CRISPR germline editing

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How long will it be before CRISPR germline editing is approved in single gene diseases?

Gene Therapy
CRISPR/Cas9 Genome Editing
Genetic diseases and personalized medicene
Mark Robertson
74 months ago

6 answers

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Well, there are two major challenges to get this approved. First, on the technical front, despite all the hype about CRISPR, its off-target editing effect is real, and it would be too high to tolerate in germline editing setting. That being said, Chinese research was the first to edit human embryo a few years back, and two Nature papers last year showed some gene editing in human embryos. Still, the tools need to be improved. Second, on the ethical level, it would be extremely hard to get anything involving human embryo to be studied in clinical setting, not to mention gene-edited embryo, in western countries. All said, technical difficulty is still there but can be solved sooner or later. Ethical difficulty? Not in the US (or Europe) in foreseeable future, but Asian countries would be a different story.

Jun Tang
74 months ago
Thanks Jun Tang. 3 parent mitochondrial babies granted in the UK already have germline edits. So there is precendent. I cant help thinking that germline editing is going to happen now that the technology is freely available, so we need to be prepared. - Mark 74 months ago
WOW, Mark. I did hear about 3-parent baby but did not know germline-edited 3-parent baby. Can you direct me to source of this research? - Jun 74 months ago
I just mean that the very act of 3 parents being involved will default be inherited for all future generations - at least interms of future mitochondrial content - Mark 74 months ago
Interesting - Dr. David E. 64 months ago
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It's already happening in China.

Leonardo Ferreira
74 months ago
Any more detail Leonardo? - Mark 74 months ago
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China was the first in the world to publish human germ line genome editing using CRISPR/Cas9. In 2015, a group in China reported editing in defective human embryos. In 2016, another group in China reported editing in viable human embryos. These are scientific articles by academic labs; one doesn't know what's going on in other research sectors. Some clinicians have recently been found to have performed mitochondrial replacement therapy before it is fully developed and approved, the same is most likely true of CRISPR germline editing for human single gene diseases. CRISPR has been used to edit blood cells in China since 2015 as part of a cancer clinical trial. It is reported that it took one afternoon to approve it (vs. two years for something similar in the US). So I think the answer to your question is: soon!

Leonardo Ferreira
74 months ago
Thanks Leonardo but apart from mitochondrial work I dont know of any human changes that have been allowed to progress towards full term. I still think thats a really different milestone and would be surprised if thats going to happen anywhere soon. But let's see! - Mark 74 months ago
Thanks - Dr. David E. 64 months ago
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With mitochondrial replacement therapy one is already permanently changing the genome of the future baby. Just not the nuclear genome, but the mitochondrial genome, yet it also codes for genes and can carry disease susceptibility variants... If both mitochondrial and nuclear germ line changes are done with the purpose of correcting genetic disease, how different do you think the regulatory milestones of approving either will be?

Leonardo Ferreira
74 months ago
I thought in UK at least mitochondrial edits (e.g. for the 3 parent baby) were permitted in exceptional circumstances. Nuclear changes are not (yet). Im not sure how the decsion to permit mito but not nuclear is rationalised? Has anyone thought this though properly? - Mark 74 months ago
I noticed you have been at Harvard Leonardo. Did you meet George Church whilst eastside? - Mark 74 months ago
Not extensively, but chatted with him a couple times. His book "Regenesis" is a good read. I never forget what he said about Europe: a place where genetically modified humans eat non genetically modified food (gene therapies were approved over there, but there are strict anti-GMO regulations). Have you met him? - Leonardo 74 months ago
No but always intruiged by his work. I like his astronuat gene slide for example :) - Mark 74 months ago
I have met Jennifer Doudna though - Mark 74 months ago
Outstanding - Dr. David E. 64 months ago
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Permitting mitochondrial DNA edition is a lower bar, because
1) male babies will not pass their new mitochondrial DNA to the next generation (Germline transmission), only females
2) mtDNA only contains 13 protein coding genes, and all these proteins are part of OXPHOS. But still, why is modifying those genes any ethically different than modifying genes involved in other cellular pathways? Given that the goal is to prevent disease, not engineer specific physical traits...

Leonardo Ferreira
74 months ago
My point exactly - Mark 74 months ago
Thanks. - Dr. David E. 64 months ago
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As a lay person following the development, and use of CRISPR technology and methods, I believe the question is to the subject matter experts, when can we expect sustained viable solutions that for even the simplest defect corrections to be medically acceptable treatments on a large enough scale such that they will achieve routine use in patient treatment plans. What is the timeline looking like?

Sandy Waters
65 months ago
The technology is in place and it's improvement will depend on regulations. There have been 3 papers showing CRISPR in human embryos (2 from China and 1 from US) . Last year Jianku He in China edited and brought to term at least two babies. Harvard plans to edit sperm cells before fertilization. - Leonardo 64 months ago
Ethical? - Dr. David E. 64 months ago

Have some input?