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The fumarylacetoacetate hydrolase (FAH) genomic DNA locus, located on chromosome 15q25.1, encodes the enzyme responsible for the final step of the tyrosine catabolic pathway (NCBI Gene ID: 2184). In hepatocytes, the loss of FAH function due to genetic mutations results in Hereditary Tyrosinemia Type I (HT1), a severe metabolic disorder where the accumulation of toxic metabolites like fumarylacetoacetate and succinylacetone leads to progressive liver failure and a high risk of hepatocellular carcinoma (UniProt P16930; OMIM 276700). While current pharmacological management involves the drug nitisinone to block upstream metabolite production, the FAH genomic locus is a primary target for curative genetic interventions such as CRISPR/Cas9-mediated gene editing and base editing (Yin et al., Nature 2014). These therapies aim to restore endogenous enzyme production by correcting the underlying genetic defect. A unique therapeutic advantage of targeting this locus is that FAH-corrected hepatocytes exhibit a selective survival advantage, allowing them to repopulate the liver and restore metabolic function even if only a small fraction of cells are initially edited (Grompe et al., Genes & Development 1993).
Restoration of functional fumarylacetoacetate hydrolase expression through gene replacement, gene editing, or base editing to correct pathogenic mutations within the hepatocyte genome.
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