GoKawiilIn late 2021, Amber Salzman interviewed for a job that she had no intention of taking. A relatively new start-up company, called Epicrispr Biotechnologies, was looking for a chief executive, and it was keen on vetting Salzman — who had decades of experience in the pharmaceutical industry — for the role. She had said yes to the meeting only as a favour to a recruiter, who had helped her to fill a key position at another company she had worked with. Joining the start-up wasn’t something she was enthusiastic about.
Halfway through the meeting, she changed her mind. Salzman had watched as Stanley Qi, the founder of Epicrispr, drew diagrams on a whiteboard explaining that the company wanted to make a genetic therapy — not by editing the code itself, but by changing the chemical markers attached to DNA, which can switch genes on or off. Then Salzman asked another team member: “‘What disease are we going after?’ And she said, ‘FSHD’.”
How ageing changes our genes — huge epigenetic atlas gives clearest picture yet
Salzman knew the condition all too well. FSHD, short for facioscapulohumeral muscular dystrophy, is an inherited disorder in which muscle problems first begin in the face and upper body and can spread to other parts, sometimes requiring wheelchair use. Salzman’s husband of more than 35 years had several cousins and a grandmother with the disease, although he had not inherited it himself.
Her family’s experience of this disorder had always been on her mind, but Salzman had never seen a way to make a difference in her previous positions: “At the time, nobody really understood what caused it.” But the conversation with Epicrispr gave her a chance to address the disease.
She took up the company’s offer to become its chief executive. In doing so, Salzman joined a niche group of drug developers trying to advance a technique called targeted epigenetic editing. The idea is to remove or add epigenetic markers — essentially chemical groups that sit on DNA (and the proteins that it is wound around). Depending on which chemical group is present or absent, genes can be activated or switched off.
Some existing medications influence epigenetic markers, but these drugs act broadly and lack specificity. This new cadre of scientists has found ways to precisely alter the epigenetic markers influencing specific genes. Epicrispr, based in South San Franscisco, California, is one of several companies working on such therapies. At the International Research Congress on FSHD, held in late June in Chicago, Illinois, it became one of the first to announce data from an epigenetic-editing trial.
Epigenetic markers have a huge impact on how our cells interpret DNA. Changing the epigenetic tags on a genome is akin to using an audio mixing board to alter a piece of music to sound like the works of composer Franz Schubert or pop star Taylor Swift, says biologist Fyodor Urnov at the University of California, Berkeley. Urnov helped to pioneer the use of various gene-editing technologies and co-founded an epigenetic-editing company called Tune Therapeutics in Seattle, Washington.
Epigenetic editing: from concept to clinic
The tools being deployed in this new era of epigenetic editing put a twist on standard gene editing, which involves using the CRISPR system to cut DNA. That system is precise, but even so, it can lead to cuts in the wrong place, which can disrupt or damage genes. “Epigenetic editing is a truly exciting concept for therapeutics because there is no chance of off-target DNA mutations being made, as is the case with gene editing,” explains Jessica Tyler, a molecular biologist at Weill Cornell Medicine in New York City.
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