Radiotherapy is a mainstay of glioblastoma (GBM) treatment;
however,
the development of therapeutic resistance has hampered the efficacy
of radiotherapy, suggesting that additional treatment strategies are
needed. Here, an
in vivo
loss-of-function genome-wide
CRISPR screen was carried out in orthotopic tumors in mice subjected
to radiation treatment to identify synthetic lethal genes associated
with radiotherapy. Using functional screening and transcriptome analyses,
glutathione synthetase (GSS) was found to be a potential regulator
of radioresistance through ferroptosis. High GSS levels were closely
related to poor prognosis and relapse in patients with glioma. Mechanistic
studies demonstrated that GSS was associated with the suppression
of radiotherapy-induced ferroptosis in glioma cells. The depletion
of GSS resulted in the disruption of glutathione (GSH) synthesis,
thereby causing the inactivation of GPX4 and iron accumulation, thus
enhancing the induction of ferroptosis upon radiotherapy treatment.
Moreover, to overcome the obstacles to broad therapeutic translation
of CRISPR editing, we report a previously unidentified genome editing
delivery system, in which Cas9 protein/sgRNA complex was loaded into
Angiopep-2 (Ang) and the trans-activator of the transcription (TAT)
peptide dual-modified extracellular vesicle (EV), which not only targeted
the blood–brain barrier (BBB) and GBM but also permeated the
BBB and penetrated the tumor. Our encapsulating EVs showed encouraging
signs of GBM tissue targeting, which resulted in high GSS gene editing
efficiency in GBM (up to 67.2%) with negligible off-target gene editing.
These results demonstrate that a combination of unbiased genetic screens,
and CRISPR-Cas9-based gene therapy is feasible for identifying potential
synthetic lethal genes and, by extension, therapeutic targets.