[HN Gopher] FDA approves first test of CRISPR for genetic defect...
___________________________________________________________________
FDA approves first test of CRISPR for genetic defect causing sickle
cell disease
Author : zuhayeer
Score : 423 points
Date : 2021-04-07 23:34 UTC (23 hours ago)
(HTM) web link (news.berkeley.edu)
(TXT) w3m dump (news.berkeley.edu)
| vagrantJin wrote:
| Yeah. My one and only concern is how tight regulation around
| genetic augmentation/editing will be. When will medical use cross
| over into cosmetic use and how do we regulate that?
| f6v wrote:
| You can already do a plastic surgery. So how is genetic editing
| to make yourself hotter different?
| faeyanpiraat wrote:
| Well you wont be able to prevent rich people from getting their
| regular life extension treatments.
| pmlnr wrote:
| I honestly thought my generation will not yet live through
| Gattaca; seems like I was wrong.
| corpMaverick wrote:
| Rich people already have easy means for genetic improvements.
| They just marry people that are more attractive, tall and
| intelligent.
| koonsolo wrote:
| Helping people with severe diseases is still far away from
| creating the perfect humans.
|
| You turning this positive into a negative is distasteful.
| saiya-jin wrote:
| Road to hell is paved with good intentions. In this case,
| creating super-humans that lack any weakness, sickness and
| are just ideal of what can human being be without those is
| putting them already way above everybody else.
|
| One doesn't need an x-ray vision or flying around to be to
| have superhuman status.
|
| I understand your optimism because it sounds properly
| awesome. But we humans always, without exceptions, fuck up
| everything that is even theoretically fuckable and often even
| the rest. If you don't see potential for evil with this then
| I guess you lack a bit of imagination.
|
| For every great discovery to help humanity there is always
| some powerful idiot thinking how it can we weaponized, used
| to gain advantage above others, the non-conforming, the
| unknown, or simply the weak.
| f6v wrote:
| > we humans always, without exceptions, fuck up everything
| that is even theoretically fuckable
|
| Don't mean to intrude, but it reads rather negative. Maybe
| you should seek help?
| pmlnr wrote:
| > Helping people with severe diseases is still far away from
| creating the perfect humans.
|
| Not as far as it looks. Honestly, it looks closer, than real
| self driving cars.
|
| > You turning this positive into a negative is distasteful.
|
| I'm incredibly happy that we, as humanity, are advancing with
| science - the mRNA vaccines are also incredible. The part
| that is not incredible is that we, as society, are in most
| cases still behave like we did in the stone age: greedy,
| selfish, narcissistic. Because of this tech that should be
| used to help those in need is most commonly used to "help"
| those with enough funds or means.
|
| Cheering for science advancements that are far out of reach
| for the majority leaves a bitter taste.
|
| EDIT BTW, Gattaca is a temporary time. Once it's passed - one
| whole generation, so say ~80 years - that world would be
| wonderful, but that limbo time, when the movie plays out, is
| the nasty part.
| maxerickson wrote:
| Gattaca isn't just about the oppression of the natural
| born.
|
| You cheer for a world full of Anton's, calculating that it
| isn't possible to make it to the other side, deciding not
| to try.
| boxed wrote:
| > Cheering for science advancements that are far out of
| reach for the majority leaves a bitter taste.
|
| Yes. Damn that new fancy tech of farming that only the rich
| can afford!
|
| Seriously. Think about what you're saying for a second.
| Tech that is only for the rich becomes affordable for the
| masses faster and faster every year. Computers were for
| _nation states_ in my parents life time. Today there are
| computers more powerful than the first computers in cheap
| _toys_.
|
| We cheer for tech that only the rich can use _now_ because
| it will be for the masses _soon_. Tech that never exists
| for the rich, will not exist for anyone ever.
|
| Check your logic.
| delfinom wrote:
| >We cheer for tech that only the rich can use now because
| it will be for the masses soon. Tech that never exists
| for the rich, will not exist for anyone ever.
|
| Realistically however, this kind of area falls squarely
| in the healthcare field which is increasingly becoming a
| thing for the rich and indentured servitude for the rest.
| alistairSH wrote:
| In the US. Other high-income nations have mostly solved
| the problem of affordable access to health care.
| pitspotter wrote:
| Curing genetic diseases is going to turn unlucky people into
| more normal people, not privileged people into superhumans.
| gomox wrote:
| Given the history of humanity, I find this take to be
| anywhere between optimistic and naive.
| meowface wrote:
| The parent said "curing genetic diseases", not "CRISPR".
| gnulinux wrote:
| Are you seriously arguing in 50 years super rich people won't
| use this for e.g. cosmetic reasons?
| The_rationalist wrote:
| If CRISPR can be bruteforced to change a significant number of
| cells for a whole organ/body then what is stopping us from
| rejuvenation? (store your DNA in while not too old in a safe
| place fill this DNA in tons of virus vectors/CRIPRs and hop you
| can be rejuvenated!)
| Vecr wrote:
| Probably not, killing off your bone marrow cells and replacing
| them is already pretty dangerous, and other organs would be way
| worse, because they have actual structure. Doing it with your
| brain would be impossible, for obvious reasons.
| dagurp wrote:
| I really hope this will be successful.
|
| Does anyone have an idea how much a treatment like this would
| cost?
| f6v wrote:
| A wild guess: million+. It's supposed to be a once in a life
| time treatment, so pharma can't milk you for life. It's not
| that pharma is inherently bad, but rather that it costs
| billions to get this through all the stages of clinical trials.
| yarcob wrote:
| TLDR:
|
| 1) Extract bone marrow from patient
|
| 2) Use CRISPR to fix broken gene in the extracted bone marrow
|
| 3) Use chemo to destroy old bone marrow in patient
|
| 4) Transplant fixed bone marrow from step 2 back into the patient
| yarcob wrote:
| The technique sounds promising, since it avoids the typical
| problem of gene therapy, which is how to get CRISPR past the
| immune system into every cell in the body. With this technique
| you can do the CRISPR procedure in vitro.
|
| A big downside to this treatment is that as far as I know this
| kind of chemo can make male patients infertile.
| codeproject wrote:
| Two years ago, Chinese Scientist Dr.He JianKui did a very similar
| thing. He edited the genome of twin girls so that they will be
| immune to the HIV-virus. By all account the project is
| successful. The announcement of this breakthrough causes a lot
| controversies. People are shocked and dismayed. Here is the link:
| https://www.nature.com/articles/d41586-018-07545-0
| meepmorp wrote:
| Using CRISPR to edit the genomes of human embryos because YOLO,
| is very different to using it in a modified version of an
| existing treatment for sickle cell anemia. Do you not see the
| difference in ethical scale and scope?
| WaitWaitWha wrote:
| >Do you not see the difference in ethical scale and scope?
|
| I agree with you that to you (and me) in this case there is a
| difference.
|
| But, who sets the scale & scope?
|
| ( _I am aware that the box has been opened, it will never be
| closed._ )
| downrightmike wrote:
| HIV is a very capable mutator, all he did was give it a
| chance in two hosts to mutate against. and then who knows
| the future danger of the kid's health. Dolly the sheep was
| cloned, but had enlarged organs. So not perfect. And what
| changes in these kids is a huge unknown and there was no
| way to predict it, because the doc just did because he
| could. Plus a whole eugenics program has a huge historical
| negative example in the last century because it lead to
| death camps.
| codeproject wrote:
| Totally Agree!!! it is the initial stage.
| codeproject wrote:
| if you read the Original Article close enough, You will see
| the subtle point here:
|
| >If this is successfully applied in young patients, it has
| the potential to prevent irreversible complications of the
| disease
|
| How young is this going to be, One years old, 1 month old...
| meepmorp wrote:
| Bone marrow transplants as a treatment for SA are already a
| thing. All this does is make it so you can use the
| patient's own bone marrow instead of a donor, hopefully
| reducing rejection. There's no subtle point to be made, the
| question you're asking is a solved one, because it's just a
| modification of an existing therapy.
|
| Now, compare that to editing human embryos in vitro then
| implanting them, just because you want to prove it's
| possible to use a gene editing technique to alter the
| genome of a person.
| pitspotter wrote:
| Trying to enhance or disable healthy genes isn't the same as
| fixing known disease-causing mutations.
|
| Moreover, identifying harmful mutations can't tell you how to
| build superhumans. So I think the similarity is only
| superficial.
| codeproject wrote:
| He JianKui's Project is not to build the superman. the parent
| of the baby girls is HIV positive. He did that so that Parent
| is not going to worry about their babies is going to get the
| disease.
| ngcc_hk wrote:
| For now.
|
| Helping China to trade is not to build a totalitarian
| country as well. Just trade.
| godmode2019 wrote:
| Can someone answer, what is the entry method of CRISPR in adults,
| don't it need to change all instances of a cell to be effective?
|
| I don't really understand the delivery method.
| konschubert wrote:
| For blood diseases it's enough to replace all blood-producing
| cells and their producers, I guess?
| azernik wrote:
| Brute force:
|
| "...some of the patient's hematopoietic stem cells... [are]
| harvested for gene editing outside the body. After these cells
| are removed, the remaining bone marrow is destroyed with
| chemotherapy to allow space for the repaired and reinfused stem
| cells to grow."
|
| EDIT: This is apparently the same procedure as conventional
| bone marrow transplants in SCA patients. CRISPR is just slotted
| into that workflow to synthesize a transplant, without needing
| to find a donor.
| causality0 wrote:
| But does the CRISPR method require the patient to remain on
| anti-rejection drugs the rest of their life?
| Gibbon1 wrote:
| I would assume more likely not since they are the patients
| own cells.
| [deleted]
| grapecookie wrote:
| Bro if it actually uses chemo to destroy your marrow and then
| grafts new youGM marrow? thats Frankenstein and evil af.
| [deleted]
| liamwire wrote:
| Even with the amount of hype around CRISPR, that is...
| incredible. Turning patients into their own donors feels
| magical.
|
| I suppose in this instance, the patients wouldn't need
| immunosuppressants after their treatment, as I'd expect
| standard care patients currently need for life?
| rcthompson wrote:
| I think it's an open question. After this treatment, the
| patient's red blood cells will be producing a new protein
| that they have never produced before. This protein only
| differs from the previous one by one amino acid, so the
| question becomes how sensitive the immune system is to such
| a change. Given that the immune system has some difficulty
| recognizing cancer cells with multiple protein-coding
| mutations in them, I think it's likely that a single amino
| acid change will fly under the radar and not require any
| immune suppression, at least for the vast majority of
| recipients of this treatment.
| mschuster91 wrote:
| Wiping out the bone marrow should also (essentially)
| reset the immune system IIRC.
| rcthompson wrote:
| Yes, but T-cells learn to distinguish self from non-self
| in the thymus, and I don't believe this treatment alters
| the hemoglobin gene sequence in the thymal epithelial
| cells. Of course, the thymus, like the rest of the body,
| will be served by red blood cells containing the new
| hemoglobin gene, but I'm not sure if this alone is
| sufficient for immature T-cells in the thymus to learn it
| as a self protein.
| farfalle wrote:
| Bone marrow transplant (BMT) recipients can still
| experience graft versus host disease (GVHD) which is when
| the transplanted marrow produces healthy cells that start
| to attack the host body.
|
| Besides GVHD, it is like you said. BMT patients are one
| of the few transplant types that can eventually come off
| of immuno-suppressants with a successful transplant. The
| patient's original bone marrow is supposed to be wiped
| out by chemotherapy (and sometimes some radiation) to
| make room for the new marrow transplant.
| eganist wrote:
| Can we take a moment to appreciate the straightforward
| naming of _graft-versus-host disease_? I couldn 't find
| the history of its discovery beyond this (https://www.sci
| encedirect.com/science/article/abs/pii/S03014...) and
| even there, I couldn't find any indication of how it came
| to receive that name specifically, but it's much better
| than "[scientist's name]'s disease/syndrome" that we keep
| running into because people want credits at the expense
| of accessibility of knowledge.
| quiescant_dodo wrote:
| The fundamental idea of using the donor's own stem cells is
| known as an Autologous Stem Cell Transplant and has existed
| for a while. It is used as therapy for a fair number of
| blood cancers (e.g. multiple myeloma or a few leukemias).
|
| Using "something" to manipulate the donor cells has also
| been done for these autologous HSCTs. I know of "CAR T cell
| therapy", but there are likely others. (
| https://www.cancer.gov/about-
| cancer/treatment/research/car-t... )
|
| I think some small number of autologous HSCT recipients
| require immunosuppressants, but from what I remember the
| number is very very small. (Allogenic HSCT recipients, who
| receive cells from a different person, are _much_ more
| likely to require lifetime immunosuppressants.)
|
| It's super cool that they're able to treat genetic diseases
| this way!
| mbreese wrote:
| Because this is a blood based disease, I'm guessing they would
| extract blood from the patient or extract them from bone marrow
| (more likely), treat the cells outside the body, and then
| transfuse the modified blood cells back onto the patient to try
| and engraftment them in the bone marrow.
|
| All of the hard CRISPR stuff is likely in vitro.
|
| However, I don't know anything about what the specific plans
| are though, this is just speculation.
| refurb wrote:
| Sickle cell anemia can be "cured" by inducing expression of
| fetal hemoglobin (fHb). You don't need to shut off the
| defective gene and the disease is effectively "cured" if you
| replace enough scHb with fHb.
|
| So you remove bone marrow from the patient, modify the cells,
| put them back in. The modified cells produce fHb at a high
| enough level that symptoms of Sickle Cell go away.
|
| Not that different than the already approved CAR-T therapies
| (with the exception they don't use CRISPR for the genetic
| modification).
| maxerickson wrote:
| This treatment modifies the adult hemoglobin gene.
| keven wrote:
| For people interested in Crispr, Rich Horgan started a non-profit
| called Cure Rare Disease working to fast-track customized
| therapeutics for his brother and other families with Duchenne
| Muscular Dystrophy using in-vivo gene editing.
|
| https://cureraredisease.org/
| pastrami_panda wrote:
| For those interested in CRISPR tech I'd highly suggest reading up
| on BEAM therapeutics. It's base pair editing which makes it much
| more precise compared to CRISPR which is editing DNA chains. They
| don't have editors for all base pairs yet but they have a couple
| and it looks very promising.
| jfarlow wrote:
| The Base Editor (and Prime Editor, etc.) _is_ CRISPR (Cas9) but
| with additional components fused to it that provide it
| additional features allowing it to edit in a more elegant way
| over the naked Cas9.
|
| https://serotiny.bio/notes/proteins/sabe4gam/
| jonplackett wrote:
| So CRISPR now has frameworks? Cool.
| o0-0o wrote:
| Very cool. Now please, work on Myelo Fibrosis next!
| mrfusion wrote:
| So how do they get the crispr into the cell and into the cell
| nucleus? Would fixing scd be all or nothing?
| meepmorp wrote:
| The treatment is basically a bone marrow transplant, which
| would typically use donor cells from another person; CRISPR
| lets you use the patient's marrow instead, hopefully reducing
| rejection and other issues.
|
| You extract marrow and CRISPR it to get rid of the problem
| gene. Then you kill off all of the bone marrow in the patient,
| and replace it with the new stuff. That's a cure.
| stjohnswarts wrote:
| Big if true.
| nerdkid93 wrote:
| I was super pumped for this tech to start being used in human
| clinical trials, but a couple of years ago, there was a study[0]
| that raised some key concerns about CRISPR therapeutics
| increasing the risk of cancer due to some edited cells self-
| destructing once their genomes have been modified, leaving behind
| cells with a higher risk of cancer due to not being as sensitive
| to genomic edits. Have these challenges been overcome yet?
|
| [0]: https://www.scientificamerican.com/article/crispr-edited-
| cel...
| suifbwish wrote:
| Woah! So the cells that accept the CRISPR modifications do so
| because they have dysfunctional p53 gene activation. This most
| likely means they are specifically the cells most likely to
| become tumors if they undergo any mutations triggering
| carcinogenesis as p53 and its helper genes are mainly
| responsible for killing off cells that become cancerous among
| other things.
|
| This means that you can use CRISPR to selectively kill these
| cells only since they would be the only ones that easily accept
| and express the CRISPR modifications. This could be ground
| breaking if it is not already tried.
| DoreenMichele wrote:
| _"We are motivated to work toward a cure that can be accessible
| and affordable to patients worldwide,"_
|
| Sickle Cell is prevalent in some populations because the gene
| mutation is protective against malaria. (Probably only beneficial
| if you have one copy, not two.)
|
| I hope they will keep this in mind and work to eradicate malaria
| hand-in-hand with trying to eradicate the genes that are
| protective against it when they look to take it global.
| IIAOPSW wrote:
| "I would die for 2 brothers or 8 cousins". -JBS Haldane
|
| https://en.wikipedia.org/wiki/Kin_selection
| toomuchtodo wrote:
| There is a candidate mRNA malaria vaccine in the pipeline.
|
| https://blogs.sciencemag.org/pipeline/archives/2021/03/01/a-...
| yarcob wrote:
| > Probably only beneficial if you have one copy, not two.
|
| One copy of the gene partially protects you from malaria; two
| copies of the gene make you very sick.
|
| That's why even in Africa only a small portion of the
| population has the gene. The gene is an evolutionary advantage
| as long as the prevalence in the population is low. As soon as
| the frequency of the gene in the population goes up, it becomes
| a disadvantage because if both you and your partner have the
| gene your kid has a 25% chance of getting two copies.
| f6v wrote:
| That's right, but the sad truth is that those who will afford
| gene editing and those who are at daily risk of malaria are two
| very different groups of people.
| azernik wrote:
| This particular treatment does not affect the germ line. i.e.
| it corrects the defect in the patient, but they can still pass
| it on to their children, who would be (malaria-protected)
| carriers.
| maxerickson wrote:
| It's fine if they just figure out how to cure sickle cell
| anemia. Great even.
|
| No one will force people in areas where malaria is endemic to
| have sickle cell anemia treated, and a treatment for sickle
| cell anemia won't slow down treatment/eradication of malaria.
| DoreenMichele wrote:
| I'm sure no one actually forced mothers in developing
| countries to buy Nestle baby formula either. Babies died
| anyway.
|
| There are lots of sources out there. Here are just a couple.
|
| https://en.wikibooks.org/wiki/Professionalism/The_Nestl%C3%A.
| ..
|
| https://www.ranker.com/list/nestle-baby-formula-
| boycott/meli...
| maxerickson wrote:
| It's certainly not _impossible_ that governments of African
| countries would spend thousands of dollars per person to
| prematurely cure sickle cell anemia, but I think we can say
| that it 's _unlikely_.
| f6v wrote:
| > thousands of dollars per person to prematurely cure
| sickle cell anemia
|
| This cure is going to cost much much more. So highly
| unlikely.
| DoreenMichele wrote:
| The actions of African governments is not what concerns
| me here.
| maxerickson wrote:
| What other actors are going to give people unwanted bone
| marrow transplants?
|
| I guess medical companies testing the technology might do
| things to get people to participate in trials, but I'm
| not real sure people with sickle cell anemia would be mad
| about having to use modern anti-malarials instead of
| suffering with sickle cell.
| XorNot wrote:
| We're a hair's breadth away from using genetic engineering to
| make the mosquito extinct.
|
| We have the technology (gene drive) but scientists just aren't
| sure if we should do it.
| DoreenMichele wrote:
| They are right to have concerns.
|
| There was an island where they used poison to kill all the
| mosquitoes because it was a big problem. All the mosquitoes
| dies and then all the things that ate the mosquitoes died.
|
| And then all the things that ate things that ate mosquitoes
| died. And it went through a few more layers of this, like
| some modern day version of the Biblical plagues.
|
| That doesn't mean we shouldn't do it. It just means it is
| correct to not take the decision lightly.
|
| (Unfortunately, I've never found a good write up of this true
| story on the internet. I read it long ago back when dinosaurs
| roamed the earth and I had a bright yellow rotary phone and
| got information printed on dead trees.)
| Salgat wrote:
| Do you have a source for this? I linked below the best I
| could find, which makes no mention of any issues with them
| wiping it out.
|
| https://www.cnn.com/2019/07/18/health/asian-tiger-
| mosquitoes...
| DoreenMichele wrote:
| Possibly Sardinia:
|
| _The eradication of malaria helped Sardinia improve its
| public health programs and also paved the way for socio-
| economic development. But at a huge environmental cost
| that is incalculable. Some farmers accused the DTT of
| killing their livestock, bees and also fish._
|
| https://totalsardinia.com/malaria/
|
| _Sheepherders, fish farmers, and beekeepers blamed their
| dead sheep, dead fish, and dead bees on DDT spraying._
|
| https://www.wanderingitaly.com/blog/article/785/sardinia-
| and...
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819864/
|
| Edit: Odds are good I read about it originally in
| Reader's Digest in the late 1970s or early 1980s if you
| want to find a dead tree copy at a library.
| yardie wrote:
| Except there are multiple species of mosquito. Only 1 of
| them is a primary carrier for malaria. And if it disappears
| another mosquito in the family will replace it.
| est31 wrote:
| You don't have to extinguish all mosquito species. It's
| enough to only target those which can carry diseases.
| Ideally one would engineer mosquitos to avoid humans
| because of their smell.
| bamboozled wrote:
| Maybe we could also considering modifying ourselves to be
| less susceptible to mosquitos.
|
| Including helping people who live in poverty to have
| better housing and medicine so their less susceptible to
| Malaria ?
| incompatible wrote:
| Perhaps it would be possible to modify mosquitoes so that
| they don't need blood to reproduce. Other insects manage
| it somehow.
| jackson1442 wrote:
| Modifying ourselves leads into the messy territory of
| bodily autonomy and consent. You can see this pretty well
| in the anti-COVID-vaccine crew. I feel like it'd be much
| more popular to modify mosquitos than apply some
| modification to humans.
|
| Not to mention the ethical (regarding equity) concerns:
| disease from mosquitoes affects poverty-stricken areas
| the most, yet the people with the most access to these
| bodily modifications or procedures are going to be from
| wealthy countries.
| jcims wrote:
| Mosquitoes are a rather distinct element in the natural
| world and it just seems unlikely that we are capable of
| understanding the full set of downstream effects of
| eradicating them entirely.
| bamboozled wrote:
| I actually was talking about our behavior, not our actual
| genetics or biology.
|
| My understanding is that a lot of the diseases we want to
| kill mosquitoes for are also more likely to affect people
| in developing countries.
| andreareina wrote:
| There are few developed countries in the tropics.
| Singapore is one, and dengue is a concern here. I
| understand that the way it's mostly kept under control is
| through a lot of spraying, which isn't exactly great.
| grapecookie wrote:
| obviously this mutation would not last.
| Turing_Machine wrote:
| Right. There are thousands of species of mosquito, most
| of which don't carry human diseases.
|
| Of the ones that do, many of are of African origin --
| they evolved there along with us (and the diseases they
| carry). They are thus essentially invasive species in the
| rest of the world.
|
| The nice thing about potentially using CRISPR-based gene
| drives to extirpate (e.g.) Aedes aegypti is that it would
| affect _only that species_ , unlike our current
| pesticides which tend to kill insects of many different
| species indiscriminately.
| bamboozled wrote:
| Common sense must tell people that whether we like
| mosquitos or not, they're part of the food chain. A food
| chain which is already stressed due to climate change.
|
| Scientist who are eager to take out mosquitos sound more
| like kids who are eager to play with their new gene drive
| rather than consider the actual impacts.
| mNovak wrote:
| While I agree it's likely, 'common sense' is also not
| science and we shouldn't take as a given that they are an
| integral part of the food chain. Pest species do exist.
|
| Saving lives is generally a strong motivator, so it's
| worth considering the possibilities.
| tylermw wrote:
| No, scientists who are eager to take out mosquitos want
| to do it because it will save millions of lives. People
| have been dying of malaria for millennia--climate change
| has nothing to do with this particular issue/solution.
| bamboozled wrote:
| We're all very concerned, but we don't really spend very
| much money on Malaria treatments, relief and vaccines
| overall. Especially in the developing world. There isn't
| even really much urgency to do anything about it.
|
| No operation warp speed to help save hundreds of
| thousands of lives a year. It's almost just like a fun
| topic to make people feel better about themselves.
|
| I've read more about how transmission of malaria works
| and basically mosquitoes carry it from biting infected
| humans then pass it to other humans, it's not that
| mosquitos are evil, they don't even know what's going on.
|
| I think there is a question of ethics involved
| personally, that's because if mosquitoes had the power to
| wipe us out, we wouldn't be that happy if they decided to
| go ahead with the plan.
| Jedd wrote:
| This seems alarmist.
|
| The citation you provided elsewhere (for Sardinia) was for
| some DDT _spraying_ - which was obviously not targeted
| exclusively at mosquitoes, and explains why lots of other
| things died.
|
| Targeting the very small set of mosquito species (that
| carry malaria) with something that will wipe them out
| within a few generations (under 12 months) seems
| tremendously safe, because a) it's a small subset of the
| total mosquito population, b) you can test this in isolated
| (eg. island) environments, and c) by the very nature of
| this, rollback is easy -- once the species has died out
| locally, if needed you can quickly & safely re-populate
| with non-modified specimens.
| DoreenMichele wrote:
| It's not alarmist. Not by any stretch of the imagination.
|
| I'm an environmental studies major and I have a genetic
| disorder. I'm getting healthier when that is supposed to
| be impossible and it's in part because I'm an
| environmental studies major and I think of the body as a
| complex ecosystem.
|
| You kill one thing or change one thing and there are
| always myriad knock on effects. Always. Anytime you do
| anything that's actually at all effective, there is hell
| to pay.
|
| I am getting better by trading short term costs for long
| term gains, the exact opposite of what Western medicine
| typically does. We monetize disease by trading short term
| gains -- that doctors can claim credit for, justifying
| their fees -- for long term costs which we politely admit
| to with multi-page warning materials included with all
| drugs and then normalize largely ignoring that stuff and
| taking it anyway. Then when your condition gets worse,
| they blame it on your genes instead of on the side
| effects of the harsh drugs they have been poisoning your
| system with for years and years.
|
| It's possible to make targeted changes to an ecosystem,
| but it's not easy and even if you get it right, there are
| costs involved. Managing such change is hard and there
| tends to be hidden costs that the experts want to disavow
| responsibility for and they can generally get away with
| it because cause and effect can be hard or impossible to
| prove.
|
| I hope they cure Sickle Cell. I hope they eradicate
| malaria. Parasitic infections are pretty awful.
|
| I hope they do it in a way that doesn't involve millions
| of Africans being thrown under a bus so Westerners can
| feel like heroes while hand waving off the human costs
| for the locals which Westerners have a long history of
| running rough shod over on the excuse that we imagine we
| are superior to them or something.
| Jedd wrote:
| > You kill one thing or change one thing and there are
| always myriad knock on effects. Always. Anytime you do
| anything that's actually at all effective, there is hell
| to pay.
|
| I stand by my earlier claim.
|
| While I acknowledge the potential of unintended
| consequences, and the often surprising interconnectedness
| of many elements within an ecosystem, I further dispute
| the claim that any change necessitates other, exclusively
| bad, 'hell to pay' changes.
|
| Here I am, in rural Australia, and within a kilometre of
| me these are the pests that I would be ecstatic to get
| rid of, and that would have close to zero negative, and
| myriad positive, knock-on effects:
|
| prickly pear, tiger pear, heliotrope, pattersons curse,
| foxes, rabbits, several species of med fruit fly &
| mosquitoes.
|
| Almost all of these are guaranteed to have no negative
| knock-on effects simply because they were introduced here
| in the past two centuries.
| DoreenMichele wrote:
| Australia is like the poster child for unintended
| ecological consequences. All those introduced species you
| cite to refute my opinion I would cite to support it.
|
| Though the camel being introduced to Australia seems like
| something of a silver lining. From what I gather,
| Australia is now like a haven for the species.
| Jedd wrote:
| I'm interested in how you defend (if I'm reading that
| correctly) retaining those pests in Australia.
|
| Further afield from my humble abode, yes, Phytophthora,
| lantana, black rats, blackberry, feral goats / pigs /
| deer, cane toads, camels, etc.
|
| The reason we can export camels to the middle east is
| that when we imported them from there, we didn't import
| the various parasites that are now rampant in that part
| of the world.
|
| Perversely this gives us an export trade _and_ a
| massively out of control population of highly destructive
| and resilient beasts.
|
| If we could remove all wild camels from Australia over
| the space of 10 years you'd be hard-pressed to identify
| any net negatives, and certainly it'd be impossible to
| identify any negatives that were detectable when mapped
| onto a graph of the positive effects.
| DoreenMichele wrote:
| No, you are not reading that correctly.
|
| They are invasive species that exploded in Australia due
| to a lack of natural predators. How you can cite their
| existence as a refutation of anything I've said baffles
| me.
|
| I've been up excessively long. With any luck, I'll be
| asleep soon.
|
| Ciao.
| danmaz74 wrote:
| > Always. Anytime you do anything that's actually at all
| effective, there is hell to pay.
|
| Just the first counter examples that comes to my mind:
| "Western medicine" eradicated smallpox and polio; what
| was the hell price for those?
|
| "Western medicine" really only means medicine based on
| the scientific method, and shouldn't be conflated with
| the profit maximisation mechanisms which are so prevalent
| in the US medical system.
| DoreenMichele wrote:
| Overpopulation is one of the consequences of actually
| solving problems. Birth rates fall after mortality rates
| fall. The result is a bump in population size.
|
| This is a known phenomenon. It's very well documented.
|
| It's not a reason to keep letting people die, but the
| transition comes with costs.
|
| That's just reality.
|
| Antibiotics were supposed to be the end of disease. Now
| we are brewing antibiotic resistant infections.
|
| It's common for diseases to jump species when adequately
| threatened. Organisms don't like being eradicated and
| will fight back.
|
| You see more genetic mutations in diseases, fomenting
| resistance, when they are under pressure.
|
| We've lost some of the medical best practices I grew up
| with. I have no idea if that's directly related to the
| eradication of small pox or polio. I haven't specifically
| studied those cases.
|
| Change comes at a cost. That doesn't mean it isn't worth
| pursuing. It does mean that cavalier attitudes about how,
| _clearly_ , this is all upside have a tendency to be
| dangerous.
| danmaz74 wrote:
| There are cavalier attitudes on one side, and alarmist
| attitudes on the other side, and in my humble opinion
| saying that "Anytime you do anything that's actually at
| all effective, there is hell to pay" falls in the latter.
|
| What's the hellish consequence of eyeglasses?
| DoreenMichele wrote:
| _What 's the hellish consequence of eyeglasses?_
|
| That's a misreading of my statement that talks about
| killing a thing in an ecosystem and thereby upsetting the
| balance of the ecosystem.
| zo1 wrote:
| > _We 've lost some of the medical best practices I grew
| up with._
|
| Which practices are you referring to here?
| DoreenMichele wrote:
| When I was growing up, medicine was more focused on
| social elements. It more explicitly recognized that
| people spread disease from person to person.
|
| At one time, the way we stopped STDs was we took the
| names of all your recent hookups, contacted them and let
| them know they had been with someone who had just tested
| positive for a particular STD and offered them testing
| and treatment.
|
| In my teens, the AIDS crisis hit. In the US, it was
| mostly associated with gay men and IV drug users. These
| populations had reasonable concerns about giving a list
| of contacts to authorities and pushed for drug research
| and stronger privacy policies.
|
| My understanding is we largely no longer use this proven
| method of stopping the spread of most STDs.
|
| I can also remember going to a doctor with a sibling and
| a couple of cousins and all of us getting treated so that
| the issue wouldn't just go round and round through the
| family. I feel like that was a fairly common practice at
| the time and we mostly don't do stuff like that anymore.
|
| Historically, doctors did house calls and were one of the
| smartest, best educated people in town and towns were
| relatively small. They could address issues that helped
| contribute to your medical problem beyond just
| prescribing drugs and surgeries.
|
| Now we act like human beings are specimens in a petri
| dish and like their physical health is unrelated to their
| lifestyle or the fabric of their life.
|
| I think this is a big problem. The phrase "We've thrown
| out the baby with the bathwater" comes to mind but
| doesn't quite fit.
|
| What we've done is tossed aside wisdom and context to
| worship at the alter of ooh shiny diagnostics. The high
| tech diagnostics are useful but the largely unnoticed
| loss of wisdom and context is a serious problem and we
| aren't even trying to solve it because we mostly haven't
| noticed that it matters.
| Dig1t wrote:
| I think about this a lot.
|
| What's to stop some random, non-scientist, group of people
| from just doing this? Mosquitos are pretty evil..
| maxerickson wrote:
| If you make a gene drive you are a scientist.
|
| Hopefully whoever decides to just go do it has the sense to
| only target mosquitoes that preferentially feed on humans.
| Much less ecosystem impact that way.
| danielheath wrote:
| > If you make a gene drive you are a scientist.
|
| These days, introducing a known mutation via a CRISPR
| gene drive is engineering. The hard part is scaling it so
| your mutation doesn't die out, testing to ensure that it
| is actually propagating, etc.
|
| > Hopefully whoever decides to just go do it has the
| sense to only target mosquitoes that preferentially feed
| on humans.
|
| You have to repeat a considerable amount work for every
| single target species. I highly doubt they'd target more
| than one.
| maxerickson wrote:
| There's several species that preferentially feed on
| humans and we've done a banger spreading them around.
| grishka wrote:
| The frogs gotta eat something.
| XorNot wrote:
| The general consensus at the moment is that there's no
| apparent food chain where mosquitos are the primary source.
| AlotOfReading wrote:
| Except for places like the arctic, where they're
| basically primary pollinators and a food of choice for
| most predatory insects.
| learc83 wrote:
| Do all the species of mosquitoes your talking about feed
| on humans, and do they carry malaria?
| AlotOfReading wrote:
| Yes and yes?
| Turing_Machine wrote:
| No, they don't.
|
| The (many) species of mosquito found in the Arctic do not
| carry malaria. Malaria is largely a tropical and
| subtropical disease.
| AlotOfReading wrote:
| Avian malaria is endemic to Alaska, and both Finland, and
| Siberia formerly had endemic human malaria, especially
| the more southern regions. Something up there is
| definitely capable of being a vector for it.
| learc83 wrote:
| But is malaria a big enough problem in the arctic to
| bother targeting the mosquito species there that _could_
| carry malaria? From a quick Google search, I 'm guessing
| no.
| BurningFrog wrote:
| What's talked about is only making the 30-40 of the 3500
| mosquito species that carry malaria extinct.
|
| Ecologically, they can normally be replaced by some of the
| 3460 others.
| jostmey wrote:
| I've learned a lot about gene therapy. The immune system is a
| major bottleneck to wide spread gene therapy. If you modify the
| genetic makeup of cells in your body, the immune system will
| recognize the new antigens being presented by these cells and
| attack. Many gene therapy target point mutations that don't
| require significant alterations to correct that would alarm the
| immune system.
| amelius wrote:
| Don't point mutations cause proteins to fold differently? And
| thus causing the proteins to become globally different rather
| than locally different?
| jostmey wrote:
| 1. Most point mutations won't result in significant changes,
| but if we are talking about gene therapy, the specific point
| mutation probably did effect protein folding or function 2.
| Proteins in each cell are broken down into unfolded fragments
| and presented on major histocompatibility complexes as
| antigen.
| f6v wrote:
| It's also that we don't have organism-scale models of how
| change in one gene will affect other body functions. We don't
| know how to build these kind of models and we don't have even
| 1% of the data to do that. Organoids are just emerging, but
| they aren't 1:1 representation of what happens in real human.
| doubtfuluser wrote:
| For my understanding: crisper works by cutting the dna at
| specific points surrounding the relevant part and then
| exchanging, right? How likely is it, that in the whole DNA string
| there are other instances this "surrounding" matches and would be
| cut? How is this prevented / not causing side effects?
| yarcob wrote:
| The nice thing about CRISPR is that you can use pretty long
| sequences for matching, so in theory you can just pick a
| sequence that doesn't occur anywhere else and cut there.
|
| (Before CRISPR, you would use restriction enzymes with a short,
| fixed recognition sequence, typically 4-6 base pairs [1]. In
| that case it was a bit tricky to find the right enzyme that
| cuts the DNA in the right place, and not in an unwanted place.
| And you couldn't just cut the DNA in any place you want.)
|
| [1]:
| https://en.wikipedia.org/wiki/List_of_restriction_enzyme_cut...
| julienreszka wrote:
| DNA has something like "Bytes"
|
| Clustered Regularly Interspaced Short Palindromic Repeats
| doggodaddo78 wrote:
| Is there more than one cause of sickle cell?
| [deleted]
| xiphias2 wrote:
| Hasn't Vertex already run an experiment on people and cured
| sickle cell disease using CRISPR last year? What's new here
| (except that the organizations are different)?
|
| https://sicklecellanemianews.com/ctx001-sickle-cell-disease
| maxerickson wrote:
| That trial deactivated a gene (causing a different one to be
| more active).
|
| This trial is inserting/editing a gene.
| xiphias2 wrote:
| Thanks!
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(page generated 2021-04-08 23:02 UTC)