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Abstract

CRISPR/Cas technologies have transformed our ability to add functionality to the genome by knock-in of payload via homology-directed repair (HDR). However, a systematic and quantitative profiling of the knock-in integration landscape is still lacking. Here, we present a framework based on long-read sequencing and an integrated computational pipeline (knock-knock) to analyze knock-in repair outcomes across a wide range of experimental parameters. Our data uncover complex repair profiles, with perfect HDR often accounting for a minority of payload integration events, and reveal markedly distinct mis-integration patterns between cell-types or forms of HDR templates used. Our analysis demonstrates that the two sides of a given double-strand break can be repaired by separate pathways and identifies a major role for sequence micro-homology in driving donor mis-integration. Altogether, our comprehensive framework paves the way for investigating repair mechanisms, monitoring accuracy, and optimizing the precision of genome engineering.

Abstract summary

Claude Opus 5.5 · xhigh effort · 18 Oct 2026 · from the abstract · CC BY-NC-ND 4.0

Long-read sequencing with the knock-knock pipeline profiles CRISPR knock-in repair, finding perfect homology-directed repair is often a minority of integration events and mis-integration varies by context.

A systematic, quantitative picture of how donor payloads actually integrate after CRISPR knock-in has been missing. This framework maps the whole spectrum of integration outcomes across a range of experimental parameters, which bears on how accuracy is monitored and improved.

Key results

  1. ClaimedRepair profiles after knock-in are heterogeneous, and perfect homology-directed repair (HDR) frequently makes up only a minority of the payload integration events recovered.

    Stated as a conclusion of the long-read profiling; the abstract gives no frequencies, no loci and no comparison conditions. · Abstract

  2. ClaimedPatterns of donor mis-integration differ substantially between cell types and between the forms of HDR donor template used.

    Described as a marked distinction across cell types and template formats; neither the cell types, the template formats nor the effect sizes are given in the abstract. · Abstract

  3. ClaimedThe two sides of a single double-strand break can be resolved by different repair pathways, and sequence micro-homology is a major driver of donor mis-integration.

    Presented as the mechanistic read-out of the outcome classification; no quantification of pathway usage or micro-homology length is reported in the abstract. · Abstract

Methods, data and reproducibility

Long-read sequencing of the products of CRISPR/Cas knock-in experiments, paired with a computational pipeline (knock-knock) that classifies integration and repair outcomes, run across a range of experimental parameters including cell type and the form of the homology-directed repair donor template.

  • CRISPR/Cas knock-in repair outcomes profiled across cell types and HDR donor template formats
Methods & tools
knock-knock, CRISPR/Cas, long-read sequencing
Limitations (2)
  • No frequencies are reported for perfect HDR or for any mis-integration class, so the size of the heterogeneity cannot be judged from what is available here. · noted in this summary
  • The cell types, target loci, donor template formats and sequencing depth behind the comparisons are not named, so the generality of the repair profiles is untestable. · noted in this summary

Read this if you build or validate CRISPR knock-in edits and need to know how often integration departs from perfect HDR.

Citations
64

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