This article may be expanded with text translated from the corresponding article in Chinese. (January 2019)Click [show] for important translation instructions.
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Lulu (Chinese :露露) and Nana (Chinese :娜娜) are pseudonyms of twin Chinese girls born in October 2018 as the world's first germline genenome edited babies, the clinical experiment of which led to legal and ethical controversies with an indictment of the experimenter, He Jiankui. [1] News of their birth were made public on 25 November 2018. [2] [3] The girls' parents, an HIV-positive father and HIV-negative mother, were among the participants in a clinical project run by He Jiankui. The subjects were offered standard in vitro fertilization services and in addition, used CRISPR-Cas9, a technology for modifying DNA. Specifically, Lulu and Nana were modified of the CCR5 gene in their embryos that were generated, to attempt to confer genetic resistance to HIV. [4] The clinical project was conducted secretly until November 2018, when MIT Technology Review ran the story about the experiment upon which He Jiankui immediately announced the birth of Lulu and Nana on YouTube. [5] [6] He Jiankui has reported that the girls were born healthy. [7]
The reaction to He's actions was widespread criticism [8] [9] and included concern for the well-being of the girls. [4] [10] [11] Near the end of November, Chinese authorities suspended all his research activities. [12] As of 28 December 2018, He is sequestered in a university apartment, under some sort of surveillance, [13] [14] and may face serious consequences. [15] In February 2019, news was reported that suggested the Chinese government may have helped fund the CRISPR babies experiment, at least in part, based on newly uncovered documents. [16] [17] [18]
In 2019, The World Health Organization has launched a global registry to track research on human genome editing, after a call to halt all work on genome editing. [19] [20] [21]
In May 2019, lawyers in China reported, in light of the purported creation by Chinese scientist He Jiankui of the first gene-edited humans, the drafting of regulations that anyone manipulating the human genome by gene-editing techniques, like CRISPR, would be held responsible for any related adverse consequences. [22] In December 2019, MIT Technology Review reported a substantial overview of the controversy to date. [23] [24] Later in December 2019, Chinese authorities announced that He Jiankui had been sentenced to three years in prison and fined 3 million yuan (US$430,000) for his genetic research efforts. [25] [26]
On 10 June 2017, a Chinese couple, an HIV-positive father and HIV-negative mother, pseudonymously called Mark and Grace, [27] attended a conference held by He Jiankui at the Southern University of Science and Technology (SUSTech) in Shenzen. They were offered in vitro fertilization along with gene-editing of their embryos so as to develop innate resistance to HIV infection in their offspring. They agreed to volunteer through informed consent and the experiment was carried out in secrecy. Six other couples having similar fertility problems were subsequently recruited. [1] The couples were recruited through a Beijing-based AIDS advocacy group called Baihualin China League. [28] When later examined, the consent forms were noted as incomplete and inadequate. [27] For performing the experiment, He Jiankui claimed that he obtained approval from the ethics committee of the Shenzhen HarMoniCare Women's and Children's Hospital, upon an inquiry of which the hospital denied such approval. The hospital's spokesperson declared that there were no records of such ethical approval, saying, "[The] gene editing process did not take place at our hospital. The babies were not born here either." [29] It was later confirmed that the approval certificate was forged. [30] [31]
The embryos that became Lulu and Nana were generated during a clinical experiment run by He Jiankui, a Chinese scientist of the Southern University of Science and Technology in Shenzhen, while he was on leave from the university and working through Shenzhen Harmonicare Women’s and Children’s Hospital. [28] TDr. He kept the clinical project secret from the scientific community until the experiment's announcement, and as of 28 November 2018, it was unclear whether the participants had given truly informed consent. [32] [33]
He Jiankui, the researcher, took sperm and eggs from the couples, performed in vitro fertilization with the eggs and sperm, and then edited the genomes of the embryos using CRISPR/Cas9. [28] The editing targeted a gene, CCR5 , that codes for a protein that HIV uses to enter cells. [33] [34] He was trying to create a specific mutation in the gene, (CCR5 Δ32), that few people naturally have — that possibly confers innate resistance to HIV, [33] as seen in the case of the Berlin Patient. [35] Dr. He said that Lulu and Nana still carried functional copies of CCR5 along with disabled CCR5 given mosaicism inherent in the present state of the art in germ-line editing.[ citation needed ] There are forms of HIV that use a different receptor gene instead of CCR5; therefore, the work of Dr. He did not theoretically protect Lulu and Nana from those forms of HIV. [33] He used a preimplantation genetic diagnosis process on the embryos that were edited, where three to five single cells were removed, and fully sequenced them to identify chimerism and off-target errors. Dr. He says that during the pregnancy, cell-free fetal DNA was fully sequenced to check for off-target errors, and an amniocentesis was offered to check for problems with the pregnancy, but the mother declined. [33] Lulu and Nana were born in secrecy in October 2018. [36] Dr. He said that they appeared to be healthy. [32]
He Jiankui was planning to reveal his experiments and the birth of Lulu and Nana at the Second International Summit on Human Genome Editing, which was to be organized at the University of Hong Kong during 27–29 November 2019. [37] However, on 25 November 2018, Antonio Regalado, senior editor for biomedicine for MIT Technology Review, posted on the journal's website about the experiment based on He Jiankui's applications for conducting clinical trial that had been posted earlier on the Chinese clinical trials registry. At the time, He Jiankui refused to comment on the conditions of the pregnancy. [5] Prompted by the publicity, He Jiankui immediately posted about his experiment and the successful birth of the twins on Youtube the same day. [38] [39] Dr. He's experiment had received no independent confirmation, and had not been peer reviewed or published in a scientific journal. [40] [41] [42] [43] Soon after He Jiankui's revelation, the university at which He was previously employed, the Southern University of Science and Technology, stated He's research was conducted outside of their campus, and they were unaware of the research project and its nature. [44] China’s National Health Commission also ordered provincial health officials to investigate his case soon after the experiment was revealed. [40]
He did not disclose the parents' names and they did not make themselves available to be interviewed, so their reaction to this experiment and the ensuing controversy is not known. [28] There was widespread criticism in the media and scientific community over the conduct of the clinical project and its secrecy, [45] and concerns raised for the long term well being of Lulu and Nana. [32] [43] Bioethicist Henry T. Greely of Stanford Law School declared, "I unequivocally condemn the experiment," [46] and later, "He Jiankui’s experiment was, amazingly, even worse than I first thought." [47]
Michael W. Deem, an American bioengineering professor at Rice University and Dr. He's doctoral advisor, was involved in the research, and was present when people involved in He's study gave consent. [28] Deem came under investigation by Rice after news of the work was made public. [48] A series of investigations were opened by He's university, local authorities, and the Chinese government. On 25 November 2018, MIT Technology Review published a story about the work, based on documents that had been posted earlier that month on the Chinese clinical trials registry. [42] After that story was posted, Dr. He released a promotional video on YouTube and the next day the Associated Press published an interview with him. [42] [28] He had engaged a public relations firm as well. [49] He eventually presented the work that led to the birth of the girls on 28 November at the International Human Genome Editing Summit. [32] On 29 November 2018, Chinese authorities suspended all of He's research activities, saying his work was "extremely abominable in nature" and a violation of Chinese law. [50] As of 28 December 2018, He Jiankui is sequestered in a university apartment under some sort of surveillance, [51] [52] and may face serious consequences. [53]
On 29 January 2019, it was learned that a U.S. Nobel laureate Craig Mello interviewed He about his experiment with gene-edited babies. [54] In February 2019, He's claims were reported to have been confirmed by Chinese investigators, according to NPR News. [55] Later in February 2019, news was reported that suggested the Chinese government may have helped fund the CRISPR babies experiment, at least in part, based on newly uncovered documents. [56] [57] [58]
In December 2019, He Jiankiu received a 3-year prison sentence for "illegal medical practices" as well as a fine of 3 million Chinese yuan ($429,000). [59] [60]
In January 2019, scientists in China reported the creation of five identical cloned gene-edited monkeys, using the same cloning technique that was used with Zhong Zhong and Hua Hua – the first ever cloned monkeys - and Dolly the sheep, and the same gene-editing Crispr-Cas9 technique allegedly used by He Jiankui in creating the first ever gene-modified human babies Lulu and Nana. The monkey clones were made in order to study several medical diseases. [61] [62]
In February 2019, scientists reported that Lulu and Nana may have inadvertently (or perhaps, intentionally [18] ) had their brains altered, [63] since CCR5 is linked to improved memory function in mice, [64] as well as enhanced recovery from strokes in humans. [65] Although He Jiankui stated during the Second International Summit on Human Genome Editing, that he was against using genome editing for enhancement, [66] he also acknowledged, that he was aware of the studies linking CCR5 to enhanced memory function.
In April 2019, for the first time, use of the CRISPR technology to edit human genes to treat cancer patients, with whom standard treatments were not successful, has been reported. [67] [68]
In June 2019, researchers suggest that the purportedly genetically edited humans may have been mutated in a way that shortens life expectancy. [69] [70] [71] However, this study was later retracted. [72]
A genetically modified organism (GMO) is any organism whose genetic material has been altered using genetic engineering techniques. The exact definition of a genetically modified organism and what constitutes genetic engineering varies, with the most common being an organism altered in a way that "does not occur naturally by mating and/or natural recombination". A wide variety of organisms have been genetically modified (GM), from animals to plants and microorganisms. Genes have been transferred within the same species, across species and even across kingdoms. New genes can be introduced, or endogenous genes can be enhanced, altered or knocked out.
Gene therapy is a medical field which focuses on the utilization of the therapeutic delivery of nucleic acid into a patient's cells as a drug to treat disease. The first attempt at modifying human DNA was performed in 1980 by Martin Cline, but the first successful nuclear gene transfer in humans, approved by the National Institutes of Health, was performed in May 1989. The first therapeutic use of gene transfer as well as the first direct insertion of human DNA into the nuclear genome was performed by French Anderson in a trial starting in September 1990. It is thought to be able to cure many genetic disorders or treat them over time.
A designer baby is a baby whose genetic makeup has been selected or altered, often to include a particular gene or to remove genes associated with a disease. This process usually involves analysing a wide range of human embryos to identify genes associated with particular diseases and characteristics, and selecting embryos that have the desired genetic makeup; a process known as preimplantation genetic diagnosis. Other potential methods by which a baby's genetic information can be altered involve directly editing the genome – a person's genetic code – before birth. This process is not routinely performed and only one instance of this is known to have occurred as of 2019, where Chinese twins Lulu and Nana were edited as embryos, causing widespread criticism.
Genetically modified animals are animals that have been genetically modified for a variety of purposes including producing drugs, enhancing yields, increase resistance to disease, etc. The vast majority of genetically modified animals are at the research stage with the number close to entering the market remains small.
Michael W. Deem is the John W. Cox Professor of Biochemical and Genetic Engineering and Professor of Physics & Astronomy at Rice University in Houston, Texas. He is known for his work in parallel tempering and proposals to improve vaccine development by estimating the antigenic "distance" for any two samples of virus. His awards include a National Science Foundation CAREER Awards (1997), Top 100 Young Innovator, MIT Technology Review (1999) and Alfred P. Sloan Fellow (2000).
Genome editing, or genome engineering, or gene editing, is a type of genetic engineering in which DNA is inserted, deleted, modified or replaced in the genome of a living organism. Unlike early genetic engineering techniques that randomly inserts genetic material into a host genome, genome editing targets the insertions to site specific locations.
Genetic engineering can be accomplished using multiple techniques. There are a number of steps that are followed before a genetically modified organism (GMO) is created. Genetic engineers must first choose what gene they wish to insert, modify, or delete. The gene must then be isolated and incorporated, along with other genetic elements, into a suitable vector. This vector is then used to insert the gene into the host genome, creating a transgenic or edited organism. The ability to genetically engineer organisms is built on years of research and discovery on how genes function and how we can manipulate them. Important advances included the discovery of restriction enzymes and DNA ligases and the development of polymerase chain reaction and sequencing.
A gene drive is a genetic engineering technology that propagates a particular suite of genes throughout a population by altering the probability that a specific allele will be transmitted to offspring from the natural 50% probability. Gene drives can arise through a variety of mechanisms. They have been proposed to provide an effective means of genetically modifying specific populations and entire species.
Biotechnology risk is a form of existential risk that could come from biological sources, such as genetically engineered biological agents. These can come either intentionally or unintentionally. A chapter in biotechnology and biosecurity was published in Nick Bostrom's Global Catastrophic Risks, which covered risks such as viral agents. Since then, new technologies like CRISPR and gene drives have been introduced.
Josiah Zayner is a biohacker and scientist best known for his self-experimentation and his work making hands-on genetic engineering accessible to a lay audience, including CRISPR.
John Jin Zhang is a medical scientist who made important contributions in fertility research, and particularly in in vitro fertilization. He made headlines in September 2016 for successfully producing the world's first three-parent baby using the spindle transfer technique of mitochondrial replacement. Having obtained an M.D. from Zhejiang University School of Medicine, an M.Sc. from University of Birmingham, and a Ph.D. from University of Cambridge, he became the founder-director of New Hope Fertility Center in New York, USA.
Human germline engineering is the process by which the genome of an individual is edited in such a way that the change is heritable. This is achieved through genetic alterations within the germ cells, or the reproductive cells, such as the egg and sperm. Human Germline engineering is a type of genetic modification that directly manipulates the genome using molecular engineering techniques. Aside from germline engineering, genetic modification can be applied in another way, somatic genetic modification Somatic gene modification consists of altering somatic cells, which are all cells in the body that are not involved in reproduction. While somatic gene therapy does change the genome of the targeted cells, these cells are not within the germline, so the alterations are not heritable and cannot be passed on to the next generation.
Zhong Zhong and Hua Hua are a pair of identical crab-eating macaques that were created through somatic cell nuclear transfer (SCNT), the same cloning technique that produced Dolly the sheep in 1996. They are the first cloned primates produced by this technique. Unlike previous attempts to clone monkeys, the donated nuclei came from fetal cells, not embryonic cells. The primates were both born at the Institute of Neuroscience of the Chinese Academy of Sciences in Shanghai.
Off-target genome editing refers to nonspecific and unintended genetic modifications that can arise through the use of engineered nuclease technologies such as: clustered, regularly interspaced, short palindromic repeats (CRISPR)-Cas9, transcription activator-like effector nucleases (TALEN), meganucleases, and zinc finger nucleases (ZFN). These tools use different mechanisms to bind a predetermined sequence of DNA (“target”), which they cleave, creating a double-stranded chromosomal break (DSB) that summons the cell's DNA repair mechanisms and leads to site-specific modifications. If these complexes do not bind at the target, often a result of homologous sequences and/or mismatch tolerance, they will cleave off-target DSB and cause non-specific genetic modifications. Specifically, off-target effects consist of unintended point mutations, deletions, insertions inversions, and translocations.
He Jiankui is a Chinese biophysics researcher who was an associate professor in the Department of Biology of the Southern University of Science and Technology (SUSTech) in Shenzhen, China. Earning his Ph.D. from Rice University in Texas on protein evolution including that of CRISPR, He Jiankui learned gene-editing technique (CRISPR/Cas9) as a postdoctoral researcher at Standford University in California.
CRISPR gene editing is a method by which the genomes of living organisms may be edited. It is based on a simplified version of the bacterial CRISPR/Cas (CRISPR-Cas9) antiviral defense system. By delivering the Cas9 nuclease complexed with a synthetic guide RNA (gRNA) into a cell, the cell's genome can be cut at a desired location, allowing existing genes to be removed and/or new ones added.
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Deng Hongkui is a Chinese immunologist and stem cell researcher. He is a Changjiang Professor, the Boya Chair Professor, and Director of the Institute of Stem Cell Research at Peking University. He was awarded US$1.9 million by the Bill & Melinda Gates Foundation for his research on vaccines for HIV and hepatitis C. In 2017, he and Chen Hu engineered resistance to HIV in mice using CRISPR gene editing, and for the first time used the technique on an AIDS patient.
Unnatural Selection is a 2019 TV documentary series that presents an overview of genetic engineering and particularly, the DNA-editing technology of CRISPR, from the perspective of scientists, corporations and biohackers working from their home. It was released by Netflix on October 18, 2019.