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April 17, 2026Genome Research1 citations

Highly efficient and scarless genome editing via essential gene-coupled homology-directed repair

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JYJoo Hye YeoHKHo KimSOSang Ho Oh

Key Points

  • The aim is to enhance the efficiency of homology-directed repair (HDR) for precise genome editing in mammalian cells using a novel approach.
  • Introduction of ESS-HDR, a platform using essential-gene coediting to aid HDR.
  • Application of CRISPR-Cas9 to induce double-strand breaks at both target and essential genes.
  • Use of donor templates for genome modification and restoration of essential-gene function.
  • Single-cell clone analysis to confirm enrichment of HDR-proficient cells.
  • ESS-HDR improves HDR efficiencies by 7-16-fold in HEK293 cells and 41-fold in primary epidermal keratinocytes.
  • Knock-in efficiencies are enhanced by 6-34-fold in HEK293, U2OS, and HeLa cells.
  • ESS-HDR outperforms existing chemical HDR enhancers.

Abstract

Homology-directed repair (HDR) enables precise genome editing; however, its application in mammalian cells is limited by low efficiency due to competition from error-prone repair pathways and intrinsically restricted HDR activity. Existing HDR-enhancement strategies, including small-molecule treatments and marker-based selection, are constrained by cytotoxicity, genomic scarring, and inconsistent performance. Here, we present ESS-HDR (essential gene-supported scarless HDR), a robust, drug- and marker-free platform that selectively enriches HDR-proficient cells. By leveraging essential-gene coediting, ESS-HDR enables precise and scarless genome modification with enhanced efficiency. CRISPR-Cas9 induces double-strand breaks at both the target locus and an essential gene, accompanied by two donor templates: one introducing the desired edit and the other restoring essential-gene function. Only cells that undergo accurate HDR at the essential locus survive, providing endogenous selection without exogenous markers. Single-cell clone analysis confirms that enrichment of HDR-proficient cells enhances editing at the target locus. Using ssODN donors carrying a 1-nt substitution or a 10-nt insertion, ESS-HDR increases HDR efficiencies by 7-16-fold in HEK293 cells and 41-fold in primary epidermal keratinocytes compared to conventional single-site HDR. With plasmid donors targeting TUBA1B , LMNB1 , or ACTB1 , ESS-HDR improves knock-in efficiencies by 6-34-fold across HEK293, U2OS, and HeLa cells. ESS-HDR also outperforms chemical enhancers including RS-1, SCR7, nocodazole, and AZD7648. Together, these findings establish ESS-HDR as a broadly applicable strategy for efficient, scarless genome editing without external selection markers.

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Cite This Study

Yeo et al. (2026) studied this question.

synapsesocial.com/papers/69e1ce605cdc762e9d85762ahttps://doi.org/10.1101/gr.281194.125
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Essential HDRescue: A Co-Targeting Strategy to Enhance Precision Genome Editing by Co-Editing Essential Genes2026
  2. 2Enhancing homology-directed repair efficiency with HDR-boosting modular ssDNA donor2024 · 13 citations
  3. 3Functional screening in human HSPCs identifies optimized protein-based enhancers of Homology Directed Repair2024 · 5 citations
  4. 4Gene editing in hematopoietic stem cells by co-delivery of Cas9/sgRNA ribonucleoprotein and templates for homology-directed repair in 'all-in-one' lentivirus-derived nanoparticles.2025
  5. 5Cyanine-modified ssODNs enhance CRISPR-Cas9 HDR in stem cell embryo models via chromatin and chemical modulation2026