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Genomic DNA at the intended CRISPR cut site refers to the specific nucleotide sequence within the host genome targeted for modification by a CRISPR-Cas system. This target is defined by a protospacer sequence complementary to a synthetic guide RNA (gRNA) and must be adjacent to a protospacer adjacent motif (PAM) (Jinek et al., Science, 2012). In therapeutic applications, this site is strategically selected to disrupt a disease-causing gene, correct a pathogenic mutation, or insert a functional genetic element (Hsu et al., Cell, 2014). Upon binding, the Cas nuclease induces a double-strand break or performs single-base editing at this precise locus. The subsequent cellular repair mechanisms, such as non-homologous end joining (NHEJ) or homology-directed repair (HDR), result in the desired therapeutic genetic change (Komor et al., Nature, 2016). This target is central to the mechanism of exagamglogene autotemcel, the first FDA-approved CRISPR therapy, which targets the BCL11A erythroid-specific enhancer to treat sickle cell disease (FDA, 2023). Ensuring high specificity for this target is critical to minimize off-target effects and potential genotoxicity (Fu et al., Nature Biotechnology, 2013).
Site-specific DNA binding and cleavage (or chemical modification) mediated by a guide RNA-nuclease complex, followed by endogenous cellular DNA repair processes such as non-homologous end joining (NHEJ) or homology-directed repair (HDR).
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