On a recent flight, I came across a Time magazine story about gene editing and a potential future in which humans could cut out the bad parts of our DNA in order to avoid health conditions like diabetes or complications.
While this is a futuristic take on the current state of research, it’s not a stretch to think it could be possible some day soon. In fact, it’s already being debated at the global policy level as some doctors and clinical researchers begin pushing for this type of gene therapy to treat certain conditions.
For those of us with any type of diabetes, it’s an intriguing train of thought.
Much of what was in the Time piece from June 2016 focused on the five-year-old concept CRISPR-Cas9, a discovery the story says “is transforming research into how to treat disease, what we eat and how we'll generate electricity, fuel our cars and even save endangered species. Experts believe that CRISPR can be used to reprogram the cells not just in humans but also in plants, insects -- practically any piece of DNA on the planet.”
In fact, just last summer, researchers at MIT and Harvard’s Broad Institute announced their development of a specific tool that can reprogram how parts of DNA regulate and express themselves – potentially paving the way for gene manipulation to prevent chronic conditions.
In February, an international committee of the U.S. National Academy of Sciences (NAS) and the National Academy of Medicine in Washington, D.C., issued a report that basically gave a yellow light to proceed with embryonic gene editing research, but on a cautionary and limited basis. The report noted that this kind of future human gene editing might be allowed someday, but only after much more risk-benefit research and “only for compelling reasons and under strict oversight.” It’s anyone’s guess what that might mean, but one thought is it could be limited to couples who both have a serious genetic disease and whose only last resort might be this kind of gene editing to have a healthy biological child.
As for gene editing in the cells of patients with diseases, clinical trials are already underway on HIV, hemophilia and leukemia. Existing regulatory systems for gene therapy are good enough to oversee that work, the committee found, and while gene manipulation “should not proceed at this time," the committee panel did say research and discussions should continue.
Interestingly, this type of gene editing research is already happening on a handful of fronts, including for diabetes:
- Researchers have corrected the genetic defect in Duchenne muscular dystrophy in mice and deactivated 62 genes in pigs so that organs grown in the animals, such as heart valves and liver tissue, won't be rejected when scientists are ready to transplant them into people.
- This story from December 2016 reports that at the Lund University Diabetes Centre in Sweden, researchers have used CRISPR to “turn off” one of the genes thought to play a part in causing diabetes, effectively decreasing beta cell death and increasing insulin production in the pancreas.
- At New York City's Memorial Sloan Kettering Cancer Center, biologist Scott Lowe is developing therapies that turn on and off genes in tumor cells to make them easier for the immune system to destroy.
- Malaria researchers are exploring a number of ways that CRISPR can be used to manipulate mosquitoes to make them less likely to transmit the malady. The same is happening with mice that transmit bacteria causing Lyme disease.
- These methods are reported to have potential to mprove the health and welfare of food producing animals -- for example, hornless cattle, pigs resistant to African swine fever or porcine reproductive and respiratory virus -- and alter specific traits of food plants or fungi, like non-browning mushrooms, for example.
- This 2015 research concludes that this type of gene editing tool will become more precise and help us better understand diabetes in years to come, and a recent study published in March 2017 shows the promise of gene therapy using this technique, for potentially curing T1D someday (!), though it's only been studied in animal models, so far.
- Even the Boston-based Joslin Diabetes Center has an interest in this gene editing concept and is working to create a core program focused on this type of research.
With new DNA-exploration tools popping up through services like Ancestry.com and 23andMe, this concept is becoming more of a reality all the time. On the diabetes research front, programs like TrialNet are aggressively seeking certain autoimmune biomarkers to trace the genetics of T1D through families, in order to target early treatment and even future prevention.
We can't help noting how reminiscent this all is of the novel Brave New World and the designer babies controversy, making one ponder the ethics: Is it right to meddle with aspects of humanity we don’t like, to strive for health “perfection”?
Not to get too deep into politics or religion here, but clearly we all want a cure for diabetes, and other diseases. Yet are we willing (or required) to "play God" to get there?