6. Summary and outlook
Over the last few years, the development of several gene editing technologies, ZFN, TALEN, and CRESPR-Cas9, has greatly promoted biology research and clinical trials for gene therapy. Among these three biotechnologies CRESPR-Cas9 is the latest player in the field but received great attention and applications. The main advantage of CRISPR-Cas9 is its simplicity, efficiency, and versatility for gene manipulations. Targeting efficiency is one of the most important parameters for assessing a genome-editing tool especially the one used for gene therapy. Although a number of reports have confirmed that CRISPR-Cas9 has better targeting efficiency than ZFNs and TALENs, the efficiency still varies with cell types and research labs. For example, in zebrafish the targeting efficiency by CRISPR-Cas9 system has reached to 100% [46] and in one-cell mouse embryo 78% [108]. In contrast, in human CD4+ T cells the Cas9 system obtains efficiencies ranging from 5% to 20% [71,86] and in induced pluripotent stem cells only 2–5% [70]. Therefore, further improvement of the target efficiency and stability in hematopoietic cells is necessary. Moreover, it is unclear whether and how CRISPRCas9 is able to target CCR5 or CXCR4 effectively in all CD4+ T cells in vivo.