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Amplification-free, CRISPR-Cas9 Targeted Enrichment and SMRT Sequencing of Repeat-Expansion Disease Causative Genomic Regions

Yu‐Chih TsaiiD, David GreenbergiD, James PowelliD, Ida HöijeriD, Adam AmeuriD, Maya StrahliD, Ethan Ellis, Inger Jonasson, Ricardo Mouro PintoiD, Vanessa Chantal WheeleriD, Melissa Laird SmithiD, Ulf B GyllensteniD, Robert SebraiD, Jonas KorlachiD, Tyson A. ClarkiD

Abstract

Targeted sequencing has proven to be an economical means of obtaining sequence information for one or more defined regions of a larger genome. However, most target enrichment methods require amplification. Some genomic regions, such as those with extreme GC content and repetitive sequences, are recalcitrant to faithful amplification. Yet, many human genetic disorders are caused by repeat expansions, including difficult to sequence tandem repeats.\n\nWe have developed a novel, amplification-free enrichment technique that employs the CRISPR-Cas9 system for specific targeting multiple genomic loci. This method, in conjunction with long reads generated through Single Molecule, Real-Time (SMRT) sequencing and unbiased coverage, enables enrichment and sequencing of complex genomic regions that cannot be investigated with other technologies. Using human genomic DNA samples, we demonstrate successful targeting of causative loci for Huntingtons disease (HTT; CAG repeat), Fragile X syndrome (FMR1; CGG repeat), amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (C9orf72; GGGGCC repeat), and spinocerebellar ataxia type 10 (SCA10) (ATXN10; variable ATTCT repeat). The method, amenable to multiplexing across multiple genomic loci, uses an amplification-free approach that facilitates the isolation of hundreds of individual on-target molecules in a single SMRT Cell and accurate sequencing through long repeat stretches, regardless of extreme GC percent or sequence complexity content. Our novel targeted sequencing method opens new doors to genomic analyses independent of PCR amplification that will facilitate the study of repeat expansion disorders.

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Abstract summary

Verified abstract synthesis

Claude Opus 5.5 · xhigh effort · 2 Nov 2026 · from the abstract

Combining amplification-free CRISPR-Cas9 targeted enrichment with Single Molecule, Real-Time (SMRT) long-read sequencing captures and sequences human repeat-expansion disease loci across HTT, FMR1, C9orf72, and ATXN10 without PCR bias.

Most targeted sequencing enrichment methods rely on amplification, which fails to faithfully amplify disease-causing tandem repeat expansions and regions with extreme GC content. Combining amplification-free CRISPR-Cas9 targeting with Single Molecule, Real-Time (SMRT) long-read sequencing enables multiplexed capture and sequencing of these complex loci.

Key results

  1. ShownAmplification-free CRISPR-Cas9 enrichment paired with SMRT sequencing successfully targets and reads across four human repeat-expansion disease loci.

    Demonstrated on human genomic DNA for HTT (CAG repeat in Huntington's disease), C9orf72 (GGGGCC repeat in amyotrophic lateral sclerosis and frontotemporal dementia), FMR1 (CGG repeat in Fragile X syndrome), and ATXN10 (variable ATTCT repeat in spinocerebellar ataxia type 10). · Abstract

  2. ShownMultiplexed targeting isolates hundreds of individual on-target DNA molecules per SMRT Cell and sequences through long repeats regardless of sequence complexity or extreme GC percentage.

    Reported across multiplexed human genomic DNA assays in a single SMRT Cell without PCR amplification. · Abstract

Methods, data and reproducibility

Used the CRISPR-Cas9 system for multiplexed, amplification-free targeted enrichment of genomic loci from human genomic DNA, followed by Single Molecule, Real-Time (SMRT) long-read sequencing.

  • Human genomic DNA samples targeted at HTT, FMR1, C9orf72, and ATXN10 repeat loci · human
Methods & tools
CRISPR-Cas9, Single Molecule, Real-Time (SMRT) sequencing
Reproducibility gaps
Abstract only; protocol parameters, sample counts, and data accessions are not reported in the abstract.
Limitations (1)
  • The abstract does not report the number of human DNA samples tested, exact on-target enrichment fold, or error rates across the sequenced repeat expansions. · noted in this summary

Who should read:Read this if you sequence tandem repeat expansions or high-GC genomic regions and need an amplification-free targeted long-read enrichment protocol.

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