Figure 2.
Genome editing to increase HbF production. Only HBG2 and its upstream binding sites for BCL11A and ZBTB7A are depicted. The expression of BCL11A, 1 of 2 major repressors of HbF gene expression, is controlled by an erythroid-specific enhancer. BCL11A binds to a TGACCA motif centered at position −115 in the promoters of both HBG2 and HBG1. ZBTB7A, the other major HbF gene repressor, not shown, binds at positions −195 to −197 and −201 to −202 upstream of both γ-globin genes. A still unknown transcription factor(s) is likely to bind the −158 site. The −158 polymorphism is found only in HBG2. CRISPR-Cas9 editing of either the BCL11A erythroid-specific enhancer, shown as a double-strand break, or its binding sites in the HbF gene promoters, shown before editing, reverses the repression of these genes increasing HbF.