On Cloud Cas9?

CRISPR-Cas9 has had a whirlwind impact on gene editing; the versatile method of targeting specific DNA strands even winning the 2020 Nobel Prize in Chemistry. And, of course, the technique hasn’t been overlooked by the field ophthalmology; ocular diseases with clear genetic drivers of pathology are prime targets for such genetic manipulation – and one such example is primary open angle glaucoma (POAG), where elevated TGFβ2 expression contributes to increased IOP through pathological changes in the trabecular meshwork (TM). Researchers from the Indiana University School of Medicine in Indianapolis, USA, screened for the optimal genetic sequence to inhibit TGFβ2 expression – and proved its utility in human TM cells and in a mouse model of TGFβ2-induced ocular hypertension (1). Clearly, such “CRISPR interference” can only be used to treat POAG when elevated TGFβ2 expression plays a role – but will this proof of concept mean that surgeons increasingly switch from the scalpel to the molecular scissors?