Taking a look at the preclinical data for their programs so far.
1/ They have two main programs around correcting Sickle Cell disease. Their first program BEAM-101 is doing a simple gene knockout on the gene that suppresses Fetal Hemoglobin expression causing the reactivation of the Fetal Hb gene.
2/ Their second program uses base editing to change the defective base in the Sickling Hemoglobin to a Makassar that works normally.
3/ BEAM-101:
ex-vivo editing of Fetal Hb using electroporation
Showed 90% editing in CD34 cells
Showed greater than a 60% increase in Fetal Hb
Showed a decrease in Sickling Hb to less then 20%
This is well below the level necessary to prevent sickling
They only have mouse data.
4/ There exists 2 potential off target risks of base editing. They are guide dependent and guide independent off target deaminations. They ran extensive tests and showed no signs of any potential off target deaminations.
5/ BEAM-102:
ex-vivo editing of the Beta Hb using electroporation
This approach attempts to fix the defective Beta globin gene why changing the A to a G which makes it a usable variant of Beta Globin called the Makassar Variant.
6/ Showed 80% correction of HB to the Makassar variant
70% of the produced RBC colonies showed 70% bi-allelic editing
20% of the produced RBC colonies showed 20% mono-allelic editing
7/ CAR-T:
They have an early CAR-T program focused on anti-CD7 for T cell ALL. I give them credit for going after a leukemia that isn't being targeted by everyone else. T cell ALL is the rarer form of ALL as most are B cell related.
8/ BEAM-201:
Universal CD7 targeted CAR-T
Created using electroporation
Included knockout of TRAC, CD52, CD7 and PD1 while inserting the anti CD7 CAR.
9/ Showed 96% to 99% on target editing of all 4 knockouts
No known chromosomal rearrangements were seen
85% of cells expressed the CAR after insertion
Estimated that 77% of had all 5 genetic modifications
In-vivo demonstrated CD7 dependent cytokine expression
10/ Showed in-vivo clearing of CD7 models
Next Steps will be in-vivo delivery using Lipid Nanoparticles.
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This company is all about what we do with that genetic data after we got it.
1/ The sequencing companies make the machines to actually sequence the DNA or RNA. $NVTA is about taking that genetic data and translating it into something that can be used my medical professionals to treat patients.
2/ This is about using automation, software and a database to use the genetic data acquired by the sequencing. I call this the Genomics Application company.
They are building the best long and short read company in sequencing.
1/ They already have the long read sequencing with the SMRT technology. They have an install base of 326 instillations as of Q3. That has a lot of potential to grow. Half their revenues comes from the selling of the consumables that goes into running those devices.
2/ As the Base grows, this becomes like the Apple model with and ecosystem. They buy the device and then you earn revenue off the use of that device.
Digging into how Single Molecule, Real Time (SMRT) technology.
1/ The SMRT technology takes advantage of DNA synthesis. To understand it, we must do a brief review of DNA synthesis. When DNA gets copied, a single strand of DNA gets copied by the DNA polymerase enzyme.
2/ The nucleotides are picked up by the DNA polymerase and incorporated into the new strand of DNA that is being built that is an exact opposite copy of the template strand.
Taking a look at the use of CRISPR CAS9 use in ex-vivo cell therapies.
1/ $CRSP is using the same CRISPR/CAS9 system as $NTLA. This is made up of the CAS9 enzyme which has 2 nuclease domains that do the cutting of the DNA into a Double Stranded Break. It also includes a guide RNA for searching the DNA for the correct site.
2/ The biggest danger of the CAS9 enzyme is that cuts both strands of the DNA at the same location. Without the use of a template strand, this will trigger Non Homologous End Joining which is a very inaccurate process.
Taking a look the science behind CRISPR CAS9 and in-vivo liver editing.
1/ $NTLA is using the CRISPR/CAS9 system. This is made up of the CAS9 enzyme which has 2 nuclease domains that do the cutting of the DNA into a Double Stranded Break. It also includes a guide RNA for searching the DNA for the correct site.
2/ The biggest danger of the CAS9 enzyme is that cuts both strands of the DNA at the same location. Without the use of a template strand, this will trigger Non Homologous End Joining which is a very inaccurate process.
This will be a look at the underlying technology of base editing. I plan another guide for the science and maybe another for the corporate.
1/ They are using base editing technology. This takes the CRISPR CAS9 enzyme along with the guide RNA attached to a deaminase enzyme to make a modification to a single base of the DNA.
2/ The guide RNA looks for a photospacer sequence in the DNA. That is just a matching sequence of DNA that matches the guide RNA. Next to the photospacer sequence will the the Photospacer adjacent motif (PAM).