Editing genes to cure diseases

Dr Derrick Aarons

Saturday, December 26, 2015

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AS the Christmas season continues today, many of us may still be indulging in the excesses of food and drink that may have short, as well as long-term consequences for the quality and length of our lives. But, how many of us actually contemplate our lives in the future, specifically with regard to the length and quality of it? Further, if we could alter our genetic make-up to reduce some of the genetically inherited and debilitating diseases, would we?

If advances in science and technology were able to prevent or cure genetically inherited diabetes, high blood pressure, sickle cell disease and thalassemia, Alzheimer’s and Parkinson’s diseases, as well as certain cancers, do you think you as an individual or society should vote against such a development?

GENE EDITING
TECHNOLOGY

This issue now confronts us. In April 2015, scientists in China were able to use the recently developed and relatively inexpensive CASPR-Cas9 gene-editing technology to cut and splice out “bad” genes that were present in human embryonic stem cells, and replace them with healthy genes. The latter stem cells were, however, reportedly never implanted into women for their development into humans.

Although not yet used in man, the technique has been used in animals to make more muscular rats, goats, and pigs, and has been used in mosquitoes to make them resistant to the malaria parasite.

Debate has since been ongoing, as never before has mankind been so close to eradicating all genetically inherited diseases from the face of the earth. Yet, many religious as well as irreligious people have balked at the possibility of altering the genetic make-up of the embryo, whether from a ‘not playing God’ perspective or for fear of harm that is yet unforeseen.

YOUR VIEW OF
THE WORLD

The position you take on the matter may depend on your view of the world and your perception of our purpose.

If you believe that we got here by evolution, then Darwin’s view is that we are simply the result of a random set of mutations in our genes that have allowed us to survive our harsh environment in a natural selection process, and this has enabled us to live long enough to reproduce and then eventually die. Since we have a wide assortment of genes in our physical make-up, then the “bad” genes that cause diseases, such as cystic fibrosis (in which an afflicted young person may die in their early 30s due to lungs that are blocked by very thick mucous) or Huntington’s brain disease, are not “gifts” from God, but rather are essentially mistakes in nature.

If, however, you believe that we are all designed by God, then you may not want to alter the genetic make-up of the embryo to prevent future disease as that may be interfering with God’s will.

There is, however, a third post-Darwinian view, which says that the genes we have are neither a “gift” from God nor derived from natural selection for survival, but rather occur through nature’s random allotment. Some people get “bad” genes as the “hand” that nature allots them (random occurrence), while others do not; and so, some people fare far better (or worse) throughout life.

Depending on your view of life, therefore, you may or may not support science and technology’s editing of genes to prevent severe disease and suffering.

A PROHIBITION ON THE
USE OF GENE EDITING

At a Human Gene Editing Summit by scientists and policymakers from the United States, the United Kingdom, and China during the first week of December, the summit’s organising committee recommended a temporary halt on the gene editing of human eggs, sperms and embryos to allow time for research to be conducted to identify any potential safety risks.The research will be permitted or monitored based on the extent to which individual countries across the world have any regulations in place that specifically address research.

However, one week later, researchers at Toronto’s Hospital for Sick Children claimed the first successful use of the CRISPR gene-editing technique to remove a duplicated gene from a human genome in an unusual form of Duchenne muscular dystrophy — a progressive weakness and loss of muscle function which first begins in the lower limbs of young boys, and worsens quickly — which was due to gene duplication. The technique was used in the lab on cells donated by an afflicted 14-year-old boy.

THE WAY FORWARD

In all this, we should note that no international law exists on this matter. Whilst some countries may be willing to introduce legislation to prohibit gene editing within their borders, other countries such as Jamaica do not even have a law that governs or addresses research.

So what are your thoughts on this very important matter? Would gene editing likely produce more benefit than harm, or would its use be showing disrespect for human life? Should we ban the editing of genes, or impose limits or restrictions on what can be done?

Derrick Aarons MD, PhD is a consultant bioethicist/family physician, a specialist in ethical issues in medicine, the life sciences and research, and is the ethicist at the Caribbean Public Health Agency – CARPHA. (The views expressed here are not written on behalf of CARPHA.)

 


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