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A. K. Sato and S. Rife
system. DNA sequences that are complementary to the spacerRNA will be targeted by the complex and, once bound, cleaved by the Cas nuclease (see Fig.2.1) [18].
By storing fragments of foreign DNA in CRISPR sequences, these species are able to recognize and more effectively eliminate pathogens. And, in 2012, research­ers showed that this system could be modied to enable highly precise gene editing.
Building on decades of work, Jennifer Doudna at UC Berkeley and Emmanuelle Charpentier at the University of Sweden collaborated to engineer a synthetic CRISPR DNA sequence that simplied the CRISPR-Cas complex (by combining spacerRNA and tracerRNA into a single transcript known as a single-guide RNA; Fig.2.2a) and enabled it to target non-viral DNA sequences, opening the door to prescribed gene editing [19]. Further modication to the system by Feng Zhang of the Broad Institute made the heterologous expression of CRISPR-Cas systems in eukaryotic cells possible, further expanding its potential for engineering biological systems through precise gene editing [20].
Though it is not often discussed as such, CRISPR-Cas represents a powerful product of synthetic biology wherein modied bacterial genes are heterologously
Fig. 2.1 CRISPR-Cas9 adaptive immune system of Streptococcus pyogenes against bacterio- phages. Diagram showing how the CRISPR-Cas9 complex processes viral DNA within Streptococcus pyogenes. Upon entry into the cell, cas nucleases digest the DNA and insert it into the bacterial genome at CRISPR loci. These inserts are referred to as spacer sequences. Expression of the spacer sequence along with an inborn tracer sequence will generate a guide RNA comprised of both spacer and tracer RNAs. Together with the Cas9 nuclease, this complex targets and digests complimentary viral sequences. (Figure adapted from “CRISPR-Cas9 Adaptive Immune System of Streptococcus pyogenes Against Bacteriophages,” by BioRender.com [2022]. Retrieved from
https://app.biorender.com/biorender- templates)
2 Synthetic Biology inDrug Development andBeyond
31
Fig. 2.2 CRISPR-Cas9in Drug Discovery. (a) In bacteria, CRISPR guide RNAs are comprised of two distinct RNA sequences, known as the crRNA and tracerRNA.Use of CRISPR gene editing in drug discovery was enabled by the generation of a synthetic mimic of the natural guide RNA com­plex. This synthetic version is comprised of a single-guide RNA with sequences corresponding to the crRNA and tracerRNA. (b) CRISPR screening workow. Large-scale CRISPR screening can be used to identify potential drug targets by perturbing individual genes and subsequently analyz­ing for desired effects. (Figure adapted from “CRISPR Screening Protocol,” by BioRender.com [2022]. Retrieved from https://app.biorender.com/biorender- templates)
expressed in a wide range of hosts for productive means. Since its discovery, CRISPR-Cas systems have been developed for numerous applications, including the discovery of therapeutic drug targets [11].
Drug discovery can be carried out in one of two ways: target-forward approaches or phenotype-forward approaches. In the latter, libraries of compounds are screened for their ability to elicit a specic phenotype within a model system. This approach can be useful when the target disease pathology is not well characterized or when novel drug targets are desired. On the other hand, target-forward approaches involve the screening of libraries of compounds for their activity against specic drug tar­gets that are known to hold therapeutic value.
32
A. K. Sato and S. Rife
CRISPR-Cas can support both approaches. Target-forward drug discovery starts with identifying targets of interest, a process greatly improved with CRISPR screen­ing. Through large-scale CRISPR screens, researchers can methodically perturb gene expression across a large range of targets in an effort to elicit a desired pheno­type (such as reduced proliferation). Results from these screens can produce new therapeutic targets by revealing the proteins and pathways that are critical to disease pathology. Once identied, libraries of compounds can be screened for their ability to target these specic proteins.
A recent example of this came from the Bassik lab at Stanford University, where a team of researchers performed a large-scale CRISPR screen to identify synthetic lethal drug combinations in a BCR-ABL expressing chronic myeloid leukemia cell line [21]. The team utilized a dual-guide approach so that each cell in the study would receive two sgRNAs, and thus have two genes simultaneously knocked out. Approximately 490,000 sgRNA pairs were created, enabling the team to simulate 21,321 drug combinations and identify numerous synthetic lethal combinations.
In addition to driving target identication and validation, CRISPR can also aid in the development of screening models. A signicant challenge in drug discovery is ensuring that efcacy in the laboratory setting translates to the bedside. As many as 90% of therapeutics entering clinical trials fail due to a lack of efcacy or unfore­seen toxicities [22]. Quantitative decision-theoretic modeling of the drug discovery pipeline suggests that better preclinical models, ones that more accurately reect human physiology, could substantially improve drug development productivity [23].
To this end, CRISPR-Cas has been used to engineer both cell lines and animal models that better emulate human disease [24]. Having the ability to introduce disease- specic mutations into the desired model—be it human cells or rodents— enables the ne-scale study of disease pathogenesis, rapid screening of compounds in a disease-relevant context, and provides an opportunity for early go/no-go decision- making. All of this builds toward a more productive drug development pipeline.
Beyond its use as a tool in drug development, CRISPR-Cas is also being explored as a therapeutic in and of itself, largely for the treatment of monogenic disorders. A clinical trial initiated in 2019 by pharmaceutical company Editas Medicine is study­ing the ability of a CRISPR-Cas system to improve vision for patients harboring heterozygous or homozygous point mutations in the Centrosomal Protein 290 (CEP290) gene, which leads to Leber Congenital Amaurosis Type 10 [25, 26]. As of the writing of this book, the trial is ongoing and isexpected to conclude in May of
2025. And, in December of 2023, the US FDA approved two of the rst ever CRISPR-based therapeutics (Casgevy and Lyfgenia) forthe treatment of sickle cell anemia [27, 28].
While CRISPR-Cas technology is proving to be an invaluable tool for drug development, there remain signicant challenges that limit its application. Practical challenges include difculties with effectively delivering multiple macromolecules (such as the vectors encoding both Cas nucleases and gRNAs) to primary cell lines and living tissues. More difcult is the challenge of anticipating and preventing off­target editing. Though the CRISPR-Cas system is capable of highly specic editing,
2 Synthetic Biology inDrug Development andBeyond
promiscuous nuclease activity as well as imperfect gRNA design can lead to unin­tended editing. Here, imperfect gRNA designs are those that target non-unique DNA sequences that may be identical—in whole or in part—to other loci within the genome. These redundant loci can attract CRISPR-Cas activity. The many chal­lenges associated with CRISPR-Cas systems and the ongoing efforts to overcome those challenges are covered in depth by Liu et al., in Precision Clinical Medicine [29].
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2.4 Engineering Biosynthetic Gene Clusters
forDrug Discovery
An analysis of 1881 approved drugs in the United States between January 01, 1981, and September 30, 2019, found that only 463 (24.6%) were produced through entirely synthetic means, meaning without inspiration from natural products [30]. Stated another way, nature remains a signicant source of medicinal compounds, from biologics to small molecules.
Nature-derived therapeutics can often be traced back to secondary metabolites— biologically active small molecules whose activity is not critical to the growth of an organism but may contribute to signaling or defense systems. Secondary metabo­lites can be structurally complex and difcult, if not impossible, to synthesize in the laboratory. Therefore, extraction has been the primary approach to accessing sec­ondary metabolites, which may then serve as the chemical skeleton for further mod­ication and development [31].
However, extraction processes can put signicant strain on natural resources and may be prohibitively expensive to operationalize at scale. Additionally, natural con­centrations of these compounds can be very low, necessitating large quantities of starting material. Owing to these limitations, the sourcing of secondary metabolites has largely been focused on organisms that can be cultured in the laboratory setting or else farmed in signicant quantities. Alternatively, some laboratories are attempt­ing to synthesize chemical pathways that generate secondary metabolites invitro.
The advent of both next-generation sequencing (NGS) and synthetic biology has greatly expanded opportunities for new drug discovery by enabling the production of secondary metabolites in chassis organisms [3135].
This is done through the identication, synthesis, and cloning of biosynthetic gene clusters (BGCs). Secondary metabolites are frequently produced through an enzymatic relay that enables the formation of complex and pharmacologically active structures. Importantly, the DNA encoding these enzymes is often grouped together into clusters, or BGCs, that can range from several kilobases to >100kb in length. These clusters can be identied by mining next-generation sequencing (NGS) data using advanced bioinformatics [3136].
Though the specic enzymes used in this process can vary, enzymes like polyketide synthases (PKSs) and non-ribosomal peptide synthetases (NRPs)
34
frequently appear in the production pathways for toxins, antibiotics, cytostatics, and immunosuppressants [36, 37]. Therefore, bioinformatic tools can be used to mine genomic databases for potential BGCs by searching for PKSs, NRPs, and their con­stituent elements. Once identied, these gene clusters can be synthesized and cloned into chassis organisms.
This approach has several advantages. Porting BGCs into chassis organisms obviates the need for the original host organism to be involved in compound screen­ing, reducing ethical, nancial, and operational concerns. Additionally, BGCs in chassis organisms can be optimized to produce large quantities of the candidate compounds, enabling testing of compounds that may have otherwise been over­looked due to low expression levels in their native host [38]. Further, the synthetic nature of this approach allows for combinatorial experimentation such that novel variants and unique gene combinations can be tested en masse.
A recent preprint from Liu etal. highlights this potential. Using metagenomic data from soil samples, Liu etal. analyzed >6.8 billion BGCs for the potential to produce inhibitors of human methionine aminopeptidase-1 (HsMetAP1)—a vali­dated oncology target [39]. This search yielded 35 BGCs with enzymes that are likely to produce secondary metabolites against HsMetAP1. Heterologous expres­sion of two of these BGCs in a bacterial chassis resulted in the discovery of several novel HsMetAP1 inhibitors, one of which demonstrated sub-micromolar potency and high selectivity in an invitro enzymatic assay (specically a methionine amino­peptidase colorimetric activity assay based on an R&D Systems commercial kit). This example demonstrates how heterologous expression of BGCs can be used to discover new small molecules with therapeutic potential.
Heterologous expression of BGCs is far from trivial, though. Gene regulation and cellular context can be important factors in determining the catalytic efciency and end products of a BGC.When these enzymatic networks are ported into chassis organisms, the costly and time-consuming process of directed evolution may be required to optimize secondary metabolite production. Herein, directed evolution describes the creation of libraries in which BGC elements will undergo an iterative process that involves random mutation, screening of mutants for desired properties, and further mutation of selected mutants until optimal performance is attained. Such a process can be time and resource intensive for individual genes, much less gene clusters.
A. K. Sato and S. Rife
2.5 Unprecedented Antibody Discovery andDevelopment
Through Synthetic Biology
Over the past two decades, biologics have been an increasingly important source of new molecular entities [40]. Between the years 2000 and 2021, 723 new drugs were approved in the United States, 158 (21.9%) of which were biologics [41]. Within this category, monoclonal antibodies are by far the most common.
2 Synthetic Biology inDrug Development andBeyond
Owing to size and physiochemical differences, small molecules and antibodies display substantially different pharmacokinetics, which can be both benecial and detrimental. For example, antibodies generally have longer half-lives in the body, enabling longer exposure to the therapeutic and intermittent dosing. However, anti­bodies also struggle to penetrate beyond tissue barriers (such as the blood-brain barrier), which can greatly limit their distribution [42]. As polymeric proteins, anti­bodies are also susceptible to deamidation, glycosylation, and oxidation events that can alter their biological properties.
Therefore, the development of antibodies and other biologics often includes extensive rounds of iterative optimization in an effort to tailor the antibody’s phar­macological and pharmacokinetic properties. This process is widely referred to as a design, build, test, learn (DBTL) cycle. During the design phase, libraries of anti­bodies can be computationally designed such that each antibody clone contains a combination of missense mutations that are expected to affect the antibody’s prop­erties, such as binding afnity or stability.
Synthetic biology intersects with and drives this process in many ways. Much of this work relies on the same tools and high-level workows already discussed: Synthetic DNA sequences representing whole or partial antibodies are heterolo­gously expressed in a chassis organism—be it a bacteria cell, mammalian cell, or a transgenic mouse—in order to screen, optimize, and manufacture novel biologics.
In the following sections, we will briey describe two of the primary approaches in biologics development—one based on B-cell technology, and one based on phage display—as well as the impact of synthetic biology in enabling these approaches.
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2.5.1 B-Cells andHybridoma Technology forAntibody
Discovery andDevelopment
Hybridoma technology advanced antibody discovery and development efforts con­siderably by enabling the long-term culture of B-cells collected from immunized animals. First described in 1975, hybridoma technology fuses mouse myeloma cells with antibody-producing B-cells to form an immortalized B-cell line from which antibodies can be collected [43]. Clonal expansion of B-cells, each expressing a dif­ferent antibody variant, can then be used to produce antibody libraries (Fig.2.3).
Hybridoma technology enables robust production of monoclonal antibodies in the laboratory and has been used to develop many currently approved biologics [43,
44]. However, antibodies derived from non-human species are very likely to be
recognized as foreign proteins by the human immune system and elicit a life­threatening response. To mitigate this risk, therapeutic antibodies must be made to resemble human antibodies using tools from synthetic biology.
Antibodies are hetero-tetrameric proteins consisting of two identical heavy chains and two identical light chains joined together through disulde bonds. At one end of the protein complex can be found variable regions for both the heavy and
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Fig. 2.3 B-cell hybridoma library creation. Workow for the creation of antibody libraries using hybridoma technology. (Figure adapted from “Monoclonal Antibodies Production,” by BioRender.
com [2022]. Retrieved from https://app.biorender.com/biorender- templates)
A. K. Sato and S. Rife
light chains. As their name suggests, variable regions have highly varied amino acid sequences whose unique composition determines the antibody’s unique antigen specicity and afnity. Within these variable regions, three amino acid loops (known as complementarity-determining regions, or CDRs) are critically inuential in determining antigen recognition. The rest of the antibody complex consists of frameworks and constant regions whose amino acid sequences are largely con­served within species [45].
Reducing immunogenic potential requires careful modication of the candidate antibody to preserve antigen specicity while incorporating human frameworks wherever possible. Multiple approaches have been developed, all of which rely on creating novel antibody genes in which elements of the original antibody’s DNA sequence are replaced with human antibody sequences [44].
For example, chimeric antibodies commonly fuse promising mouse antibodies with human antibody frameworks. In these synthetic antibodies, the DNA encoding the human antibody variable regions are replaced by the corresponding variable region in the mouse therapeutic antibody, such that the nal product contains human constant regions and non-human variable regions. This is also sometimes referred to as CDR grafting because the CDR from one animal is transplanted onto a human antibody framework [44].
2 Synthetic Biology inDrug Development andBeyond
37
Novel chimeric antibodies are easily produced through the use of de novo DNA synthesis (discussed in more detail below), homology-based cloning methods, and chassis organisms. Though the majority of therapeutic antibodies used to treat humans are chimeras, the development of chimeric antibodies remains relatively risky compared to fully human antibodies [46].
Alternatively, transgenic mouse models, such as HuMabMouse and XenoMouse, have been created by replacing mouse immunoglobulin genes for those derived from the human genome [44]. Rather than expressing murine antibodies, these mice produce human antibodies and can thus be used to create fully human hybridoma cells. While undoubtedly useful, the application of transgenic mice is limited by their costly and slow nature, two attributes that make it difcult to apply to emergent cases, such as infectious diseases.
Rather than humanizing antibodies, it is also possible to start with human anti­bodies. Human B-cell screening is an approach whereby antibody libraries are sourced from the human B-cell repertoire of resear ch participants [44, 47]. Heterogeneous populations of plasma and memory B-lymphocytes can be collected from either lymphatic tissue or peripheral bone marrow cell populations and subse­quently screened in cell-based or bead-based assays. As these cells naturally excrete antibodies, individual B-cells can be isolated and assessed for antigen-binding activity. Those that show binding activity can then be sequenced to identify the cor­responding DNA sequence.
Such an approach provides several benets. It is estimated that at least 107 anti­body variants can be found among circulating human immune cells at any given time. Based on the mathematical possibility of different V(D)J recombinations, it is estimated that the true human B-cell repertoire size is between 1012 and 1018 distinct variants [47]. However, the human body has natural maturation processes that pre­vent B-cells containing autoreactive, truncated, or otherwise non-functional anti­bodies from entering circulation. This maturation process is advantageous for antibody development.
Additionally, B-cell screening can be a valuable tool when combating infectious diseases. Patients who have previously been infected with the target pathogen are very likely to have memory B-cells that produce high-afnity antibodies. Collection and screening of B-cells from these patients can help researchers rapidly develop therapeutic antibodies. This was made evident early in the SARS-CoV-2 pandemic when B-cells collected from previously infected patients were used to rapidly iden­tify 49 different human anti-SARS-CoV-2 antibodies within a matter of weeks [48].
For a more in-depth review of B-cell technology, we refer you to Pedrioli and Oxenius’ recent review in Cell [47].
Though a powerful method for antibody discovery, human B-cell screening has notable limitations related to throughput and scale. But perhaps the biggest limita­tion is that B-cell screening can only survey antibodies that nature has already pro­duced. Sometimes, it is advantageous to go beyond what already exists and develop a de novo antibody sequence. For this, researchers turn to synthetic libraries.
38
A. K. Sato and S. Rife
2.5.2 Synthetic Libraries andDisplay Systems
As with small molecules, the discovery and development of novel biologics often begins with the screening of large libraries in which millions of antibody (or anti­body fragment) sequences are represented. When these libraries are diverse, with uniform representation among variants, and are free of liability motifs that can lead to poor pharmacokinetics, hundreds of promising candidates can be found and car­ried forward for further characterization and optimization.
Historically, antibody libraries have been sourced from the serum of animals previously infected with target antigen [44]. With a natural, pre-existing repertoire of diverse antibodies, the animal’s immune system is often readily able to produce polyclonal antibodies against a wide range of targets. However, this approach has many drawbacks related to variability, a general inability to scale, and ethical con­cerns surrounding animal welfare that preclude its use in the development of therapeutics.
Whereas hybridoma technology relies on animal immune systems to surface candidate antibodies, recent advances in both DNA synthesis technology and syn­thetic biology have given researchers the power to design, produce, and screen cus­tom antibody libraries. Specically, DNA synthesis can now be reliably performed on a large scale [9], such that millions of custom oligonucleotides can be generated per run on platforms such as Twist Bioscience’s silicon-based DNA synthesis plat­form. This makes it possible to synthesize large libraries of deliberately designed antibodies.
There are many approaches to designing such a library that go beyond the scope of this chapter. However, whether starting with a known antibody sequence or tak­ing a broader approach, computational tools can be used to identify key loci in an antibody sequence where missense mutations are likely to impact antigen recogni­tion [49]. The library would subsequently consist of antibody variants containing combinations of missense mutations (a so-called combinatorial variant library). Such libraries may contain as many as 1010 unique antibodies for screening [50].
Once designed, antibody libraries may then be constructed using DNA synthesis technology. Modern synthesis platforms leverage a myriad of approaches to create variant libraries that can generally be divided into direct and degenerate approaches.
Degenerate approaches rely on randomly incorporating nucleotides at specied locations within the growing oligonucleotide. Most common among these methods is the NNK approach, wherein the rst and second positions of a codon may be occupied by any of the four nucleotide possibilities (A, T, G, C). The nal position denoted by a K, the so-called wobble position, is limited to just two potential nucle­otides (G, T).
NNK synthesis can be extremely effective for directed evolution; however, its inefciencies and bias-prone nature greatly limit its application in antibody devel­opment. Consider the redundancy of the genetic code, wherein multiple codons may apply to the same amino acid. Using NNK synthesis, you are likely to generate multiple distinct codons that correspond to the same amino acid, resulting in
2 Synthetic Biology inDrug Development andBeyond
39
redundant variants that may not provide additional value to your study. This also means it is difcult to create uniform libraries—libraries where every variant anti­body is equally represented—using NNK.
For example, because six different codons code for the amino acid arginine, it is far more likely to occur relative to amino acids like phenylalanine that only have two corresponding codons. Using NNK, then, a mutation in any given loci is more likely to substitute an arginine than phenylalanine, biasing the test pool away from antibody variants containing less common amino acids.
Finally, NNK synthesis can produce stop codons. When creating large libraries with multiple variants per oligo, premature stop codons are likely to affect a signi­cant portion of the library, resulting in many truncated and non-functional antibod­ies [51].
Collectively, these drawbacks mean that creating combinatorial variant libraries with NNK synthesis is prohibitively inefcient. The combination of redundant anti­body clones, non-uniform antibody representation, and truncated antibodies (pro­duced by premature stop codons) generates an expensive library with few unique, viable antibody clones to screen. Put another way, NNK approaches reduce the functional diversity in antibody libraries and may require costly, time-consuming efforts to compensate for this, ultimately increasing the researcher’s screen­ing burden.
The use of libraries synthesized with trinucleotide phosphoramidites (trimers) can be a good alternative to NNK libraries because it gives the user more control. Unlike NNK libraries, which randomly incorporate individual nucleotides, trimer approaches incorporate blocks of three nucleotides at a time. The trinucleotide blocks can be synthesized through various means and are designed such that every desired codon is represented, whereas undesired codons—such as stop codons or those coding for cysteine—can be avoided.
While trimer synthesis affords the user with more control, it is still libel to pro­duce biased oligonucleotide libraries where certain amino acids are over- represented. This is because each trimer phosphoramidite has a different reaction factor that dictates the rate of the coupling reaction during synthesis. For example, the trimer AAC (encoding asparagine) couples with the greatest efciency—meaning it is very likely to be incorporated whenever given the opportunity—and thus has a reac­tion factor of 1.0. In contrast, the trimer CAG (coding for glutamine) has a lower coupling efciency and a reaction factor of 2.0. In order to prevent over- representation of asparagine in the nal product, the oligonucleotide synthesis reaction mixture will need to have two CAG trimers for every one AAC trimer [52, 53].
The coupling efciency of trimers is also lower than individual nucleotides because three nucleotides are being coupled instead of one, which increases steric hindrance. If the coupling efciency is high, we can expect to see fewer truncated oligos and a higher percentage of full-length material. Truncated material in the pool will impact downstream processes such as cloning because shorter fragments clone preferentially. For the same reasons as above, if trimers are used to construct a long domain, such as an antibody’s third heavy chain complementarity- determining region (CDRH3), the percent full length can be very low.