Animal models are essential tools for understanding the biological mechanisms of human diseases and development of new therapeutics. In vitro models, such as cell or organoid culture, do not reproduce the complexity of cellular subtypes and cell-cell interactions that occur in vivo in organs1,2. Thus, animals provide whole-organism models with greater detail of cellular and system-level interactions, disease progression, and the safety of therapeutics. Rodents are practical model organisms given their low cost, quick generation time, and comprehensive genetic characterization. However, rodent models for human diseases are limited by physiological and anatomical differences with humans, as well as their faster metabolism and shorter lifespans3,4. This is evidenced by the high proportion of therapies tested in animal models that fail in clinical trials, the majority of which use rodents5,6,7,8. Sheep, pigs, goats, dogs, and non-human primates have been used to produce models for a wide variety of human diseases, which may help increase the clinical translation rate for new therapies and medicines3,9,10,11,12. These species also offer many advantages over rodent models due to their increased similarity to humans. Large animal models for human disease thus provide the most accurate models available and play a critical role in translating animal studies into clinical applications.
Clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 is a versatile and programmable method for genetic modification of animal cells and introduction of precise disease-causing mutations. CRISPR-Cas9-mediated gene editing employs a guide RNA (gRNA) complementary to the target site, allowing CRISPR-associated protein 9 (Cas9) to form a double-stranded break (DSB) in a targeted manner13. Cellular repair of DSBs occurs primarily through two mechanisms: non-homologous end joining (NHEJ) and homology-directed repair (HDR). The NHEJ pathway repairs a DSB by joining DNA ends, an error-prone mechanism that may result in the formation of random insertions or deletions (indels) at the break site14. These mutations may knock out (KO) the gene by creating a frameshift mutation or a premature stop codon, which disrupt the gene’s function. HDR, occurring mainly during the S and G2 phases of the cell cycle, is when the cell repairs a DSB using a homologous allele as a repair template15,16. Incorporation of specific insertions, deletions, or substitutions, known as knock-ins (KI), is possible by introducing a synthetic single-stranded oligodeoxynucleotide (ssODN) or other template DNA with the edit of interest, which the cell can use to repair the break. CRISPR-Cas9 may also be used for multiplexed editing to introduce multiple mutations at once for modeling multigenic diseases3. Compared to previous gene-editing techniques such as zinc-finger nucleases (ZFNs) or transcription activator-like effector nucleases (TALENs), CRISPR-Cas9 is much simpler and more resource efficient to use in large animal cells17. Different loci can be targeted easily by designing a new gRNA, which has helped accelerate the introduction of new large animal models using CRISPR-Cas93,13. However, several limitations remain, including the editing efficiency of CRISPR-Cas9, which can vary considerably depending on the species, cellular environment, and nature of the edit18,19. HDR rates, in particular, are lower than NHEJ rates and depend greatly on the cell type, genomic loci, and cell cycle stage20,21. Moreover, the introduction of unintended edits at off-target loci, or even on-target loci, remains an issue22. Even so, CRISPR-Cas9 has become the primary gene editing platform for producing genetically engineered large animal models.
Somatic cell nuclear transfer (SCNT) facilitates the creation of genetically modified embryos with high precision and homogeneity. This process, first successfully performed in mammals in 1997, involves the transfer of a cell nucleus into an enucleated oocyte23. SCNT possesses many advantages over other techniques, such as zygotic microinjection, in which genetic material or DNA-editing systems are directly injected into the zygote or early embryo24,25,26. Zygotic microinjection carries the inherent risk of genetic heterogeneity, or mosaicism, between cells in the embryo, which can occur if DNA replication or cell division occurs prior to genetic modification27,28,29. The value of such mosaic embryos for animal models is reduced due to the difficulty of genotyping and phenotypic characterization29. In SCNT, gene editing is decoupled from embryo production; each cloned embryo is derived from a single cell, eliminating the risk of mosaicism and ensuring the embryo is genetically homogeneous30,31,32. Additionally, donor cells are edited and carefully screened in vitro to confirm clonality and the presence of the desired modification prior to the SCNT procedure, saving time and resources25,26. This is especially important when introducing specific KIs. Cell screening also allows the identification of potential mutations in off-target sites, thus reducing the risk of genetic disruption at other loci. These advantages address many of the concerns associated with CRISPR-Cas9. Therefore, SCNT provides greater control over the genetics of the resulting embryos compared to zygote microinjection, especially for more complex edits such as multiplexed edits, large insertions, and humanized alleles33. Although, SCNT is limited by low cloning efficiency, technical requirements, and abnormal epigenetic reprogramming, the latter of which can lead to molecular and phenotypic disruptions in clones, potentially obscuring the effects of genetic modification in founder animals. However, these epigenetic alterations are not passed on to the offspring32,33. Despite these limitations, the combination of SCNT with CRISPR-Cas9 enables precise genome engineering with strict control over embryo genetics, supporting the reliable production of large animal disease models without mosaicism. Here, we describe a detailed approach for genetic modification of sheep fetal fibroblasts (SFF) using either NHEJ or HDR, followed by SCNT for cloned embryo production, with the ultimate goal of generating sheep models of human disease. This approach is largely applicable to other livestock species, though gene editing may require optimization in different cell types, with this protocol acting as a useful starting point.