A
hot new tool to edit the human genetic code has a big wow factor: the promise
of long-sought cures for intractable diseases. But depending on how it's used,
that same tool could alter human heredity.
The
debate has brought hundreds of scientists and ethicists from 20 countries to a
highly unusual, three-day meeting in Washington on the ethics of human gene
editing.
"We
could be on the cusp of a new era in human history," Nobel laureate David
Baltimore of the California Institute of Technology said Tuesday in opening the
international summit to examine what he called "deep and disturbing
questions."
"The
overriding question is when, if ever, would we want to use gene editing to
change human inheritance?" he said.
That
question gained urgency after Chinese researchers made the first attempt at
altering genes in human embryos, a laboratory experiment that didn't work well
but did raise the prospect of one day modifying genes in a way that goes far
beyond helping one sick person — it also could pass those alterations on to
future generations.
"That
really does raise the issue of, how do we use this technology in a responsible
fashion," said molecular biologist Jennifer Doudna of the University of
California, Berkeley, who helped pioneer the most-used gene-editing tool. Her
calls for debate on its implications and boundaries led to this week's
gathering, a step that could eventually lead to research recommendations.
At
issue are tools to precisely edit genes inside living cells, finding specific
sections of DNA to slice and repair or replace much like a biological version
of cut-and-paste software. There are a few methods but one with the wonky name
CRISPR-Cas9 is so fast, cheap and simple for biologists to use that research is
booming.
The
potential is huge: Scientists are engineering animals with humanlike disorders
to unravel the gene defects that fuel them. They're developing treatments for
muscular dystrophy, sickle cell disease, cancer and HIV. They're trying to grow
transplantable human organs inside pigs. They're even hatching mutant
mosquitoes designed to be incapable of spreading malaria, and exploring ways to
wipe out invasive species.
One
hurdle is safety. While the CRISPR tool is pretty precise, it sometimes cuts
the wrong section of DNA. Tuesday, CRISPR pioneer Feng Zhang of the Broad
Institute at MIT and Harvard reported Tuesday tweaking the tool's molecular
scissors to significantly lower chances of off-target editing errors — an
improvement that could have implications both for developing therapies and for
germline research.
"The
reality is, it will be years until this is turned into some kind of a
therapy," Doudna cautioned reporters.
Yet
many scientists said it's not too early to consider the biggest ethical
quandary, that performing what's called germline editing, manipulating
reproductive cells — sperm, eggs or embryos — could spread gene changes to
future generations.
In
the U.S., germline editing for clinical use — meaning for pregnancy — "is
a line that should not be crossed at this time," John Holdren of the White
House Office of Science and Technology Policy said Tuesday.
Last
spring's experiment in China highlighted that ethics aside, embryo editing
wasn't anywhere near ready for real-world use, because those off-target edits
risked fixing one problem only to create another.
But
there's controversy over whether and how to continue laboratory experiments to
see if it eventually could work. And just as fraudulent stem cell clinics
already lure desperate patients, there's worry about misuse of gene-editing
techniques before they're proven.
Around
the world, laws and guidelines vary widely about what germline, or hereditary,
research is allowed. Some ban any research; some allow only lab research but
not pregnancies; some have no policies. In the U.S., the National Institutes of
Health won't fund germline research but private funding is allowed.
What
one country attempts "will have consequences in others," the White
House's Holdren noted.
It's
not just about editing embryos. At the University of Pittsburgh, Dr. Kyle Orwig
is exploring treatments for male infertility that could alter sperm-producing
cells that don't do their job.
Critics
note there are other ways to halt transmission of inherited disease. Already,
couples undergo in vitro fertilization and have the resulting embryos tested
for the family's problem gene before deciding which to have implanted, noted
Marcy Darnovsky of the Center for Genetics and Society advocacy group.
Allowing
gene editing for medical reasons would open the door to designer babies with
cosmetic changes, too, she added.
"It
would alter future human societies, perhaps profoundly so," Darnovsky said
Tuesday.
Pre-testing
of embryos doesn't solve the problem for all families with devastating rare
diseases, said Dr. George Daley of Boston Children's Hospital, recounting
families that have dozens of embryos created through IVF to come up with one or
two usable ones.
"Is it more ethical to
edit embryos, or to screen a lot of embryos and throw them away? I don't know
the answer," Doudna said.
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