With the advancement of artificial intelligence and the introduction of numerous new medical innovations such as a drone that can deliver medical supplies, we have to wonder which of the new innovations will provide the same societal turning point for health that penicillin or the introduction of sanitation systems.
Gene modification is often highlighted as the fundamental turning point in health that moves us into the sci-fi world of the future. Gene editing is the ability to change a gene’s sequence and introduce new beneficial mutations. The technology has seen rapid advancement within the last decade including the ability to personalize healthcare treatment to its use to feed the world through creating disease resistant crops.
No two humans are alike, the same can be said about our genes. With the introduction of gene editing comes the ability to see and understand every individual’s genome. Every human has their own genetic pattern and with that comes the difference in ailments and illnesses they are more susceptible to.
The technology could be used as a preventative diagnostic tool. For example, a doctor would view the DNA, see that the patient is more susceptible to a certain kind of cancer and could work with them to set preventative measures in place.
There is already genetic mapping in place for some types of cancer that informs the clinician’s choice of treatment to optimise outcomes. In the case of breast cancer the presence of specific genes have been linked to a significantly increased risk and women with these genes are sometimes offered preventative surgery to remove their breast tissue.
Genetic screening antenatally can help parents make decisions about the risks to their foetus of continuing a pregnancy if a potentially fatal condition is identified, in time this may evolve to offer parents genetic treatments to edit and replace faulty genes. This seems sensible in the case of hereditary degenerative conditions but what about if the foetus had genes identified that were associated with being gay or a tendency to obesity and these could be edited out?
With the ability to edit cells comes the opportunity to introduce new beneficial mutations to the populace. Scientists could introduce disease-resistant mutations into human stem cells to increase the body’s resistance to the disease. For example, a group of Chinese scientists was able to introduce an HIV resistant gene into mice, successfully preventing the virus from infecting other genes. While this has not been successfully tested on a human, this technology could give beneficial mutations to others once found. Another trial is set for July 2018, where gene-editing software will be used to destroy HPV genes.
In order to combat deadly bacteria, scientists in North Carolina are utilizing the technology to create bacteriophages, a virus that would destroy bacteria that it infects.
No matter the use of technology, human trials have yet to begin, but many are hoping that gene editing software is the key to handling rampant diseases. However as this technology evolves there is a real risk of unintended consequences, by deleting a gene sequence to prevent one condition we may unintentionally create another vulnerability or susceptibility. For example the genetic carrier state for sickle cell disease provides protection against the disease malaria and is in itself of limited clinical impact for most patients, however it might become possible to edit it out, removing the risk of children being born to two sickle cell trait parents with sickle cell disease, but removing the protection to malaria – in reality we now have effective treatment and prophylaxis for malaria so this loss might not be that important, but in other cases it might be…
Even though fertility rates have been steadily decreasing, the world’s population is expecting to reach 8.6 billion by 2030. With the increase in population, additional food resources will be needed. With gene editing, companies can edit the code of foods to ensure that they grow faster and healthier. Scientists could modify the size of vegetation, how it develops, and even the shape to reach maximum harvest potential.
While some may fear the food would be another GMO, they are wrong. To create GMOs, a foreign DNA is introduced to the genome. These food resources wouldn’t add new DNA but instead would alter what is already there, a subtle but significant difference.
Like any other medical innovation, these technologies raise ethical questions. Should we allow individuals the ability to edit their genes? How would this technology be catered to the public? Would it be a private technology for those who can afford it, or would the general public be allowed access to utilize it? There are no easy answers to any of these questions, but they will need to be answered before gene editing can be used at scale. The progression of this technology will not stop anytime soon and there is a real need for society to discuss the ethics and the issues as the science evolves from science fiction into science fact.