RT Journal Article SR Electronic T1 Global detection of DNA repair outcomes induced by CRISPR-Cas9 JF bioRxiv FD Cold Spring Harbor Laboratory SP 2021.02.15.431335 DO 10.1101/2021.02.15.431335 A1 Mengzhu Liu A1 Weiwei Zhang A1 Changchang Xin A1 Jianhang Yin A1 Yafang Shang A1 Chen Ai A1 Jiaxin Li A1 Fei-long Meng A1 Jiazhi Hu YR 2021 UL http://biorxiv.org/content/early/2021/02/16/2021.02.15.431335.abstract AB CRISPR-Cas9 generates double-stranded DNA breaks (DSBs) to activate cellular DNA repair pathways for genome editing. The repair of DSBs leads to small insertions or deletions (indels) and other complex byproducts, including large deletions and chromosomal translocations. Indels are well understood to disrupt target genes, while the other deleterious byproducts remain elusive. We developed a new in silico analysis pipeline for the previously described primer-extension-mediated sequencing assay to comprehensively characterize CRISPR-Cas9-induced DSB repair outcomes in human or mouse cells. We identified tremendous deleterious DSB repair byproducts of CRISPR-Cas9 editing, including large deletions, plasmid integrations, and chromosomal translocations. We further elucidated the important roles of microhomology, chromosomal interaction, recurrent DSBs, and DSB repair pathways in the generation of these byproducts. Our findings provide an extra dimension for genome editing safety besides off-targets. And caution should be exercised to avoid not only off-target damages but also deleterious DSB repair byproducts during genome editing.Competing Interest StatementThe authors have declared no competing interest.