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The on-target genomic DNA locus complementary to the single guide RNA (sgRNA) is the specific chromosomal sequence targeted for modification by CRISPR-Cas systems (Jinek et al., 2012, Science). This locus is defined by a sequence match to the sgRNA's spacer and the presence of a Protospacer Adjacent Motif (PAM) required for Cas protein binding (Sternberg et al., 2014, Nature). In clinical applications, such as the FDA-approved Exagamglogene autotemcel (Casgevy), the target is often a regulatory element like the BCL11A erythroid-specific enhancer used to treat sickle cell disease (Frangoul et al., 2021, NEJM). The interaction between the sgRNA and this DNA locus facilitates site-specific double-strand breaks or chemical modifications like base editing (Gaudelli et al., 2017, Nature). Precision at this site is vital to avoid off-target mutations at similar genomic sequences, which remains a primary safety concern in gene editing (Fu et al., 2013, Nature Biotechnology). Consequently, this target represents the fundamental site of action for programmable genomic medicines.
The target is recognized by a CRISPR-Cas ribonucleoprotein complex through Watson-Crick base pairing between the sgRNA and the genomic DNA, leading to site-specific cleavage or chemical modification (Jinek et al., 2012, Science).
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