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How gene editing could protect us from future pandemics

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Hollywood’s blockbusters such as X-men, Gattaca, and Jurassic World have explored the intriguing concept of “germline genome editing” – a biomolecular technique that can alter the DNA of sperm, eggs, or embryos. If you remove a gene that causes a certain disease in an embryo, not only will the baby be free of the disease when born – so will its descendants.

The technique is, however, controversial – we can’t be sure how a child with an altered genome will develop over a lifetime. But with the COVID-19 pandemic showing just how vulnerable human beings are to disease, is it time to consider moving ahead with it more quickly?

There’s now good evidence that the technique works, with research normally carried out on unviable embryos that will never result in a living baby. But in 2018, Chinese scientist He Jiankui claimed that the first gene-edited babies had indeed been born – to the universal shock, criticism, and intrigue of the scientific community.

This human germline genome editing (hGGe) was performed using the Nobel-prize winning CRISPR system, a type of molecular scissors that can cut and alter the genome at a precise location. Researchers and policy makers in the fertility and embryology space agree that it is a matter of “when” and not “if” hGGe technologies will become available to the general public.

In 2016, the UK became the first country in the world to formally permit “three-parent babies” using a genetic technique called mitochondrial replacement therapy – replacing unhealthy mitochondria (a part of the cell that provides energy) with healthy ones from a donor.

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COVID-19 protection

Scientists are now discussing genome editing in the light of the COVID-19 pandemic. For example, one could use CRISPR to disable coronaviruses by scrambling their genetic code. But we could also edit people’s genes to make them more resistant to infection – for example by targeting “T cells,” which are central in the body’s immune response. There are already CRISPR clinical trials underway that look to genome edit T cells in cancer patients to improve anti-tumor immunity (T cells attacking the tumor).

This type of gene editing differs from germline editing as it occurs in non-reproductive cells, meaning genetic changes are not heritable. In the long term, however, it may be more effective to improve T-cell responses using germline editing.

It’s easy to see the allure. The pandemic has uncovered the brutal reality that the majority of countries across the world are completely ill equipped to deal with sudden shocks to their, often, already overstretched healthcare systems. Significantly, the healthcare impacts are not only felt on COVID-19 patients. Many cancer patients, for instance, have struggled to access treatments or diagnosis appointments in a timely manner during the pandemic.

This also raises the possibility of using hGGe techniques to tackle serious diseases such as cancer to protect healthcare systems against future pandemics. We already have a wealth of information that suggests certain gene mutations, such as those in the BRCA2 gene in women, increase the probability of cancer development. These disease genetic hotspots provide potential targets for hGGe therapy.