The technique, called nano-enhanced optical delivery (NOD), sidesteps the viral vectors that dominate current ophthalmic gene therapy. Adeno-associated viruses (AAVs), the workhorses of retinal gene transfer, carry a payload limit of roughly 4.7 kilobases, which restricts the delivery of large therapeutic genes and gene-editing tools such as CRISPR/Cas9. Viral vectors can also provoke inflammatory and immunological reactions, carry theoretical risks of genomic integration, and offer essentially no spatial control over where the therapeutic gene is expressed once administered. For diseases characterized by localized degeneration, such as geographic atrophy in advanced AMD, the inability to confine gene expression to the affected retinal regions is a significant drawback.

NOD addresses these limitations with a physical mechanism. The researchers functionalized gold nanorods with 5-kilodalton carboxyl-terminated polyethylene glycol to minimize nonspecific binding and prevent aggregation in physiological solutions. Transmission electron microscopy confirmed rod-shaped particles averaging approximately 120 nanometers in length and 25 nanometers in width, with a zeta potential of roughly −28 millivolts at pH 7. Ultraviolet–visible–near-infrared spectroscopy revealed a strong longitudinal plasmonic absorption band in the near-infrared region overlapping the 980-nanometer wavelength of the delivery laser. When irradiated at this wavelength, the nanorods convert optical energy into localized thermal energy, generating hotspots at the cell surface that transiently permeabilize the plasma membrane and allow extracellular plasmid DNA to enter the cell.

The therapeutic payload in this study was the MCO-020 plasmid, which encodes a multi-characteristic opsin designed to confer ambient-light sensitivity to retinal neurons. The expression cassette uses a CAG promoter driving the MCO-020 coding sequence, followed by a human growth hormone polyadenylation signal. The researchers first optimized delivery parameters in HEK293 cells, where immunostaining for the mCherry reporter protein revealed that transgene expression occurred only in cells exposed to laser irradiation. Cells incubated with plasmid and nanorods in the absence of laser exposure showed no detectable reporter expression, confirming that laser activation is required for plasmid entry. Increasing laser power from 10 to 20 milliwatts produced substantially stronger reporter fluorescence, and longer irradiation durations of 400 seconds yielded higher expression than 200 seconds. Adjacent non-irradiated areas within the same culture showed negligible signal, demonstrating that gene delivery was confined to the laser-targeted area.

To integrate this delivery mechanism with real-time anatomical guidance, the team combined a spectral-domain OCT subsystem centered at 840 nanometers with the 980-nanometer delivery laser through a fiber coupler, so that both beams share a common optical path toward the retina. The combined beam is collimated and directed toward the eye using micro-electromechanical system scanning mirrors and telescopic lenses. Fourier transformation of the detected interference spectrum produces depth-resolved structural images of the retina. Using en-face OCT imaging, the targeted region of interest is identified and marked on the imaging interface, and retinal features such as blood vessels serve as reference landmarks for tracking the position of the targeted region throughout the procedure. This feedback system enabled dynamic adjustment of the delivery beam to maintain precise alignment with the selected retinal area.

In vivo experiments were conducted in rd1 mice, which carry a mutation in the Pde6b gene encoding the β-subunit of rod photoreceptor phosphodiesterase. This mutation causes rapid degeneration of rod photoreceptors followed by secondary cone loss, producing severe visual impairment while preserving inner retinal neurons. The researchers injected 1 microliter of MCO-020 plasmid mixed with gold nanorods into the vitreous cavity of one eye, then positioned the animal under the OCT-guided delivery system approximately 2 hours later. A 980-nanometer continuous-wave near-infrared laser with an approximately 15-micrometer Gaussian focal spot was raster scanned over an approximately 1 × 1 millimeter retinal area, with laser powers of 10 to 30 milliwatts and total irradiation durations of 200 and 400 seconds evaluated.

OCT imaging performed immediately after laser irradiation revealed no detectable disruption of retinal structure or evidence of additional tissue damage within the targeted region. Retinal thickness measurements obtained from B-scan images showed no statistically significant differences between baseline and post-treatment time points. Confocal microscopy demonstrated robust MCO-020 expression, visualized through mCherry immunostaining, in retinal cells located within the laser-targeted region. Quantitative analysis showed that the number of MCO-expressing cells increased with increasing laser power, indicating that higher power produced greater transfection efficiency. Longitudinal quantification revealed persistent transgene expression for several months following delivery, with detectable expression remaining evident at the 12-month partial dataset point.

Electrophysiological recordings confirmed that the delivered opsin was functionally active. Visually evoked potential (VEP) recordings from the visual cortex showed dose-dependent increases following MCO-020 delivery, with treated mice exhibiting mean cortical responses of approximately 15 microvolts compared with roughly 6 microvolts in untreated controls, a statistically significant difference. In animals with strong retinal transgene expression, VEP responses were clearly detectable in the visual cortex, confirming successful transmission of visual signals through the retinal circuitry. These cortical responses persisted for up to 52 weeks following treatment, indicating long-term functional activity of the optogenetically modified retinal neurons. Intraocular pressure measurements remained comparable to control eyes throughout the study period, and retinal cell viability assays showed no significant differences between untreated controls, laser-only, nanorod-only, and combined treatment groups.

Biodistribution analysis performed at 12 months showed MCO-020 vector DNA below the limit of detection of 50 copies per nanogram in all evaluated non-target tissues, including brain, gonads, kidney, mesentery, spleen, heart, lungs, and liver. This finding supports limited systemic distribution following ocular delivery. In a separate focal photoreceptor injury model generated in wild-type mice using a 532-nanometer green laser, OCT en-face imaging confirmed localized retinal damage, and microfocal ERG recordings obtained from the damaged area showed markedly reduced responses prior to treatment. Following OCT-guided NOD delivery of MCO-020, significant recovery of focal ERG responses was observed within 1 week, demonstrating restoration of localized retinal activity in an experimentally defined region of injury.

The authors note several limitations. Direct retinal temperature measurements and nanorod-specific thermal modeling were not performed, so the reported exposure calculations characterize the delivered optical dose but do not establish the local temperature rise at the nanorod–cell interface. The full therapeutic window was not defined by escalation from ineffective exposure to the threshold for tissue injury, and published retinal laser-damage thresholds may not directly predict the NOD threshold because plasmonic nanorods locally enhance optical absorption and heat generation. The rd1 model represents inherited retinal degeneration rather than age-related macular degeneration and does not reproduce the chronic RPE dysfunction, inflammatory processes, or macular anatomy associated with human geographic atrophy. Nevertheless, the absence of detectable changes in retinal morphology, thickness, cell viability, intraocular pressure, and electrophysiological function supports tolerability within the tested operating range. The researchers suggest that the combination of OCT guidance and nano-enhanced optical delivery could serve as a platform for localized delivery of therapeutic genes, including gene-editing tools that exceed viral packaging limits, to retinal regions affected by degeneration.

Subject of Research: Optogenetic gene delivery

Article Title: Optical coherence tomography guided targeted non-viral optical delivery of opsin-encoding genes into the retina

Article References: Kim, S., Carlson, M., Batabyal, S., Dibas, A., & Mohanty, S. (2026). Optical coherence tomography guided targeted non-viral optical delivery of opsin-encoding genes into the retina. Frontiers in Pharmacology, 17, Article 1831339. https://doi.org/10.3389/fphar.2026.1831339

Image Credits: AI Generated

DOI: 10.3389/fphar.2026.1831339

Keywords: gene therapy, optogenetics, retinal degeneration, non-viral delivery, optical coherence tomography, gold nanorods, MCO-020, Optical, coherence, tomography, guided, targeted

The delivery strategy is disarmingly simple. Preformed high-fidelity Cas9-ribonucleoproteins are mixed with a molar excess of the peptide in a buffer containing the crowding reagent PEG-PVA, which encourages complexation. The cationic peptide electrostatically binds the negatively charged guide RNA within the RNP, forming nanoparticles that cells take up through a route involving class A scavenger receptors. Ornithine residues built into the peptide’s sequence shield it from degradation by serum proteases. Gel shift assays confirmed that even the lowest peptide ratios immobilized the RNPs, and transmission electron microscopy revealed substantially enlarged nanoparticles at a 1:100 molar ratio compared with RNPs alone. Confocal microscopy using red-fluorescent Cas9 showed punctate intracellular signal within one hour, consistent with endosomal entrapment, followed by diffuse cytoplasmic and nuclear fluorescence by 24 hours.

Optimization began with a titration of Cas9-RNP concentrations, from 10 to 17 nanomolar, against peptide molar ratios spanning 1:50 to 1:200. Higher doses drove editing rates up to roughly 75 percent in fibroblasts and 70 percent in keratinocytes but devastated viability, dropping to as low as 9 percent at the most aggressive condition in keratinocytes. The sweet spot emerged at 10 nanomolar Cas9-RNP with a 1:100 peptide ratio, which preserved about 90 percent viability in fibroblasts and 86 percent in keratinocytes, compared with 74 and 66 percent respectively for electroporation. Although electroporation edited a larger fraction of surviving cells, the superior survival of peptide-treated cultures yielded comparable total numbers of edited cells.

Gene expression profiling added a biological argument for gentleness. Using droplet digital PCR 24 hours after editing, the team found that electroporation upregulated CDKN1A, a marker of cell cycle arrest, while suppressing BUB1, a master regulator of mitotic spindle assembly, in fibroblasts. Most strikingly, electroporated fibroblasts showed elevated TGFB1 expression, a hallmark of fibroblast activation and differentiation into myofibroblasts. Because TGF-beta1 is a major driver of fibrosis and squamous cell carcinoma progression in recessive dystrophic epidermolysis bullosa, seeding engineered skin grafts with electrically stressed, myofibroblast-prone cells could undermine clinical outcomes. Peptide delivery perturbed these pathways to a noticeably smaller extent.

A single amino acid proved consequential. Adding one C-terminal lysine to PepFect14 produced PF14-K, which delivered a consistent, roughly 10 percent improvement in editing across three guide RNAs compared with the parent peptide. Structural analysis offered a possible explanation: circular dichroism spectroscopy showed slightly elevated alpha-helical content in PF14-K, and dynamic light scattering revealed larger RNP-peptide particles, around 130 nanometers versus 90 nanometers for the original peptide, with similar polydispersity. The longer, positively charged lysine side chain may strengthen interaction with the RNP’s negatively charged surface. By contrast, a variant in which the N-terminal stearic acid was replaced by oleic acid lost activity across all tested guides, consistent with the idea that the saturated fatty acid’s straight tail promotes tight hydrophobic packing that stabilizes the nanoparticles, while oleic acid’s double-bond kink disrupts it.

Solvent and serum conditions also mattered. Dissolving the peptide in 90 percent ethanol with 10 percent DMSO, rather than water, yielded subtle but reproducible editing gains, echoing prior observations that this solvent combination better solubilizes both the charged and hydrophobic faces of amphipathic peptides and discourages formation of large micellar aggregates. Despite the peptide’s ornithine-stabilized serum resistance, transfection in serum-free medium improved editing by 15 to 20 percent, with two of three guide RNAs reaching statistical significance. Under fully optimized conditions, PF14-K routinely achieved 70 to 75 percent editing in primary fibroblasts and 50 to 60 percent in keratinocytes, at viability exceeding 80 to 90 percent, versus roughly 70 percent for electroporated cultures.

The therapeutic applications were tested directly in patient-derived cells. For recessive dystrophic epidermolysis bullosa, which stems from COL7A1 mutations, the team used dual Cas9-RNPs to excise mutation-bearing exons and restore the reading frame. In patient keratinocytes carrying a heterozygous single-base deletion within exon 31, PF14-K achieved deletion efficiencies up to 58.4 percent by Nanopore amplicon sequencing, and up to 67.8 percent in patient fibroblasts. Electroporation reached 85 to 90 percent but at the cost of viability averaging just 50.7 percent in patient fibroblasts and 63.3 percent in patient keratinocytes, cells already fragile and slow-growing. Flow cytometry confirmed restoration of COL7 protein in up to 61 percent of peptide-edited keratinocytes. Because 20 to 35 percent editing is considered sufficient for therapeutic benefit in epidermolysis bullosa, the peptide-edited cell populations, being both sufficiently corrected and substantially healthier, could represent a superior graft product.

The most technically demanding result was precise homology-directed repair. Using short single-stranded repair templates co-delivered with the RNPs, the researchers corrected a prevalent nonsense mutation in LAMB3, c.1903C>T, which underlies junctional epidermolysis bullosa. In primary patient keratinocytes, the baseline 3:1:100 molar ratio of template to RNP to peptide achieved 14 percent mutation correction. Raising the peptide ratio to 3:1:150 lifted silent marker incorporation to 48 percent, and adding small-molecule inhibitors of the DNA repair enzymes polymerase theta and DNA-PK pushed precise correction to 37 percent by CRISPResso2 analysis, with electroporation reaching up to 51 percent, or 65 percent with inhibitors, but again with lower viability. Notably, the authors state this is the first demonstration of HDR-mediated repair of a pathogenic mutation, or exon skipping, in primary human cells using a non-viral cell-penetrating peptide strategy; earlier peptide HDR efforts were confined to transfection-permissible cell lines, reporter constructs, or safe-harbor loci.

Caveats remain. The AZD7648 DNA-PK inhibitor used in the dual-inhibition scheme has been linked to large-scale genomic alterations in other contexts, so genome-wide off-target assessment will be essential, even though pairing it with a polymerase theta inhibitor has been shown to mitigate genotoxicity. The gene expression analysis covered only a small panel of markers, and three-dimensional skin models will be needed to test whether PF14-K can deliver editors into intact tissue; prior work showed the parent peptide can deliver miRNA via subcutaneous injection in mice, an encouraging precedent. Still, the mix-and-incubate approach requires nothing more exotic than a commercially synthesized peptide and preformed RNPs, sidestepping the packaging limits and insertional risks of viral vectors, the specialized hardware and cytotoxicity of electroporation, and the microfluidics and mRNA-manufacturing burden of lipid nanoparticles. With base and prime editors increasingly bypassing the need for DNA templates altogether, the researchers argue that PF14-K and its successors could extend non-viral genome editing to a broad range of hard-to-transfect primary cells, and perhaps one day, directly to the skin itself.

Subject of Research: Non-viral CRISPR/Cas9 delivery into primary human skin cells using a PepFect14 cell-penetrating peptide analog for genome editing and repair of epidermolysis bullosa mutations

Article Title: A PepFect14 analog improves non‐viral CRISPR delivery in primary human cells to facilitate genome editing and repair

Article References: du Rand, A., Masterson, C., Verdon, D., Siow, A., Loef, E., Dunbar, R., Kingston, R., Harris, P., & Sheppard, H. (2026). A PepFect14 analog improves non‐viral CRISPR delivery in primary human cells to facilitate genome editing and repair. Bioengineering & Translational Medicine, Article e70172. https://doi.org/10.1002/btm2.70172

Image Credits: AI Generated

DOI: 10.1002/btm2.70172

Keywords: CRISPR, Cas9 ribonucleoproteins, cell-penetrating peptides, PepFect14, PF14-K, epidermolysis bullosa, COL7A1, LAMB3, homology-directed repair, gene therapy, keratinocytes, non-viral delivery

Prime editing is often described as a molecular search-and-replace system. It couples a catalytically impaired Cas9 nickase to an engineered reverse transcriptase, and it is programmed by a prime editing guide RNA, or pegRNA, which both locates the genomic target and carries the template encoding the desired edit. Because the method writes new genetic information without making a double-strand break in the DNA and without requiring an external donor template, it has long been viewed as one of the most versatile tools in the genome editing repertoire, capable of installing all twelve possible base-to-base conversions as well as small insertions and deletions. Yet translating that versatility into animals, and ultimately patients, has proved difficult. The prime editor protein is far too large to fit inside a single adeno-associated virus vector, forcing researchers to rely on cumbersome dual-vector systems, while concerns about the long-term expression of an editor in a patient’s tissues have made viral delivery unattractive for clinical development.

Non-viral delivery offers a way around those concerns. Lipid nanoparticles, the same technology that carried mRNA vaccines into billions of arms, can deliver the prime editor in transient mRNA form together with its pegRNA, giving the editor a brief window of activity before it is degraded by the cell. The problem has been efficiency. Earlier attempts to deliver prime editing systemically with lipid nanoparticles produced editing levels far below what would be needed clinically, required repeated injections, or depended on doses of RNA so high that they exceeded what regulators would consider translatable. The fragile nature of long RNA molecules inside the bloodstream and inside cells is a central culprit: unmodified or lightly modified pegRNAs are rapidly chewed apart by nucleases, and even end modifications at the RNA termini, the standard protective measure borrowed from antisense oligonucleotide chemistry, leave long internal stretches of the guide exposed and vulnerable.

The Wuhan-led team’s solution was to extend chemical protection far beyond the ends of the guide RNA. Rather than modifying only the terminal nucleotides, the researchers densely incorporated modified RNA motifs throughout both the fixed regions of the pegRNA, such as the scaffold and the engineered extension motifs like evopreQ1, and the variable regions, including the spacer, the reverse transcriptase template, and the primer binding site. The chemical toolkit relied on well-established modifications from the RNA therapeutics field, principally 2′-O-methyl groups on the ribose sugar and phosphorothioate linkages in the phosphate backbone, both of which are known to shield RNA from nuclease degradation and, in the case of 2′-O-methyl groups, to subtly alter pairing geometry and affinity. The team describes the resulting molecules as super-end-modified RNAs, in which terminal protection and dense internal modification act in combination.

The optimization was systematic. In human cell experiments using electroporated prime editor mRNA, the researchers tested modification patterns in each structural element of the pegRNA in turn, measuring editing outcomes at endogenous loci such as EMX1, where the system installed a three-base deletion, and HEK3, where it installed a single-base insertion. They varied the density of 2′-O-methyl and phosphorothioate modifications at the 5′ end of the spacer, in the primer binding site, in the reverse transcriptase template, and in the extended scaffold motifs, and then combined the best-performing patterns. Analyses of editing byproducts showed that the dense modifications did not increase the proportion of indels or unwanted scaffold-insertion events relative to total editing, and cell viability assays indicated the heavily modified guides were not toxic to the treated cells, an important consideration since excessive chemical modification of guide RNAs has previously been associated with cellular stress.

The in vivo results were the centerpiece. Using lipid nanoparticles to co-deliver prime editor mRNA and the densely modified pegRNA into mice, the team achieved nearly 70 percent prime editing efficiency in the bulk liver, a level indicating that most hepatocytes in the organ had been edited. Perhaps more consequential for clinical translation, a single injection at a lipid nanoparticle dose the authors describe as clinically translatable was sufficient to suppress the expression of the target protein in vivo, and under those dose conditions the densely modified guide produced an approximately 80-fold increase in editing efficiency compared with conventional end-modified pegRNAs. Toxicity assessments, including serum liver enzyme measurements and analysis of editing byproducts, supported the tolerability of the approach, and off-target analyses at predicted sites suggested the chemical modifications did not worsen targeting fidelity.

The generality of the strategy proved equally important. The dense motif modification approach was not confined to prime editing. When the team applied the same modification logic to guide RNAs carrying the widely used MS2 RNA motif, which is exploited in RNA-guided recruitment platforms such as base editor systems that tether an editor protein to a Cas9 nickase through an RNA aptamer interaction, they saw broad improvements across multiple RNA sequences and split RNA-guided genome editing platforms, with base editing efficiencies rising by up to 11-fold. The researchers also combined the modified guides with mRNA encoding ancillary factors known to boost prime editing, such as MLH1-domain constructs, and observed further gains in vivo, indicating that RNA chemistry and protein engineering enhancements can be layered rather than traded off against one another.

The findings arrive at a moment when the field is converging on transient, non-viral delivery as the safest route to in vivo genome editing. Clinical programs using lipid nanoparticle delivery of CRISPR-Cas9 mRNA and guide RNA have already demonstrated that single-dose in vivo gene knockout is feasible in humans, and prime editing has shown curative promise in ex vivo settings such as engineered hematopoietic stem cells for sickle cell disease. What has lagged is in vivo precision editing, where the required correction must be installed in a large fraction of target tissue cells rather than simply disrupting a gene. By raising editing yields at clinically plausible doses, the dense modification strategy narrows the gap between what prime editing can do in a dish and what it can do in a body, and because the modifications are applied to the RNA guide rather than to the editor protein, they can in principle be adopted without redesigning the editing enzymes themselves.

Challenges remain before such a system could reach patients, including extending the approach beyond the liver, where lipid nanoparticles naturally accumulate, to other tissues, scaling the manufacture of long, densely modified pegRNAs under clinical quality standards, and confirming long-term safety in larger animal models. The authors note that the methodology builds on their earlier work developing rapid methods for generating long chemically modified pegRNAs, and patent applications on the pegRNA modifications have been filed through Wuhan University. Still, the study offers a concrete, generalizable recipe: protect the guide RNA densely, deliver the editor transiently, and let chemistry do much of the work that delivery vehicles alone could not. If the efficiency gains hold across tissues and disease targets, the modest RNA molecule at the heart of prime editing may prove to be the lever that finally lifts the technology from laboratory promise toward therapeutic reality.

Subject of Research: Engineered prime editing guide RNAs with densely modified RNA motifs for robust in vivo genome editing

Article Title: Dense RNA motif modifications enable robust in vivo prime editing and enhance efficiencies of diverse editing systems

Article References: Lei, X., Chen, D., Zhang, K., Liu, X., Chen, Q., Zhang, Y., Ji, R., Zhu, J., Zhang, Q., Zhang, Y., & Yin, H. (2026). Dense RNA motif modifications enable robust in vivo prime editing and enhance efficiencies of diverse editing systems. Nature Biomedical Engineering. https://doi.org/10.1038/s41551-026-01787-4

Image Credits: AI Generated

DOI: 10.1038/s41551-026-01787-4

Keywords: prime editing, pegRNA, chemical modification, lipid nanoparticles, in vivo genome editing, base editing, RNA therapeutics, gene therapy, 2'-O-methyl, phosphorothioate, mouse liver, non-viral delivery