Nature published in November an intriguing article about the presentation by He Jiankui on his work gene editing babies, and the first people born with an edited genome. I am not surprised that CRISPR-Cas9 technology was quickly used for clinical translation. What surprises me is that knowing the power of this methodology, scientists have not behaved as they did when the recombinant DNA technology was discovered in the 1970s. Scientists led by Paul Berg, whom later shared Nobel Prize in chemistry with Sanger and Gilbert, organized the Asilomar Conference in San Diego and demanded a moratorium until safety regulations were established, which NIH did shortly later.
I was once a PhD student at University of California at Davis, and I remember the major preoccupation of conducting experiments with humans. We have not tried to follow the same strategy, though there has been a consensus against germline editing.
Why did He Jiankui use CRISPR to edit the germline? He made clear during the question-and-answer session that his aim was to prepare the technique for global use.
“Do you see your friends or relatives who may have a disease? They need help,” He said. “For millions of families with inherited disease or infectious disease, if we have this technology we can help them.”
I sympathize with his point of view. He edited the gene that codes for a protein, CCR5, which may be key in the process of HIV infection. The protein is the route by which many strains of HIV infect immune cells. We have learned with bacteria to develop the CRISPR way to deal with virus infection. This was what He did. The fact is, HIV was discovered early in the 1980s and in the last century claimed the lives of 35.4 million people, the majority in Africa and Central Asia. Since the start of the epidemic, 77.3 million people have become infected with the virus. UNAIDS estimates that $26.2 billion will be required for the AIDS response in 2020. In 2017 there were roughly 1.8 million new HIV infected people, the same as in 2016.
The text of the Nature article states that “fears are now growing in the gene-editing community that He’s actions could stall the responsible development of gene editing babies.” A nervous-seeming He spoke in front of the scientific community and was roundly criticised for ethical and technical reasons.
Admittedly, though I have not read He’s paper, it seems the quality of the science could be improved. Somewhat in favor of my point of view is George Daley, dean of Harvard Medical School, who urged support for pursuing germline editing research, despite He’s disclosure. Daley said that “it is possible that the first instance came forward as a misstep but that should not lead us to stick our head in the sand and not consider a more responsible pathway to clinical translation.”
It seems we may follow the path of recombinant DNA technology. David Baltimore, professor of biology at CalTech and a Nobel winner, said “ there has been a failure of self regulation by the scientific community.” As I remember the scientific community that generated CRISPR was more interested in solving PR issues.
This reminds me of Marie Curie, winner of the Nobel Prize in Physics in 1903 and Chemistry in 1911. She once said, “Nothing in life is to be feared, only to be understood.”
A century later it seems we have not learned her lesson. I hope fear is not what led people to vote against He Jiankui’s work.