Current methods of producing CAR-T cells with viral transduction have limitations due to non-target integration of therapeutic transgenes into the genome and potential insertional mutagenesis. In this master's thesis, we focused on non-viral genetic modification of CAR-T cells with CRISPR/Cas9 technology and its enhanced version. The main goal is to improve efficiency and safety with an advanced genome editing system, CCExo, which allows targeted insertion of the CAR receptor into the T lymphocyte genome. We designed HDRts of different lengths with a genetic sequence for the CD19-CAR transgene and RCC to increase HDR efficiency. We inserted the transgene into two specific loci, TRAC and TRBC1, which are part of the T-cell receptor. The results show that the CRISPR/Cas9 system is effective in inserting the transgene regardless of the length of homologous sequences and the presence of RCC. Compared to the classic CRISPR/Cas9 system, CCExo showed increased efficiency of targeted functional insertion of the CD19-CAR transgene into the T lymphocyte genome, especially with shorter HDRts in the presence of RCC. TRBC1 target transgene integration was further increased with electroporation with ribonucleoproteins compared to plasmid electroporation. The use of CRISPR/Cas9 technology and its improved version CCExo is proving to be a promising path for improving the preparation of therapeutic cells and CAR-T cell therapy and expanding its use in cancer treatment.
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