as a program to direct the CRISPR scissors 00:03:31.397 --> 00:03:34.933 to cut that viral DNA sequence during a future infection. 00:03:35.778 --> 00:03:40.691 Cutting a virus's DNA messes up the function of the cut viral gene, 00:03:40.715 --> 00:03:43.417 and therefore disrupts the virus's life cycle. NOTE Paragraph 00:03:46.059 --> 00:03:50.860 Remarkable researchers including Emmanuelle Charpentier, George Church, 00:03:50.884 --> 00:03:53.537 Jennifer Doudna and Feng Zhang 00:03:53.561 --> 00:03:57.530 showed six years ago how CRISPR scissors could be programmed 00:03:57.554 --> 00:04:00.141 to cut DNA sequences of our choosing, 00:04:00.165 --> 00:04:02.534 including sequences in your genome, 00:04:02.558 --> 00:04:05.901 instead of the viral DNA sequences chosen by bacteria. 00:04:06.550 --> 00:04:09.084 But the outcomes are actually similar. 00:04:09.606 --> 00:04:12.074 Cutting a DNA sequence in your genome 00:04:12.098 --> 00:04:16.225 also disrupts the function of the cut gene, typically, 00:04:16.997 --> 00:04:21.464 by causing the insertion and deletion of random mixtures of DNA letters 00:04:21.488 --> 00:04:22.641 at the cut site. NOTE Paragraph 00:04:24.625 --> 00:04:28.506 Now, disrupting genes can be very useful for some applications. 00:04:30.005 --> 00:04:34.306 But for most point mutations that cause genetic diseases, 00:04:34.330 --> 00:04:38.687 simply cutting the already-mutated gene won't benefit patients, 00:04:38.711 --> 00:04:42.679 because the function of the mutated gene needs to be restored, 00:04:42.703 --> 00:04:44.318 not further disrupted. 00:04:45.259 --> 00:04:48.141 So cutting this already-mutated hemoglobin gene 00:04:48.165 --> 00:04:50.688 that causes sickle cell anemia 00:04:50.712 --> 00:04:54.228 won't restore the ability of patients to make healthy red blood cells. 00:04:55.631 --> 00:04:59.972 And while we can sometimes introduce new DNA sequences into cells 00:04:59.996 --> 00:05:03.417 to replace the DNA sequences surrounding a cut site, 00:05:03.441 --> 00:05:07.765 that process, unfortunately, doesn't work in most types of cells, 00:05:07.789 --> 00:05:10.230 and the disrupted gene outcomes still predominate. NOTE Paragraph 00:05:12.297 --> 00:05:14.479 Like many scientists, I've dreamed of a future 00:05:14.503 --> 00:05:17.277 in which we might be able to treat or maybe even cure 00:05:17.301 --> 00:05:18.672 human genetic diseases. 00:05:19.135 --> 00:05:22.936 But I saw the lack of a way to fix point mutations, 00:05:22.960 --> 00:05:25.984 which cause most human genetic diseases, 00:05:26.008 --> 00:05:28.396 as a major problem standing in the way. NOTE Paragraph 00:05:29.434 --> 00:05:32.102 Being a chemist, I began working with my students 00:05:32.126 --> 00:05:37.061 to develop ways on performing chemistry directly on an individual DNA base, 00:05:37.085 --> 00:05:42.704 to truly fix, rather than disrupt, the mutations that cause genetic diseases. 00:05:44.522 --> 00:05:47.070 The results of our efforts are molecular machines 00:05:47.094 --> 00:05:48.482 called "base editors." 00:05:49.618 --> 00:05:55.093 Base editors use the programmable searching mechanism of CRISPR scissors, 00:05:55.117 --> 00:05:58.053 but instead of cutting the DNA, 00:05:58.077 --> 00:06:01.018 they directly convert one base to another base 00:06:01.042 --> 00:06:03.295 without disrupting the rest of the gene. 00:06:04.674 --> 00:06:08.832 So if you think of naturally occurring CRISPR proteins as molecular scissors, 00:06:08.856 --> 00:06:11.642 you can think of base editors as pencils, 00:06:11.666 --> 00:06:15.162 capable of directly rewriting one DNA letter into another 00:06:16.098 --> 00:06:19.901 by actually rearranging the atoms of one DNA base 00:06:19.925 --> 00:06:22.259 to instead become a different base. NOTE Paragraph 00:06:23.513 --> 00:06:25.689 Now, base editors don't exist in nature. 00:06:26.683 --> 00:06:29.913 In fact, we engineered the first base editor, shown here, 00:06:29.937 --> 00:06:31.294 from three separate proteins 00:06:31.318 --> 00:06:33.548 that don't even come from the same organism. 00:06:34.151 --> 00:06:39.248 We started by taking CRISPR scissors and disabling the ability to cut DNA 00:06:39.272 --> 00:06:43.811 while retaining its ability to search for and bind a target DNA sequence 00:06:43.835 --> 00:06:45.369 in a programmed manner. 00:06:46.351 --> 00:06:49.188 To those disabled CRISPR scissors, shown in blue, 00:06:49.212 --> 00:06:51.720 we attached a second protein in red, 00:06:51.744 --> 00:06:56.045 which performs a chemical reaction on the DNA base C, 00:06:56.069 --> 00:06:59.402 converting it into a base that behaves like T. 00:07:00.958 --> 00:07:04.100 Third, we had to attach to the first two proteins 00:07:04.124 --> 00:07:05.474 the protein shown in purple, 00:07:05.498 --> 00:07:09.098 which protects the edited base from being removed by the cell. 00:07:10.466 --> 00:07:13.308 The net result is an engineered three-part protein 00:07:13.332 --> 00:07:17.450 that for the first time allows us to convert Cs into Ts 00:07:17.474 --> 00:07:19.637 at specified locations in the genome. NOTE Paragraph 00:07:21.490 --> 00:07:24.522 But even at this point, our work was only half done. 00:07:24.546 --> 00:07:27.172 Because in order to be stable in cells, 00:07:27.196 --> 00:07:30.855 the two strands of a DNA double helix have to form base pairs. 00:07:32.125 --> 00:07:35.783 And because C only pairs with G, 00:07:35.807 --> 00:07:38.809 and T only pairs with A, 00:07:39.752 --> 00:07:44.598 simply changing a C to a T on one DNA strand creates a mismatch, 00:07:44.622 --> 00:07:47.471 a disagreement between the two DNA strands 00:07:47.495 --> 00:07:51.763 that the cell has to resolve by deciding which strand to replace. 00:07:53.149 --> 00:07:57.490 We realized that we could further engineer this three-part protein 00:07:58.649 --> 00:08:02.515 to flag the nonedited strand as the one to be replaced 00:08:02.539 --> 00:08:04.450 by nicking that strand. 00:08:05.276 --> 00:08:07.805 This little nick tricks the cell 00:08:07.829 --> 00:08:12.776 into replacing the nonedited G with an A 00:08:12.800 --> 00:08:15.125 as it remakes the nicked strand, 00:08:15.149 --> 00:08:19.180 thereby completing the conversion of what used to be a C-G base pair 00:08:19.204 --> 00:08:21.500 into a stable T-A base pair. NOTE Paragraph 00:08:24.585 --> 00:08:26.136 After several years of hard work 00:08:26.160 --> 00:08:30.141 led by a former post doc in the lab, Alexis Komor, 00:08:30.165 --> 00:08:33.347 we succeeded in developing this first class of base editor, 00:08:33.371 --> 00:08:37.037 which converts Cs into Ts and Gs into As 00:08:37.061 --> 00:08:39.220 at targeted positions of our choosing. 00:08:40.633 --> 00:08:45.863 Among the more than 35,000 known disease-associated point mutations, 00:08:45.887 --> 00:08:49.672 the two kinds of mutations that this first base editor can reverse 00:08:49.696 --> 00:08:55.839 collectively account for about 14 percent or 5,000 or so pathogenic point mutations. 00:08:56.593 --> 00:09:01.363 But correcting the largest fraction of disease-causing point mutations 00:09:01.387 --> 00:09:05.022 would require developing a second class of base editor, 00:09:05.046 --> 00:09:09.132 one that could convert As into Gs or Ts into Cs. 00:09:10.846 --> 00:09:14.573 Led by Nicole Gaudelli, a former post doc in the lab, 00:09:14.597 --> 00:09:17.719 we set out to develop this second class of base editor, 00:09:17.743 --> 00:09:23.870 which, in theory, could correct up to almost half of pathogenic point mutations, 00:09:23.894 --> 00:09:27.805 including that mutation that causes the rapid-aging disease progeria. NOTE Paragraph 00:09:30.107 --> 00:09:33.274 We realized that we could borrow, once again, 00:09:33.298 --> 00:09:37.366 the targeting mechanism of CRISPR scissors 00:09:37.390 --> 00:09:42.551 to bring the new base editor to the right site in a genome. 00:09:43.543 --> 00:09:46.635 But we quickly encountered an incredible problem; 00:09:47.896 --> 00:09:50.324 namely, there is no protein 00:09:50.348 --> 00:09:54.400 that's known to convert A into G or T into C 00:09:54.424 --> 00:09:55.585 in DNA. 00:09:56.760 --> 00:09:58.926 Faced with such a serious stumbling block, 00:09:58.950 --> 00:10:01.482 most students would probably look for another project, 00:10:01.506 --> 00:10:03.246 if not another research advisor. 00:10:03.270 --> 00:10:04.434 (Laughter) 00:10:04.458 --> 00:10:06.400 But Nicole agreed to proceed with a plan 00:10:06.424 --> 00:10:09.091 that seemed wildly ambitious at the time. 00:10:09.966 --> 00:10:12.305 Given the absence of a naturally occurring protein 00:10:12.329 --> 00:10:14.490 that performs the necessary chemistry, 00:10:14.514 --> 00:10:17.950 we decided we would evolve our own protein in the laboratory 00:10:17.974 --> 00:10:21.809 to convert A into a base that behaves like G, 00:10:21.833 --> 00:10:26.660 starting from a protein that performs related chemistry on RNA. 00:10:27.230 --> 00:10:31.164 We set up a Darwinian survival-of-the-fittest selection system 00:10:31.188 --> 00:10:35.180 that explored tens of millions of protein variants 00:10:35.204 --> 00:10:37.222 and only allowed those rare variants 00:10:37.246 --> 00:10:40.467 that could perform the necessary chemistry to survive. 00:10:41.883 --> 00:10:44.271 We ended up with a protein shown here, 00:10:44.295 --> 00:10:47.152 the first that can convert A in DNA 00:10:47.176 --> 00:10:49.268 into a base that resembles G. 00:10:49.292 --> 00:10:50.895 And when we attached that protein 00:10:50.919 --> 00:10:53.490 to the disabled CRISPR scissors, shown in blue, 00:10:53.514 --> 00:10:55.522 we produced the second base editor, 00:10:55.546 --> 00:10:58.641 which converts As into Gs, 00:10:58.665 --> 00:11:02.506 and then uses the same strand-nicking strategy 00:11:02.530 --> 00:11:04.450 that we used in the first base editor 00:11:04.474 --> 00:11:09.939 to trick the cell into replacing the nonedited T with a C 00:11:09.963 --> 00:11:11.638 as it remakes that nicked strand, 00:11:11.662 --> 00:11:15.833 thereby completing the conversion of an A-T base pair to a G-C base pair. NOTE Paragraph 00:11:16.845 --> 00:11:18.892 (Applause) NOTE Paragraph 00:11:18.916 --> 00:11:20.086 Thank you. NOTE Paragraph 00:11:20.110 --> 00:11:23.467 (Applause) NOTE Paragraph 00:11:23.491 --> 00:11:25.826 As an academic scientist in the US, 00:11:25.850 --> 00:11:27.997 I'm not used to being interrupted by applause. NOTE Paragraph 00:11:28.021 --> 00:11:31.172 (Laughter) NOTE Paragraph 00:11:31.196 --> 00:11:35.601 We developed these first two classes of base editors 00:11:35.625 --> 00:11:38.399 only three years ago and one and a half years ago. 00:11:39.267 --> 00:11:40.815 But even in that short time, 00:11:40.839 --> 00:11:44.561 base editing has become widely used by the biomedical research community. 00:11:45.776 --> 00:11:50.141 Base editors have been sent more than 6,000 times 00:11:50.165 --> 00:11:54.036 at the request of more than 1,000 researchers around the globe. 00:11:55.475 --> 00:11:58.991 A hundred scientific research papers have been published already, 00:11:59.015 --> 00:12:02.743 using base editors in organisms ranging from bacteria 00:12:02.767 --> 00:12:04.901 to plants to mice to primates. NOTE Paragraph 00:12:07.950 --> 00:12:09.557 While base editors are too new 00:12:09.581 --> 00:12:12.466 to have already entered human clinical trials, 00:12:12.490 --> 00:12:17.612 scientists have succeeded in achieving a critical milestone towards that goal 00:12:17.636 --> 00:12:20.485 by using base editors in animals 00:12:20.509 --> 00:12:24.418 to correct point mutations that cause human genetic diseases. 00:12:25.815 --> 00:12:26.966 For example, 00:12:26.990 --> 00:12:30.783 a collaborative team of scientists led by Luke Koblan and Jon Levy, 00:12:30.807 --> 00:12:33.220 two additional students in my lab, 00:12:33.244 --> 00:12:37.363 recently used a virus to deliver that second base editor 00:12:37.387 --> 00:12:39.577 into a mouse with progeria, 00:12:39.601 --> 00:12:43.458 changing that disease-causing T back into a C 00:12:43.482 --> 00:12:47.588 and reversing its consequences at the DNA, RNA and protein levels. NOTE Paragraph 00:12:48.880 --> 00:12:51.626 Base editors have also been used in animals 00:12:51.650 --> 00:12:54.574 to reverse the consequence of tyrosinemia, 00:12:55.642 --> 00:12:59.260 beta thalassemia, muscular dystrophy, 00:12:59.284 --> 00:13:02.974 phenylketonuria, a congenital deafness 00:13:02.998 --> 00:13:04.937 and a type of cardiovascular disease -- 00:13:04.961 --> 00:13:09.823 in each case, by directly correcting a point mutation 00:13:09.847 --> 00:13:12.400 that causes or contributes to the disease. 00:13:13.688 --> 00:13:15.744 In plants, base editors have been used 00:13:15.768 --> 00:13:19.840 to introduce individual single DNA letter changes 00:13:19.864 --> 00:13:21.832 that could lead to better crops. NOTE Paragraph 00:13:22.253 --> 00:13:26.842 And biologists have used base editors to probe the role of individual letters 00:13:26.866 --> 00:13:29.683 in genes associated with diseases such as cancer. 00:13:31.046 --> 00:13:35.613 Two companies I cofounded, Beam Therapeutics and Pairwise Plants, 00:13:35.637 --> 00:13:39.462 are using base editing to treat human genetic diseases 00:13:39.486 --> 00:13:41.092 and to improve agriculture. 00:13:41.953 --> 00:13:43.919 All of these applications of base editing 00:13:43.943 --> 00:13:47.037 have taken place in less than the past three years: 00:13:47.061 --> 00:13:49.425 on the historical timescale of science, 00:13:49.449 --> 00:13:50.731 the blink of an eye. NOTE Paragraph 00:13:52.657 --> 00:13:53.910 Additional work lies ahead 00:13:53.934 --> 00:13:56.966 before base editing can realize its full potential 00:13:56.990 --> 00:14:00.604 to improve the lives of patients with genetic diseases. 00:14:01.244 --> 00:14:04.024 While many of these diseases are thought to be treatable 00:14:04.048 --> 00:14:05.897 by correcting the underlying mutation 00:14:05.921 --> 00:14:09.437 in even a modest fraction of cells in an organ, 00:14:09.461 --> 00:14:12.437 delivering molecular machines like base editors 00:14:12.461 --> 00:14:14.228 into cells in a human being 00:14:14.252 --> 00:14:15.421 can be challenging. 00:14:16.962 --> 00:14:20.335 Co-opting nature's viruses to deliver base editors 00:14:20.359 --> 00:14:22.557 instead of the molecules that give you a cold 00:14:22.581 --> 00:14:25.268 is one of several promising delivery strategies 00:14:25.292 --> 00:14:26.951 that's been successfully used. 00:14:28.268 --> 00:14:30.633 Continuing to develop new molecular machines 00:14:30.657 --> 00:14:32.525 that can make all of the remaining ways 00:14:32.549 --> 00:14:35.441 to convert one base pair to another base pair 00:14:35.465 --> 00:14:39.845 and that minimize unwanted editing at off-target locations in cells 00:14:39.869 --> 00:14:41.069 is very important. 00:14:41.782 --> 00:14:46.488 And engaging with other scientists, doctors, ethicists and governments 00:14:46.512 --> 00:14:51.303 to maximize the likelihood that base editing is applied thoughtfully, 00:14:51.327 --> 00:14:53.708 safely and ethically, 00:14:53.732 --> 00:14:55.732 remains a critical obligation. NOTE Paragraph 00:14:57.525 --> 00:14:59.136 These challenges notwithstanding, 00:14:59.160 --> 00:15:02.815 if you had told me even just five years ago 00:15:02.839 --> 00:15:04.490 that researchers around the globe 00:15:04.514 --> 00:15:08.053 would be using laboratory-evolved molecular machines 00:15:08.077 --> 00:15:11.074 to directly convert an individual base pair 00:15:11.098 --> 00:15:12.280 to another base pair 00:15:12.304 --> 00:15:14.923 at a specified location in the human genome 00:15:14.947 --> 00:15:18.772 efficiently and with a minimum of other outcomes, 00:15:18.796 --> 00:15:19.964 I would have asked you, 00:15:19.988 --> 00:15:22.462 "What science-fiction novel are you reading?" 00:15:23.706 --> 00:15:27.166 Thanks to a relentlessly dedicated group of students 00:15:27.190 --> 00:15:31.650 who were creative enough to engineer what we could design ourselves 00:15:31.674 --> 00:15:34.599 and brave enough to evolve what we couldn't, 00:15:34.623 --> 00:15:39.663 base editing has begun to transform that science-fiction-like aspiration 00:15:39.687 --> 00:15:41.544 into an exciting new reality, 00:15:42.250 --> 00:15:45.481 one in which the most important gift we give our children 00:15:45.505 --> 00:15:48.530 may not only be three billion letters of DNA, 00:15:48.554 --> 00:15:51.664 but also the means to protect and repair them. NOTE Paragraph 00:15:52.339 --> 00:15:53.490 Thank you. NOTE Paragraph 00:15:53.514 --> 00:15:58.016 (Applause) NOTE Paragraph 00:15:58.040 --> 00:15:59.190 Thank you.