China claims to have created the World’s first designer twins

China’s claim of using gene-editing to create the World’s first designer babies have stirred outrage in the scientific world. The researchers fear that it will stall their efforts to translate gene-editing technology into safe treatments for genetic diseases.

He Jiankui is a Stanford and Rice University-trained physicist and claims to have used CRISPR-Cas9 to delete the embryos’ CCR5 gene (C-C motif chemokine receptor 5), which is linked to resistance to HIV infection and the twins were born a few weeks ago with innate immunity to HIV, the virus that causes AIDS.

He Jiankui

In 2010, when Jiankui was a Rice University student, he already published a paper on details about gene-editing using the bacterial immune system CRISPR. It was well before Geneticist Jennifer Doudna co-invented the groundbreaking current technology for editing genes, called CRISPR-Cas9.

He currently works at the Southern University of Science and Technology of China in Shenzhen and has posted videos to YouTube about his editing techniques. The research is not yet published in a peer-reviewed journal and is, however, yet to be verified by outside scientists and researchers.

The news stunned the scientist and researchers all over the globe as they prepare to gather in Hongkong for the Second International Summit on Human Genome Editing from November 27-29, 2018. David Baltimore, Nobel laureate and chair of the organizing committee said, “I don’t know the details.”

 “We don’t know what will be said,” when He speaks at a session on human embryo editing on Tuesday, November 27, 2018.

There are two main issues with the existing gene-editing technique if used to create ‘designer babies’ in the real world. The first is mosaicism, in which the edited gene does not make it way into every cell of the embryo and second are off-target effects, where other parts of the genome may get deleted accidentally, and the consequences remain unknown.

Before genome editing is used as medical treatment, it is essential that the issues of mosaicism and off-target effects are resolved. Long-term follow-up of babies who have had gene-editing done is needed to know about long-term effects.

It is also unclear that why this particular gene was editing in the twins, but reports coming out of China suggest that the father was HIV positive, but his infection was under control and mother was HIV negative. The scientists also fail to understand that why he chose the HIV gene for editing, as there already exist proven treatments to prevent HIV-positive parents from infecting their children.

There are also specific risks of having a disabled CCR5 gene, which includes a higher risk of West Nile virus infection and dying from Influenza.

The summit’s organizing committee issued a statement Monday saying they had only just learned of He’s research in Shenzhen, China. “Whether the clinical protocols that resulted in the births in China conformed with the guidance” of leading scientific bodies for conducting clinical trials of heritable genome editing “remains to be determined,” the statement said. “We hope that the dialogue at our summit further advances the world’s understanding of the issues surrounding human genome editing. Our goal is to help ensure that human genome editing research is pursued responsibly, for the benefit of all society.”

Meanwhile, Chinese officials have condemned He’s research and strongly oppose the use of gene-editing technology in humans. gene-edited babies are prohibited in China. The Ethical Guiding Principles for the Research of Human Embryonic Stem Cell which was published by the Chinese government in 2003 states that scientists are allowed to conduct genetic editing to human embryos only for research purposes, but the time for their in-vitro breeding shall not exceed 14 days from the date of fertilization or nucleus transplant.

Here is a YouTube video showing He giving information about the twins

Other YouTube videos can be watched here

Statement from the Organizing Committee on Reported Human Embryo Genome Editing

Ob/Gyn Updated Facebook page

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Ovarian Transposition: A novel laparoscopic surgical method video by Cleveland Clinics.

A recent article published in forthcoming issue of Fertility and Sterility describes and demonstrate novel surgical method of laparoscopic ovarian transposition. This is a minimal invasive approach in which the ovary is tunneled through a peritoneum.

https://obgynupdated.blogspot.com/2017/03/ovarian-transposition-novel_17.html

Treating Hypothyroidism and hypothyroxinemia in pregnancy? Clinical dilemma continues.

Treating antenatal patients with levothyroxine who have hypothyroidism or hypothyroxinemia between 8 to 20 weeks of pregnancy did not result in better cognitive outcome and IQ in children through 5 years of age as compared to women who received placebo.

The study was published online on March 2, 2017 in the New England Journal of Medicine.

https://obgynupdated.blogspot.com/2017/03/treating-hypothyroidism-and.html

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https://obgynupdated.blogspot.com/2017/03/vitamin-b-personal-weapon-to-mitigate.html

Wow, new paper based test can tell your blood group in 30 seconds!

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https://obgynupdated.blogspot.com/2017/03/wow-new-paper-based-test-can-tell-your.html

CRISPR co-inventor Jennifer Doudna keynote address about responsible use of gene editing in future.

“What if a cell’s DNA could be edited just like the text of a document so that you could actually erase letters, you could erase whole sentences, [you could] replace sentences, and you could do things that would enable scientists to change the mutations that might cause genetic disease, make changes that allow us to understand the function of DNA and different kinds of organisms and perhaps, enable us to really direct the way that organisms are evolving on the planet?”

With this promising words about future of CRISPR Cas9 technology Jennifer Doudna, co-inventor of CRISPR Cas9 technology started her keynote address at 2017 South by Southwest (SXSW) conference.

https://obgynupdated.blogspot.com/2017/03/crispr-co-inventor-jennifer-doudna.html

CRISPR co-inventor Jennifer Doudna keynote address about responsible use of gene editing in future.

“What if a cell’s DNA could be edited just like the text of a document so that you could actually erase letters, you could erase whole sentences, [you could] replace sentences, and you could do things that would enable scientists to change the mutations that might cause genetic disease, make changes that allow us to understand the function of DNA and different kinds of organisms and perhaps, enable us to really direct the way that organisms are evolving on the planet?”

With this promising words about future of CRISPR Cas9 technology Jennifer Doudna, co-inventor of CRISPR Cas9 technology started her keynote address at 2017 South by Southwest (SXSW) conference.

The whole invention of CRISPR Cas9 technology is a result of curiosity developed research project aimed at understanding how bacteria fight viruses. It started as adaptive immune system in bacteria that could be harnessed into a powerful gene editing tool that will have profound influence on the world. What started in academic laboratory and is now adopted by clinicians, scientist, government regulatory agencies and commercial companies to develop the technology for human applications for eliminating many genetic diseases.  This is a very young technology ( 5 years )which is evolving very rapidly. 

She further cited many examples where the CRISPR Cas9 technology will find application in animals and plants. It’s application in plants could change the way we look at GMO foods. It can be used to create gene drivers that enable us to drive a trait through population very rapidly. This can be used in near future to create mosquitos that are resistant to infections, thereby limiting the spread of disease.

It will also increase our understanding of why certain genetic traits in a population makes them resistant to develop cancer.

Another application of the Cas9 technology is using it to create animals that are better suited for organ donors.  In principle, we can create organ donor pigs that are better suited for human organ replacement. 

In humans, one of the earliest clinical trials regarding the clinical application of using Cas9 gene editing technology will be to correct the mutation that causes sickle cell disease and is expected to start in couple of years.

Clinical trials are already ongoing in China and USA to make changes in immune system of cancer patients to make their immune cells capable of finding cancer cells  and mounting an immune response in destroying these cells.

All these are somatic applications of the amazing technology, it can also be used for altering the germ cells. Germ line editing application of Crispr technology is surrounded by ethical dilemmas because whatever changes are made will be transferred to coming generations.

It gives us powers to make changes to DNA that will be inherited by future generations. We will be creating traits that we consider enhancement and creating super humans.

Creating Superhumans: From Jennifer Doudna keynote speech.

At present human embryo editing, is only allowed for research purpose till 14 days stage of development and not for clinical use to get pregnant till the ethical and moral considerations are addressed fully across international borders.

She concluded her lecture by iterating her interest of developing this technology further by engaging and educating with public about ethical use of CRISPR for gene editing for treating genetic diseases and not for some sort of harmful effects.

She invited the public to visit the website of Innovative Genomic Institute, a partnership between  UC San Francisco and UC Berkeley which educates the public about coordination between various  institution to go forward with application of this technique in agriculture and responsible use in  human beings. 

Dr. Jennifer Doudna, Ph.D. was named one of Time Magazine’s 100 Most Influential People in 2015.  She is a professor of molecular and cell biology and chemistry at the University of California, Berkeley, where she holds the Li Ka Shing Chancellor’s Chair in Biomedical and Health Sciences and is a Howard Hughes Medical Institute investigator.

Here is the full lecture at the SXSW conference,2017. 

CRISPR, a new genome editing tool- Ted talk by Geneticist Jennifer Doudna

CRISPR, a new genome editing tool, has the potential to cure genetic disease, potentially opening the road to "engineered humans."

Geneticist Jennifer Doudna co-invented a groundbreaking new technology for editing genes, called CRISPR-Cas9. The tool allows scientists to make precise edits to DNA strands, which could lead to treatments for genetic diseases ... but could also be used to create so-called "designer babies." Doudna reviews how CRISPR-Cas9 works — and asks the scientific community to pause and discuss the ethics of this new tool.

It has already been used for human trait selection, as we have seen in the three-parent in vitro fertilization for eliminating mitochondrial diseases.

Here is a   Ted talk by her regarding what is  CRISPER-Cas9 technology, the ethical and societal implication of the procedure in future.