Risk vs Gain
(October 13th, 2015) It was headline-grabbing news. A British scientist applied for permission to genetically modify human embryos for research purposes. Will this technology ever be used in the clinic?
Only a few months after Chinese researchers announced that they had manipulated the DNA of human embryos, a team of researchers from the UK wants to follow in their footsteps. As part of their research into the early stages of development, scientists based at the Francis Crick Institute in London have applied to the Human Fertilisation and Embryology Authority (HFEA) for permission to genetically modify embryos. If approved, this work could mean the first human embryos with altered DNA in the UK in just a few months.
The group, led by Kathy Niakan, is planning to use CRISPR-Cas9, a powerful gene editing tool invented only three years ago but with a growing following among the scientific community. The idea is to use this technique to unveil important genes during the first few days after fertilisation, as the embryo starts cell differentiation to form the placenta.
By turning on and off specific genes during these early stages it will be possible to see what effect these changes have during embryo development. The hope is that it could help researchers understand early pregnancy losses and why some women seem to suffer recurrent miscarriages.
The work proposed may be only for research purposes – with embryos destroyed within 14 days – but it still raises valid questions about whether this technique could ever be used in IFV clinics to alter faulty human genes. As this is a relatively easy and cheap technique to implement, many researchers have raised concerns about its ethical implications and its regulation.
For now, the idea of editing embryos to treat diseases in a clinical setting is still futuristic. However, Dirk Heckl, based at the Hannover Medical School in Germany, believes it’s inevitable that this technique will eventually become commonplace. For the researcher, who has used this technique for the past two years, the big question is all about risk vs. gain. “One should only apply this technology for severe diseases and if the current risks are lower than the gain that can be obtained.”
Let’s take cancer as an example. Common treatments involve dangerous and cytotoxic chemotherapy, associated with high risk. But cancer is fatal without treatment and the potential gain of cure outweighs the risks of therapy. The same can be said for genome editing: it should only be applied when the gain is higher than the risk.
This is where regulation must come into play. "Regulating agencies will have to make sure that it will be used to cure disease and not to modify traits unrelated to health conditions," says Heckl. “If regulation fails,” he adds, "one should not blame the technology but the ones that misuse it.”
“Thousands of years ago human beings learned how to control fire, which is the basis for our modern life, but has also been used to burn down whole cities and is the basis of war," concludes Heckl. "Should one ban fire? Genome editing can be used to do good and bad and, as usual, it is up to the ones using it.”