[HN Gopher] Deaf girl is cured in world first gene therapy trial
       ___________________________________________________________________
        
       Deaf girl is cured in world first gene therapy trial
        
       Author : belter
       Score  : 405 points
       Date   : 2024-05-09 11:38 UTC (11 hours ago)
        
 (HTM) web link (www.independent.co.uk)
 (TXT) w3m dump (www.independent.co.uk)
        
       | sneilan1 wrote:
       | Is this an application of CRISPR?
        
         | bglazer wrote:
         | No, this is an adeno-associated virus (AAV) gene insertion. An
         | engineered version of a naturally occurring virus inserts a
         | working copy of the OTOH gene into the genome of cells in the
         | inner ear.
         | 
         | EDIT: I was incorrect. It seems that the virus doesn't actually
         | does not insert itself into the genome. Instead it forms a
         | circular DNA loop (episome) in the cell that is like an extra
         | chromosome. The normal DNA reading machinery can make RNA from
         | the circular DNA loop just like it can from a normal
         | chromosome, so you get working proteins. The benefit is that
         | you don't risk inserting the viral DNA into a normal chromosome
         | at a spot in the DNA sequence that would break some other
         | protein. This is the main difference from CRISPR. CRISPR is
         | designed to directly alter genomic DNA.
        
           | m1n1 wrote:
           | And regular cell-division will include this episome the way
           | it does the regular chromosomes?
        
       | tyingq wrote:
       | Is "auditory neuropathy" something where there isn't any other
       | existing treatment that directly addresses the issue versus
       | compensating for it (like cochlear implants)?
        
         | dotnet00 wrote:
         | The 'neuropathy' part is meant to imply that the issue isn't
         | with the hearing mechanism itself, but rather with the part
         | that allows the mechanism to communicate with the brain. In
         | this case, the expression of a specific gene causes the
         | creation of a specific protein which plays a role in the
         | transmission of audio to the brain. This gene was either not
         | present or malfunctioning, so they added the proper gene
         | manually.
        
       | foobarian wrote:
       | This is a pretty insensitive title considering that the deaf
       | community does not consider the lack of hearing a disease. "Deaf
       | girl's hearing restored..." perhaps better.
        
         | knicholes wrote:
         | The deaf community considers the lack of hearing a disability
         | when it means they get federal financial assistance, though,
         | don't they? It can't go both ways.
        
           | soperj wrote:
           | a disability isn't a disease.
        
             | s_dev wrote:
             | If a disability means anything it means acknowledging you
             | need 'help' in some form.
        
               | eyelidlessness wrote:
               | If a condition can be applied to the human experience
               | writ large--needing help in some form--you might consider
               | that "disease", but you'd be _deeply_ into the territory
               | of existential philosophy and /or hyperbole.
        
         | screye wrote:
         | Science doesn't (and shouldn't) care for how people socialize
         | around a disability.
         | 
         | I recognize the power and a reclaimed self worth that comes
         | with reframing narratives around deafness.
         | 
         | The lack of hearing is a disease. Because diseases are
         | nominatively about being at dis-ease. As long as it's difficult
         | for deaf people to socialize with those who outside the
         | community, it dis-eases them.
        
           | anthony__j wrote:
           | like someone mentioned in a separate comment, you are
           | conflating disease with disability here. when people become
           | too old to walk without assistance, you wouldn't say that
           | they have a walking disease.
        
             | Aurornis wrote:
             | > like someone mentioned in a separate comment, you are
             | conflating disease with disability here. when people become
             | too old to walk without assistance, you wouldn't say that
             | they have a walking disease.
             | 
             | This girl's disease was a genetic auditory neuropathy.
             | 
             | They cured her genetic auditory neuropathy.
             | 
             | Pedantic arguments about what it's called are missing the
             | point. The person had a specific disease. It was cured.
        
               | anthony__j wrote:
               | to you, this is a pedantic argument. but to millions of
               | Deaf people in the US alone, this is a very important
               | political point. for example, lots of Deaf people who
               | prefer to live without cochlear implants face lots of
               | pressure from people who consider deafness to be a
               | "disease" to be "cured", when in fact, they feel their
               | most authentic way of living to be something different.
               | in this way, language is significant
        
               | macksd wrote:
               | And people who do prefer to live with cochlear implants
               | face pressure from the deaf community itself. You can't
               | win. This was an achievement. A girl who probably saw
               | this as a cure, saw success. Why can't we just be happy
               | for her instead of detracting because others wouldn't
               | make the same choice?
        
               | wizzwizz4 wrote:
               | 18-month-olds don't usually have opinions on what does or
               | doesn't count as a 'cure': that's a bit too abstract for
               | most of them. Their parents can.
        
             | TeMPOraL wrote:
             | > _when people become too old to walk without assistance,
             | you wouldn 't say that they have a walking disease._
             | 
             | Why not? We have some peculiar cultural memes related to
             | accepting the inevitable end of life, which we perhaps
             | should revisit. I see no reason to not consider _aging
             | itself_ as a slow-burn disease, one we 'll hopefully cure
             | at some point too.
        
               | xhevahir wrote:
               | "Peculiar cultural memes" is an odd way of describing a
               | piece of advice that one encounters so frequently in
               | cultures the world over.
        
               | TeMPOraL wrote:
               | Well, peculiar _now_ , given the understanding of biology
               | we gained over the last 70-ish years. Individually, it
               | still makes sense, but at social level, it stops us from
               | working on fixing the problem.
        
         | dotnet00 wrote:
         | Her condition is a genetic disorder, which is a kind of
         | disease. The deaf 'community' consists of many kinds of
         | deafness, some are not diseases, others are. Some of those
         | diseases cannot be cured, others are trivial to cure.
         | 
         | In the same way there are many different kinds of cough, some
         | due to diseases, others not, some curable, others not, yet no
         | one pretends it's offensive to talk about curing a cough. This
         | weird excessive sensitivity to language accomplishes nothing.
        
           | anthony__j wrote:
           | im being a little extra in replying here, but only because i
           | used to think like many people in this thread until i met
           | more people living with deaf and blindness, and i realized
           | that i had a big (pun unintended) blind spot in my cultural
           | understanding about disability.
           | 
           | being deaf means that you live in a wholly separate world
           | compared to a hearing person, and it changes the way you
           | understand things- its a whole separate culture, as rich and
           | complicated as any other. it does not compare to a cough, and
           | many would find such a comparison very insensitive. for an
           | example, i would check out the movie "The Sound of Metal"
        
             | dotnet00 wrote:
             | I was expecting this sort of comment, but everyone lives in
             | their own world with their own culture and perspective,
             | especially given the large immigrant populations in the
             | West. Yet, the vast majority of people get by not being
             | offended over phrasings that they could take as offensive
             | to their cultural sensibilities if they really wanted to.
             | 
             | I remember being taught a similar thing as a child, about
             | referring to people with disabilities as 'differently
             | abled' instead of 'disabled', and similarly in my home
             | country the government has made an effort to change the
             | word for disability from one which means "improperly able"
             | to "blessed" (poorly translating). But the former has not
             | stuck, and the latter has not changed how poorly disabled
             | people are treated there. Ultimately the changes turned out
             | to be little more than feel-good virtue signaling.
             | 
             | In the same way, what does not using the word 'cure'
             | accomplish in practice? Some word needs to be used in its
             | place, which will take on the same meaning and in a few
             | years people will be getting offended over that too (as any
             | way of putting it will convey the reality that deafness is
             | considered abnormal to the typical human experience). See
             | the progression of terms that are seen as insults to one's
             | mental faculties as a prominent example, even just within
             | the last 20 years of online discourse that I've been around
             | for, we've cycled through variations of retard (tard, reet
             | etc) and are now in the process of doing the same thing
             | with autistic (with the emergence of euphemisms like
             | 'artistic') since the former is now deemed a slur.
             | 
             | Or, using a less provocative example, we don't change our
             | language to be accommodating of religious communities who
             | consider certain things to be insulting to their strongly
             | held values or beliefs. We rightly point out that facts are
             | more important than their feelings, regardless of how many
             | hundreds or thousands of years old their culture and
             | beliefs are.
             | 
             | Edit: If coughs are insensitive, we can instead look at
             | tumors. There are many types in all parts of the body, some
             | are so benign that they can be ignored, others are curable,
             | others are cancerous and still curable, and yet others are
             | so cancerous they are quickly terminal. Additionally,
             | people afflicted with them tend to form a community due to
             | shared experience. But would we stop talking about tumors
             | colloquially as something which needs to be 'cured' because
             | a portion of those in the community don't want to (or
             | can't) get theirs cured?
        
         | porterbeats wrote:
         | I'm deaf in one ear and 70db loss in the other, just wanted to
         | say nobody cares what you call it as long as you aren't an
         | asshole about it. Being pediatric helps nobody
        
           | SliceOfWaifu wrote:
           | You mean pedantic.
        
           | pugworthy wrote:
           | Did you mean pedantic (annoyingly corrective) or pediatric
           | (child(ish))?
        
             | jtbayly wrote:
             | I laughed reading that as it worked so well as a typo.
        
             | projektfu wrote:
             | pedantically, pediatric means child (paithi) doctor
             | (iatros) -ish... Apologies for the transliteration into
             | latin letters.
        
         | 7thpower wrote:
         | What if ones being deaf is a symptom of a disease?
        
         | anthony__j wrote:
         | i thought this as well! you wouldn't say "autism cured". to
         | many this must seem like a semantic argument, but Deafness is
         | an entire culture and identity with hundreds of years of
         | history
        
           | vsuperpower2020 wrote:
           | They can call it anything they want, but the moment they
           | leave their "culture" and try to police our language they
           | have to justify it on facts and not just assert that they
           | feel a certain way. It's completely irrelevant to medicine if
           | they have a culture or identity based around their
           | disability.
        
         | Aurornis wrote:
         | > the deaf community does not consider the lack of hearing a
         | disease
         | 
         | The treatment addressed a specific disease: A genetic auditory
         | neuropathy.
         | 
         | It's in the subheading which is the second line when you click
         | the link.
         | 
         | You're really stretching to suggest that they are trying to
         | imply that all "lack of hearing" is a disease when even the
         | headline talks about gene therapy and the sub heading makes it
         | clear that it was a specific genetic disease.
         | 
         | This is a case of unnecessarily bringing drama to a situation
         | that doesn't even represent that drama.
        
         | lioeters wrote:
         | I used to live in Texas near the biggest deaf school in the
         | U.S. From my understanding, some people in the deaf community
         | do consider the word "cured" to be offensive because they don't
         | consider their condition to be a disease.
         | 
         | I don't know if that's the dominant view and preference, but
         | _if_ that 's the case, perhaps we should all learn to respect
         | their culture, as much as we're all learning to respect (up to
         | some point) people's self-identified identities, preferred
         | pronouns, etc. It's a matter of education and cultural change
         | so that more people are aware and respectful.
         | 
         | For those saying that science should not consider people's
         | preferences, that's true but _communicating_ about science
         | definitely should. At least up to some point where they 're not
         | offending a large number of people.
         | 
         | (..Hmm, but should they really? What about religious people who
         | are offended by the idea of evolution..)
        
           | anthony__j wrote:
           | this is great thinking. to me, the line to be drawn has a lot
           | to do with lived experience. talking about deafness involved
           | lots of people who live their entire lives affected by
           | deafness, while discussing evolution affects peoples
           | spiritual beliefs, which i see as largely a personal (if
           | cultural) choice.
        
             | lioeters wrote:
             | I guess it's a touchy topic these days. Some believe we
             | shouldn't cater to people's beliefs and choices (is
             | identity a choice? up to a point..); and especially not
             | cater to what people might find offensive. I understand
             | their point, because there are people who are overly
             | sensitive and are offended by many normal things.
             | 
             | The use of the word "cure" in this context is a perfectly
             | logical choice of wording. Should we even consider whether
             | some deaf people are offended by this word? It seems like
             | the polite thing to do, but maybe it's a slippery slope
             | that compromises the objectivity of science and clear
             | communication of scientific findings.
        
           | southernplaces7 wrote:
           | >I used to live in Texas near the biggest deaf school in the
           | U.S. From my understanding, some people in the deaf community
           | do consider the word "cured" to be offensive because they
           | don't consider their condition to be a disease.
           | 
           | And if these some people want to view it that way to help
           | themselves feel better or for whatever personal motives,
           | that's their right. However, nobody else should be obligated
           | to suspend a rational assessment of reality because of how it
           | might offend anyone's emotional and irrational notion.
           | 
           | Whether it comes from a disease, and accident or something
           | congenital, deafness is certainly at least a defect in normal
           | human function and needs to be recognized as such by those
           | who could strive to eliminate it as a problem.
        
           | TeMPOraL wrote:
           | Respect has degrees too. The issue gets thorny when, every
           | now and then, a story pops up about some members of that
           | community who want to deny their children interventions that
           | would allow them to hear, or worse, want to intervene to take
           | away their hearing, so they can fit in the same community as
           | parents.
        
           | boxed wrote:
           | The same people who say we should respect deaf culture or
           | trans rights are the same people who got super offended at
           | transracial people
           | (https://en.wikipedia.org/wiki/Rachel_Dolezal).
           | 
           | I can't take this too seriously. Either you accept
           | transracial, transsexual, and amputee wannabees, or you
           | don't. I do. Activists generally it seems don't, or at least
           | the ones screaming the loudest.
           | 
           | We can also all admit that something is a disorder and still
           | accept those people for who they are. You don't have to go
           | all crazy and try to ban homosexuality. And you don't have to
           | go crazy and try to destroy Rachel Dolezal. We can be
           | respectful.
        
         | Chris2048 wrote:
         | Did the title change, because can't disabilities also be
         | "cured"?
        
         | kwhitefoot wrote:
         | The girl in question was not part of 'the deaf community',
         | She's less than two years old, her community is her family.
        
         | xhevahir wrote:
         | I don't agree with this point of view, but people with hearing
         | shouldn't be so quick to dismiss it. Deaf people raise it every
         | time medicine makes an advance in restoring hearing.
         | 
         | Oliver Sacks has written interesting things on this subject
         | btw.
        
       | thehappypm wrote:
       | I'm optimistic that at some point, I'll be able to get a
       | treatment to take care of my red green color blindness.
       | 
       | I'm well aware that it's very much a first world problem, and
       | rightfully should be very low on the totem pole of medical issues
       | to cure.
       | 
       | But goddamnit, I want to see red.
        
         | moduspol wrote:
         | If it makes you feel better, red is overrated.
        
           | noman-land wrote:
           | I think it's rated pretty appropriately.
        
             | santoshalper wrote:
             | I think whatever it is rated, by definition, is the
             | appropriate rating.
        
           | AuryGlenz wrote:
           | Sure. Green though? It's the best.
           | 
           | You know, I've never thought of this: does anyone with a type
           | of color blindness consider their "favorite color" to be the
           | ones they can't distinguish?
        
         | silverquiet wrote:
         | I don't really know enough of the medical details - I thought
         | people with color blindness lacked the proper receptors in
         | their eyes, so it's not like in the article where a connection
         | is restored; you'd have to grow new infrastructure in the eye
         | which seems a bit more complicated. Nevertheless, would be very
         | cool if possible - I know lots of men with color blindness.
        
           | coolspot wrote:
           | Instead of modifying existing eyes, they should grow
           | additional one/two.
        
           | thehappypm wrote:
           | It's the cones in the eye -- they have a defect and make them
           | less receptive to red wavelengths. If you gene-edited them,
           | you could have new cells without that defect.
        
           | ggreer wrote:
           | In color blindness, the cone cells produce an incorrect opsin
           | protein that isn't sensitive to red (or is sensitive to a
           | frequency close to green). Gene therapy would fix that,
           | though it'd probably take a while for the brain to understand
           | the new information.
           | 
           | The main reason this therapy isn't available is because the
           | FDA has decided that the risks of gene therapy aren't worth
           | the benefit of curing color blindness. I agree with that
           | evaluation, but I also think mavericks should be allowed to
           | try curing their own colorblindness (assuming they had
           | informed consent and paid for the therapy themselves).
        
             | trebligdivad wrote:
             | The 'though it'd probably take a while for the brain to
             | understand the new information' is an interesting question;
             | on one hand people say you need to fix stuff early in
             | development while the brain is still very plastic (so great
             | for this kid); but then again there is that demo of people
             | getting used to vertically flipped vision with weird
             | glasses; so perhaps something is flexible?
        
               | adgjlsfhk1 wrote:
               | yeah I'd be pretty surprised if your brain didn't figure
               | it out in a week.
        
               | wizzwizz4 wrote:
               | The brain is good at re-mapping things where it can make
               | a distinction, but it seems to only learn distinctions in
               | so-called "critical periods". See doi:10.1038/228477a0
               | for a famous 1970s experiment on the subject.
        
               | lupire wrote:
               | There are lots of examples. Phonemes for language and are
               | a very common example of things that can't be learned
               | easily or at all later in life.
               | 
               | But huge changes like a major color might overcome that.
               | Humans learn to recognize new major objects they've never
               | seen before.
        
             | derefr wrote:
             | > I agree with that evaluation, but I also think mavericks
             | should be allowed to try curing their own colorblindness
             | (assuming they had informed consent and paid for the
             | therapy themselves).
             | 
             | I mean, what's stopping you? This guy cured his own lactose
             | intolerance: https://www.youtube.com/watch?v=J3FcbFqSoQY
             | 
             | But I'm guessing -- in part because you say "paid for the
             | therapy" -- that you don't really mean "should be allowed
             | to cure their own colorblindness"; but rather "should be
             | allowed to buy a colorblindness treatment from a vendor of
             | such" or maybe "should be allowed to request a prescription
             | of a colorblindness treatment from a doctor who acquires it
             | from a vendor of such."
             | 
             | And you're already also allowed to do _that_ -- in theory.
             | The FDA doesn 't care about people _buying_ medical
             | treatments. It cares about companies _selling_ them.
             | Because companies are profit-focused, and the quickest way
             | to money in medicine is to lie.
             | 
             | For you to be able to get what you want, there'd have to be
             | an intermediate category that stops just shy of the current
             | "FDA-approved medical therapy" category. For a treatment to
             | qualify for this category, it would still have to pass both
             | safety and efficacy studies. The only thing that would be
             | different, is that the FDA wouldn't _weigh_ the safety vs.
             | the efficacy of the treatment at the end; but instead just
             | put an absolute minimum threshold on both safety and
             | efficacy, and leave the prescriber to determine whether the
             | safety risk outweighs the efficacy.
             | 
             | But think about that word "prescriber." This would
             | certainly allow people motivated to do this to go to their
             | doctors and ask for such treatments specifically. But it
             | would also enable _doctors_ to _choose_ such therapies for
             | their patients, without the patient being previously aware
             | of the treatment option.
             | 
             | And doctors can be bought. (See: doctors prescribing on-
             | patent drugs when equally-effective generics are available;
             | doctors adding on unnecessary adjunct therapies because a
             | sales rep convinced them they should "give it a try"; etc.)
             | 
             |  _Do_ you want to live in a world where there 's no ability
             | for regulatory bodies to set a safety:efficacy-ratio
             | threshold on a doctor's ability to prescribe drugs to
             | patients? A world where a (bad) doctor might prescribe a
             | drug that has a huge risk for very little chance of
             | success, and all they have to do is put a consent form in
             | front of the patient for the huge risk -- without even
             | having to explain the low-efficacy part?
             | 
             | (Honest question. Some people might very well prefer such a
             | world.)
        
               | devilbunny wrote:
               | FWIW, doctors usually specify brands over generics when
               | it actually matters if you have the same supplier every
               | time. Bioavailability of generics is +/- 20% compared to
               | the original branded drug by law in the US. So if you
               | have a legal, generic drug here, it might be a 120% one,
               | and your next refill might be an 80% one - you just got a
               | 1/3 reduction in dose without warning. And if you have
               | seizures? That's a bad thing.
               | 
               | My wife is a neurologist. She deals with this. I'm an
               | anesthesiologist; I just give more as needed because my
               | patients don't take their own drugs. Almost everything I
               | give is generic, and the exceptions are when those fail.
               | 
               | You can make a very good living as a physician in the US
               | without being a whore. Not worth my moral sense to make a
               | few more dollars that won't go to me directly anyway.
               | Sure as hell not worth it to her; she's a hospital
               | employee.
        
               | lupire wrote:
               | True but it's not +-20%, it's "90% confidence interval of
               | the mean is within +25%/-40%" which puts the dose much
               | closer to 100% in practice.
               | 
               | https://www.pharmacytimes.com/view/debunking-a-common-
               | pharma...
               | 
               | Still, these measured %ages should be much more explicit
               | in the actual delivered drugs and in the range of values
               | that are determined safe. There are plenty og drugs where
               | double dose is fine and the therapeutic dose is "let's
               | experiment on every patient evey day to see what works".
        
               | devilbunny wrote:
               | Thanks, that's good to know.
               | 
               | Antiepileptics are a very special category of drugs in
               | that respect - they really do need to be right on target
               | every time. I know a neurologist with epilepsy - not my
               | wife - and he takes branded Zonegran. Thyroid hormone
               | supplements are similar although the consequences are
               | much lower (you're not going to accidentally kill anyone
               | in a car wreck if your thyroid hormone is low).
        
               | kelnos wrote:
               | That's a really tough one. I just watched the lactose
               | intolerance fix video you linked. Certainly that
               | fabrication process is beyond my ability. But, after more
               | of my own research, maybe I'd decide I want to pay
               | someone else to produce the therapy for me. (I'm not
               | anywhere near as lactose intolerant as the guy in the
               | video, but it's bad enough that I'd be happy to rid
               | myself if this problem.)
               | 
               | But should I be able to do that? Am I capable of
               | evaluating the risks? Am I capable of even enumerating
               | the various risk factors? This is not my field at all.
               | Maybe the person making this for me is doing it in an
               | unsafe manner, in a way that could result in dangerous
               | contamination. How would I know?
        
             | scottlamb wrote:
             | > The main reason this therapy isn't available is because
             | the FDA has decided that the risks of gene therapy aren't
             | worth the benefit of curing color blindness. I agree with
             | that evaluation, but I also think mavericks should be
             | allowed to try curing their own colorblindness (assuming
             | they had informed consent and paid for the therapy
             | themselves).
             | 
             | In what way do you agree with that evaluation then? The FDA
             | certainly doesn't force anyone to undergo a treatment. And
             | my understanding was the FDA doesn't decide who pays for a
             | given treatment. In particular I don't think they define
             | what medical insurance companies (or Medicare/Medicaid)
             | have to pay for, do they? I think they just say whether the
             | treatment is ethical to be performed at all. So when you
             | say that mavericks should be allowed to try it, I think
             | you're simply disagreeing with them?
        
             | Ballu wrote:
             | Could you provide the ref/details of this particular gene
             | therapy and FDA views? I can understand why the FDA wants
             | to move ahead slowly unless the condition is life-
             | threatening or the impact is life-changing.
        
         | delinom wrote:
         | Have you tried color blindness glasses (e.g. EnChroma)? I am
         | not familiar with them but some reaction videos were pretty
         | heartwarming.
        
           | tantalor wrote:
           | Those videos are fake the glasses don't do very much.
           | 
           | https://www.youtube.com/watch?v=RY-NF_7R-pk&t=559
        
             | swozey wrote:
             | Well that was eye opening
        
             | yakovsi wrote:
             | Colorblind person here. This debunking video is piling on
             | more BS, like oh, colorblind people learned to be amazing
             | at detecting slight color changes! No, we are not. We
             | learned what names are attached to what color, but we see
             | them differently, much poorer (save for blues). Enchroma
             | apparently helps with separation, as parent comment
             | suggests. That being said, the fake dramatic videos are
             | definitely shameful scam, agreed.
        
               | jerf wrote:
               | What boggles my mind a bit is that true colorblindness
               | glasses don't seem that difficult to me. Standard red-
               | blue 3d glasses _almost_ do it, it 's just you need red-
               | green differentiating glasses. I don't think this would
               | Open the World of Color!, but it would with a bit of
               | practice probably allow you to at least perceive a
               | difference.
               | 
               | But the glasses need to be visibly-differently (to a non-
               | color-blind person) tinted. If they look the same,
               | they're not going to work. Just like a "blue-reducing"
               | pair of glasses _needs_ to look visibly yellow, or it
               | clearly (in all senses of the term) isn 't doing
               | anything.
               | 
               | A truly optimal pair would take some sciencing but
               | bashing something prototype-quality with something like
               | https://www.amazon.com/dp/B0928YT83C would be a matter of
               | holding up the cyan-ist of the films up to one eye and
               | the magenta-ist of the films to the other, and looking at
               | some red and green things, concentrating on which eye the
               | object is bright in.
        
               | lupire wrote:
               | RB 3GD glasses _remove_ color to create a different
               | image. I don 't see how that would generalize to _add_
               | color.
        
             | achenatx wrote:
             | Im red green colorblind. When wearing my enchroma, some
             | things I thought were brown are actually very red.
             | 
             | On the other hand green lights lose their green.
             | 
             | On a day to day basis I can functionally see red and green,
             | but sometimes when a red or a green is next to a brown I
             | cant distinguish them.
             | 
             | And versions of red that regular people might have a hard
             | time distinguishing would be impossible for me to
             | distinguish.
        
           | thehappypm wrote:
           | I have, yes. I can describe it sort of like this:
           | 
           | Imagine you're watching a black-and-white movie on an old TV,
           | and it looks kind of washed out. You fiddle with the
           | contrast, and suddenly the movie looks much crisper and with
           | better contrast. You're not actually seeing more colors --
           | its just grayscale -- but you can optimize it to give you
           | more depth of perception.
           | 
           | That's what EnChroma does. It doesn't actually make you see
           | red, but it heightens the contrast to make it stand out more.
        
             | delinom wrote:
             | That's what I imagined it to be, a slight improvement but
             | obviously no miracle.
        
             | itslennysfault wrote:
             | So, does it just look like different green? Like still
             | green, but you can tell it apart from "true" green? Like
             | wearing them could you pass a colorblind test even though
             | you still can't see red?
        
               | 93po wrote:
               | i can see reds and greens, but very similar shades next
               | to each other, i can't tell. i also can't see either
               | color very well when it's a really small sample size (for
               | example, the green under my power switch on my wireless
               | mouse to show that it's on).
               | 
               | the way i think about it is that people who aren't
               | colorblind have a maximum green value that is much higher
               | than mine. the enchroma glasses, which i've tried,
               | effectively make greens more green. i feel like it makes
               | things inaccurately colored, but exaggerates colors
               | enough to be able to better differentiate. i still can't
               | see past my "maximum green" value though, which is why
               | those marketing videos of people crying are total
               | bullshit. it just looks like a very saturated instagram
               | filter. it doesn't make me see colors i haven't seen
               | before.
               | 
               | i didn't try a color blindness test with them but i
               | should have. the best memory i have of using it is that
               | it was fall time and the leaves on a bush in my yard were
               | turning red, but i had no idea until i put the glasses
               | on, and i could distinctly tell which leaves were turning
               | and which weren't.
               | 
               | i liked them and wanted to keep them, but i couldnt
               | justify the $220 price or whatever it was, so i returned
               | them. i want to get another pair some day
        
           | yieldcrv wrote:
           | > but some reaction videos were pretty heartwarming
           | 
           | shameful marketing campaign
        
           | bongodongobob wrote:
           | I've tried them, they kind of make reds pop a little more.
           | 
           | But imagine this. You put on a pair of pink tinted glasses to
           | fix your vision. Ok great, but everything is tinted now. I
           | don't find it pleasing at all. My normal is my normal,
           | putting tinted glasses on me doesn't make things look better,
           | it looks wrong.
        
         | tejtm wrote:
         | And I want to see UV like our proto progenitors, enough of
         | these little brown birds we can't tell apart.
        
           | jfengel wrote:
           | The problem there isn't your receptors, which are UV
           | sensitive. The problem is your lens, which filters it out.
           | Remove the lens and you can see UV just fine.
           | 
           | Until you get eyeball cancer, that is. UV is mutagenic.
           | That's why you filter it out.
           | 
           | People with cataracts get replacement lenses, and some exist
           | that don't filter the UV. I think they're hard to get, what
           | with the whole "eyeball cancer" thing. But if I get to my 70s
           | and need replacement lenses (I do have a family history), I'm
           | going to campaign to see if I can spend a couple of decades
           | looking at the pretty birdies.
        
             | foota wrote:
             | Are you eyes more sensitive to UV than the rest of your
             | body?
             | 
             | I guess melanin absorbs UV in the skin, so this serves a
             | similar purpose in the eye?
        
               | Analemma_ wrote:
               | I'm not sure about more sensitive, but I know the immune
               | system (which cleans up a lot of pre-cancerous cells
               | before they become a problem) is much less active in the
               | eyeball, so it probably pays to have extra defense
               | against cell damage.
        
               | lupire wrote:
               | "Sensitivity to light" is the primary function of the
               | eye.
        
             | capitainenemo wrote:
             | It's not just cancer right? UV light will damage those
             | sensitive photoreceptor cells, so you would end up seeing
             | less and less of anything over those couple of decades.
             | Even non-UV blue light is hard for the eyes to deal with.
             | Personally I'd just prefer wearing glasses that shift the
             | UV to some other part of the spectrum.
        
               | eternauta3k wrote:
               | > Personally I'd just prefer wearing glasses that shift
               | the UV to some other part of the spectrum.
               | 
               | Does this exist? I thought those kinds of non-linear
               | effects only happen at extremely high fields (e.g. with a
               | very fast pulsed laser to concentrate energy in time)
        
               | bongodongobob wrote:
               | No, at least not without active electronics.
        
               | capitainenemo wrote:
               | Fluorescence?
        
         | dekhn wrote:
         | I am really curious what the subjective experience of a color-
         | blind person undergoing gene therapy gradually being able to
         | perceive the difference between two colors that previously
         | appeared the same.
         | 
         | See also
         | https://en.wikipedia.org/wiki/What_Is_It_Like_to_Be_a_Bat%3F
         | and https://en.wikipedia.org/wiki/Knowledge_argument
        
           | eternauta3k wrote:
           | I guess the person would have no associations with the pure
           | color red. Non-colorblind people have a life full of memories
           | where red is associated with blood, lipstick, flushed cheeks,
           | race cars, etc. plus the associated feelings.
           | 
           | I'm guessing they only really get the full effect of the
           | therapy after they've lived without colorblindness for a
           | while and made those associations.
           | 
           | Do you think there's a fundamental difference between getting
           | a new color receptor and training yourself to
           | recognize/differentiate more of the colors you already have
           | the receptors to distinguish?
        
             | interloxia wrote:
             | Red is a great. I hope that it would be like the reaction
             | videos of kids having their Cochlear implant turned on for
             | the first time.
        
             | dekhn wrote:
             | I'm not attempting to speculate, I'm just saying I wonder
             | what the subjective experience would be like. I stopped
             | trying to think what it would like to be a bat a while ago.
        
             | bongodongobob wrote:
             | I think most people misunderstand color blindness in that
             | most red-green colorblind can see red, it's just muted. I
             | know what red looks like, but it needs to be plain old
             | bright red.
        
               | dekhn wrote:
               | protanopia: can't see red. protanomly: some red is
               | visible.
               | 
               | The guy I worked with who was RG CB couldn't wire up
               | stepper motors (typically use 4 wires, red green blue
               | black), he couldn't tell the difference and had to use a
               | multimeter.
        
       | tombert wrote:
       | I hope CRISP and gene therapy are going to be the watershed
       | moment in medicine that they appear to be.
       | 
       | I heard a Radiolab about CRISPR like 8 years ago, and I remember
       | thinking "if this is even half as cool as it sounds, then this is
       | utterly amazing". It feels like a whole slew of disease will just
       | stop being problems, and I look forward to the results of it.
       | 
       | Of course, I'm not a biologist, and I don't really understand any
       | aspects of this stuff, so I have an extremely lay-person
       | understanding of all this, but it seems insanely cool.
        
       | gherkinnn wrote:
       | What always interests me with stories of people hearing or seeing
       | for the first time in their life, what is it like to gain a new
       | sense?
       | 
       | One would think that growing up with a sense is integral to its
       | processing (and filtering) and the sudden introduction of a sense
       | later in life would come with all sorts of side effects.
        
         | stronglikedan wrote:
         | If I could just finally achieve a true kundalini awakening,
         | then I could tell you.
        
         | noman-land wrote:
         | There is an entire class of YouTube video of the first moments
         | that people see color, or hear, and it is absolutely, without
         | question, the most joyous and wonderful class of video out
         | there. Just so many happy tears.
         | 
         | Little kids hearing their mother's voice for the first time.
         | Friends seeing color for the first time after being given
         | corrective glasses as a gift.
         | 
         | Highly recommended watching.
        
           | delecti wrote:
           | Unfortunately most of those videos about the glasses are
           | basically staged. Some of those companies have gotten in
           | trouble for making false claims.
        
             | HumblyTossed wrote:
             | It truly is sad if that is the case that those videos are
             | staged, but, anecdotally, I worked in the eye glass
             | business (lab manager) to pay for college back in the day
             | and I assure you, I have personally seen babies see their
             | parents for the first time clearly and there was plenty of
             | tears to go around.
        
               | delecti wrote:
               | Yeah, to be clear I was specifically referring to videos
               | of people reacting to the glasses that supposedly let
               | colorblind people see color. I think EnChroma is the big
               | name in that space. I didn't specify "color correcting",
               | because that was the only kind of glasses mentioned in
               | the GP comment.
               | 
               | Normal glasses that correct refractive vision issues are
               | obviously real, and great, I'm certainly a big fan of
               | mine. And while I've never seen it in person, videos of
               | babies seeing through refractive correction glasses are
               | adorable every time.
        
           | jeffwass wrote:
           | As the father of a deaf girl who had cochlear implant surgery
           | a few years ago, I _despise_ these videos for misleadingly
           | representing the reality of the situation for most patients.
           | 
           | Those videos you mention are designed to invoke "happy-
           | feelies" to maximise engagement and monetisation, nothing
           | more.
           | 
           | The doctors warned us not to expect any reaction in our
           | daughter like in those videos.
           | 
           | Even so, I wasn't prepared for just how difficult my
           | daughter's post-implantation journey was. It took _many
           | months_ before the implants provided even remotely similar
           | benefit as the tiny amount of benefit her older hearing aids
           | could give.
           | 
           | She had to learn to hear all over again from scratch.
           | 
           | This affected her self-confidence, her friendships, her
           | schooling, and was a very difficult time for her.
           | 
           | Those turn-on videos you mention are overly saccharine to
           | make you feel good while having nothing to do with the
           | reality of the situation for almost all cases.
        
         | toast0 wrote:
         | I had a chronic stuffed nose into like the 2nd grade. So when I
         | started taking steroids for my nose, I was able to really smell
         | for the first time, and started noticing cooking smells.
         | Overall, kind of meh, missing out on smell is mostly not a big
         | deal. Smell is useful to detect odorants added to dangerous
         | gasses and to know when the cooking is done if your smoke
         | detector is too far from the kitchen, and it can help detect
         | spoiled food (but visual inspection usually works too), but
         | like I don't feel like my life was worse before I could smell,
         | and there definitely wasn't a big step change improvement.
        
         | 1970-01-01 wrote:
         | NYT has an excellent summary on it. Life becomes very hard when
         | they try to use their new sense in any meaningful way:
         | 
         | https://www.nytimes.com/2021/06/29/books/review/comnig-to-ou...
        
           | iLoveOncall wrote:
           | This is not at all a summary, it's a book review and it is
           | based on 4 hand-picked examples.
           | 
           | I wouldn't read anything into it.
        
             | 1970-01-01 wrote:
             | https://en.wikipedia.org/wiki/Molyneux%27s_problem#Current_
             | r...
        
               | iLoveOncall wrote:
               | Not sure what's that supposed to show? n = 5 and the
               | results just 5 days after the first survey were extremely
               | positive.
        
         | burnished wrote:
         | I started smoking as a teenager and almost entirely lost my
         | sense of smell. I later spent years working in cafes and bars
         | and did a lot of food and beverage tastings where I used my
         | limited sense of smell to the best of my ability and got pretty
         | good at it _. Eventually I met my favorite person, who didn 't
         | smoke, so I quit and over the course of the following weeks it
         | felt like I was regaining my sense of smell with owed interest.
         | I found out my city smells like shit and piss, flowers can have
         | powerful aromas you smell from some distance, and some smells
         | had become physically distressing to me. At one point I went to
         | my favorite person's house, commented that it smelled like old
         | grapes when they opened the door, and found out they had burnt
         | a scented candle called champagne dream hours ago. At the
         | height of it I thought I would eventually learn to smell the
         | future.
         | 
         | I find I filter more now but I still find a lot of stronger
         | smells to be deeply unpleasant and I don't recall being
         | sensitive like this as a child.
         | 
         | _I learned to identify some smells and relate the experience to
         | others but my notes tended to be very basic, especially
         | compared to a friend who was working on his level two sommelier
         | test (who was ruthlessly empirical in his epicureanism so I
         | believe wasn't bullshiting the wine snobbery).
        
           | tomaskafka wrote:
           | Wow! There is a great gag in latest Star Trek where Spock
           | reveals that Vulcans need to medically suppress their smell
           | near humans because we just stink to their sensitive noses.
        
             | TecoAndJix wrote:
             | Here is another reference from Enterprise with T'pol:
             | https://www.youtube.com/watch?v=tIYsVBaYNSU
        
               | Izkata wrote:
               | It's a recurring thing in Enterprise, Archer's pet dog
               | Porthos also bothers T'Pol at one point. I'm not sure but
               | I think Enterprise was the one that introduced this
               | aspect of Vulcans.
        
             | lupire wrote:
             | Babylon 5 had that with telepaths who sing songs to block
             | out the noise of human thoughts.
        
           | claytonwramsey wrote:
           | > At the height of it I thought I would eventually learn to
           | smell the future.
           | 
           | Oddly enough, Salman Rushdie's _Midnight's Children_ covers
           | this exact feeling almost in the same way as you describe. If
           | you haven't read it, I definitely recommend it - it's a long
           | read but also very enojoyable.
        
       | world2vec wrote:
       | My Mom was born with less than half of her hearing in left ear
       | and barely anything at all in right ear. She had surgery as an
       | adult and it slightly improved, especially on the right side.
       | 
       | Pretty sure this little girl and my Mom don't share the same
       | disability at all but she saw these news today and texted me so
       | excited because future kids won't have to endure the same.
       | 
       | Brings tears to my eyes, I'm so grateful for modern medicine and
       | its stupendous advances.
        
         | dhosek wrote:
         | It might be the condition I have, otosclerosis, where the bones
         | of the middle ear fuse. The surgery, a stapedectomy, involves
         | removing the bones and replacing them with a metallic
         | prosthesis. Unfortunately, in my case, the calcification is
         | also happening in my cochlea which means that at some
         | indeterminate time in the future, I will end up losing all
         | hearing. Not to mention that even with the prosthetic, my
         | hearing isn't 100% so I have a difficult time understanding
         | speech. There might be some gene therapy that can remedy
         | things, but I think what I may be hoping to see is the ability
         | to grow a new inner and middle ear from stem cells and
         | transplant them into my head, but I suspect that at age 55, I
         | won't see this happen in time for me.
        
           | jfengel wrote:
           | I had no idea that was possible. If you'd asked me, I would
           | have guessed that it wasn't.
           | 
           | Astonishing. Sorry it's not a permanent fix for you, but it's
           | impressive as hell that they could do anything.
        
           | throwaway2037 wrote:
           | Thank you to share about your personal experience. Will a
           | cochlear implant help for your condition?
        
             | dhosek wrote:
             | It will, but with the caveat that hearing with a cochlear
             | implant is (at least at current technology levels),
             | inferior to hearing with an actual cochlea. So there's a
             | balancing act where they want to continue having me hear
             | with my cochlea as long as possible. The other problem is
             | that with a CI, I have no hearing at all without the
             | receiver which means that I would be completely deaf while
             | swimming, showering, etc. while I have at least some
             | hearing without my hearing aids right now (although I had
             | an ear infection in December which left me completely deaf
             | for a week. It was a bit startling how much people were
             | unwilling to engage in the smallest adaptations for me--I
             | found how to set up live transcriptions on my phone and I
             | remember the cashier at the grocery store being unwilling
             | to use that so I could see what she was saying).
        
               | dhosek wrote:
               | (With the live transcription feature, I was actually able
               | to engage in normal-ish telephone conversations, maybe
               | even a little more effective than I can with using the
               | audio.)
        
           | shirleyquirk wrote:
           | Did your sense of taste change after your surgery? My sister
           | is considering a similar procedure and is concerned that
           | everything could start tasting like hot garbage.
        
           | Geee wrote:
           | Another viable future tech for this might be neural implants
           | similar to Neuralink. Not sure how viable it would be.
        
           | izend wrote:
           | I was recently diagnosed with otosclerosis, have you found a
           | hearing aid that works best for otosclerosis, my Doctor
           | mentioned that most hearing aids don't work well for low
           | frequency loss.
        
         | sandworm101 wrote:
         | >> so excited because future kids won't have to endure the
         | same.
         | 
         | When cochlear implants became routine there was a brief protest
         | by the deaf and hard-of-hearing community. The line between
         | people with a disability and a person who is simply _different_
         | is a longstanding debate. How and when medicine should
         | intervene is a hot button issue.
         | 
         | I had a relative born with a malformed ear canal. The doctors
         | rushed to get her the surgery needed so that she could hear
         | equally in both ears, before her developing brain started
         | ignoring the "bad" ear. A few years in and her hearing is now
         | better than mine.
        
       | maratc wrote:
       | Yuval Harari makes an interesting point in one of his books: that
       | many kinds of these inventions always start as a way to treat
       | people with some kind of a medical condition and bring them into
       | the "median" spectrum, but there's no stopping there and the same
       | inventions are then used to bring "median" people into the
       | "super-human" spectrum.
       | 
       | What happens next is that the "regular" humans have to compete
       | with these "super-humans", for example on a job market, or in
       | Olympics.
        
         | amelius wrote:
         | You can only switch a gene "on" once. So I'd like to see some
         | examples.
         | 
         | Or do you mean more people with all their genes switched "on"
         | so to speak?
        
           | tonetegeatinst wrote:
           | Epigenetics would like a word.
           | 
           | A gene can be expressed but from what I rember from my
           | college classes....the epigenetics can determine if the gene
           | actually works correctly and how effective it is.
           | 
           | Think of it as the ability to lower the overall expression of
           | the gene
        
         | dotnet00 wrote:
         | You say that as if this has happened before ("many kinds of
         | these inventions always start as..."), but what conditions have
         | actually had this happen?
         | 
         | I can't think of anything that started as something to help
         | bring people up to a median level, to then end up bringing
         | median people into a super-human level. Everything we've done
         | so far have all been ultimately limited by the human body, so
         | things that bring people up to the median level ultimately have
         | diminishing returns such that they don't benefit median people
         | so much.
        
           | cush wrote:
           | steroids
        
             | dotnet00 wrote:
             | Most, even in the presented example of the olympics aren't
             | having to compete against those on steroids though?
        
               | johnmaguire wrote:
               | It's hard to know how many people are getting away with
               | cheating. I'm more familiar with it in the context of
               | cycling, where performance-enhancing drugs have long been
               | a thorny issue.
               | 
               | > In 2004, 4.6% of the anti-doping samples tested were
               | positive, and that is taking into account that there were
               | many dopers who never tested positive.
               | 
               | https://lanternerouge.com/2023/03/26/how-clean-is-
               | cycling-an...
        
           | maratc wrote:
           | Think of e.g. the development of optics that brought us the
           | eyeglasses first, and the telescopic sight on a sniper rifle
           | second. Now imagine an army of median humans that need to
           | fight the army of genetically-modified humans that can see in
           | the dark.
        
           | Octokiddie wrote:
           | Breast augmentation could be one case.
        
             | dotnet00 wrote:
             | Haha I guess that might technically fit.
        
               | PebblesRox wrote:
               | You could say the same for plastic surgery in general.
               | Techniques developed to restore injured faces (e.g. of
               | soldiers) are now used for cosmetic purposes.
        
           | johnmaguire wrote:
           | Implants, prosthetics, and exo-skeletons?
        
             | dotnet00 wrote:
             | Which implants and prosthetics currently exist that are
             | such that a median person would want them and as a result
             | would become super-human?
        
               | johnmaguire wrote:
               | As was mentioned in another comment, breast augmentation
               | and other forms of body modification in the context of
               | influencers, broadcasters, actors, models, etc.
               | 
               | Prosthetics may not quite be there yet, but do you
               | seriously think they won't get there?
               | 
               | Military is actively investing in exoskeleton R&D.
               | Whether it's currently accessible to the median person is
               | sort of besides the point.
        
               | dotnet00 wrote:
               | Re-read my comment, I haven't said anything about the
               | future. My point was just that it seems weird to talk
               | about it as if it has already happened.
               | 
               | It might happen in the future, but it's worth considering
               | that a powerful prosthetic limb or exoskeleton that is
               | superior to the biological version in every way makes
               | both the disabled person and the perfectly healthy person
               | equally superhuman.
        
               | johnmaguire wrote:
               | I re-read your comment, but I still disagree that the
               | evidence provided by myself and others in response, as
               | well as evident near-term future advancements, are
               | irrelevant to the comment you responded to.
               | 
               | > a powerful prosthetic limb or exoskeleton that is
               | superior to the biological version in every way makes
               | both the disabled person and the perfectly healthy person
               | equally superhuman.
               | 
               | I think I'm not following, or else failing to see the
               | relevance to this comment. This is essentially what the
               | GP was getting at: these advancements can/will lead to
               | anatomically "correct" humans failing to compete.
        
               | dotnet00 wrote:
               | >I think I'm not following, or else failing to see the
               | relevance to this comment. This is essentially what the
               | GP was getting at: these advancements can/will lead to
               | anatomically "correct" humans failing to compete.
               | 
               | I suppose this is just down to interpretation/point of
               | focus.
               | 
               | I was focusing on the 'levels' being referenced. A
               | 'perfect' prosthetic allows all people to be able to
               | reach the same level, while the GP was talking about
               | things that bring below median people to median level
               | only, and previously median people to super-human level.
               | 
               | If we interpret this to refer to competition against
               | people who aren't using any augmentation, it covers even
               | just the act of practicing. Which in my opinion, kind of
               | defeats their point by making it excessively broad.
        
               | maratc wrote:
               | > it covers even just the act of practicing
               | 
               | Imagine that a gene modification is discovered that
               | allows a significant breakthrough in human memory. First,
               | people with Alzheimer would undergo that treatment, to
               | the cheers and applauds of virtually everyone (including
               | me and you). Then the people with _a risk_ of Alzheimer
               | would undergo it, then it would be cheap enough that
               | _anybody rich enough_ could do it. Then imagine that e.g.
               | I undergo that treatment and am now able to memorize all
               | of Wikipedia, GitHub, and Stack Overflow. Then imagine
               | competing against me for a job opening. You can practice
               | all you want but never able to reach that level, because
               | you 're limited by genes while I've got rid of that
               | limitation.
               | 
               | The Google guys are extremely well-invested in the bio-
               | tech startups, and Larry the Oracle Guy puts all his
               | money into an "institute for prolonging of human life".
               | No bonus points will be awarded for the correct answer to
               | the question "whose life exactly that institute is
               | working to prolong?"
        
           | jonasdegendt wrote:
           | Someone mentioned steroids, but Epogen is another example.
        
         | rowanG077 wrote:
         | Isn't that already the case? Genetically the average Olympian
         | is definitely super human compared to the population. Unless we
         | start adding novel genetic data to humans I wouldn't be too
         | worried.
        
         | qp11 wrote:
         | The Theory of Bounded Rationality tells us super humans are
         | over rated. There will always be problems you throw in the lap
         | of a super human, that they wont be able to solve cause of lack
         | of time, or cash, or personality or missing info, or
         | conflicting needs, or their belief system etc etc.
        
         | TeMPOraL wrote:
         | I can't think of a medically relevant example except maybe
         | stimulants and painkillers, but outside of medicine, this
         | definitely is the case with technology: many inventions have a
         | ratchet effect - they start as gimmicks, but when they reach a
         | critical mass of users, they confer so much competitive
         | benefits that they rapidly spread everywhere, and eventually
         | become _required_ to function.
         | 
         | Examples range from agriculture to the Internet; currently,
         | smartphones seem to be hitting this threshold, as more private
         | and public services become designed primarily with smartphones
         | in mind.
         | 
         | I found it enlightening to ponder the history of clocks. There
         | was a time nobody needed one; it wasn't actually useful for
         | anything[0], because nothing in agricultural societies happened
         | fast enough to require hour or minute accuracy. Some people
         | eventually found use for more accurate and precise time
         | tracking, then more, then those people realized they're able to
         | coordinate better when they have synced clocks, which made new
         | things possible, and few centuries later, our entire
         | civilization runs on clocks, and it's near-impossible to live
         | without minding what time is it.
         | 
         | --
         | 
         | [0] - Use in sea navigation notwithstanding.
        
           | maratc wrote:
           | > those people realized they're able to coordinate better
           | when they have synced clocks, which made new things possible
           | 
           | The development of clocks is related to industrialization and
           | opening of plants that need all the workers to be there at
           | e.g. 8 am for the shift to start. If you have to be at the
           | factory at 8 am you'd better know what time it is. It's not
           | that the development of clocks has brought us factories;
           | rather, the development of factories has brought us clocks.
        
             | TeMPOraL wrote:
             | It's a feedback loop; manufacturing couldn't scale without
             | clocks, and neither transportation - think e.g. train time
             | tables. Once it became _possible_ to keep people in sync
             | down to minutes, it immediately became popular, and those
             | who avoided it were increasingly left behind.
             | 
             | FWIW, I'm not saying it's a _good_ development. I 'm torn
             | on this. Outside of direct progress, we seem to be running
             | in Red Queen's races quite a lot, as improvements turn into
             | baseline.
        
             | kiba wrote:
             | The relationship is likely bidirectional as opposed to a
             | one way street.
        
         | vunderba wrote:
         | I mean this isn't really a novel point, this is true of
         | everything not just biological enhancements, but technological
         | enhancements as well. The privileged will always have first
         | dibs.
         | 
         | But historically the wealthy/first adopters help fuel the
         | continued development of said inventions, which helps drive
         | down the price, eventually allowing the larger public to have
         | access to it.
        
       | julianlam wrote:
       | I'm excited to see possible parallel applications of this therapy
       | for other hearing-loss related gene mutations such as GJB2.
       | 
       | From what I can tell from a press release from Regeneron
       | themselves, they're also working on GJB2 and STRC therapies.
        
         | janeerie wrote:
         | Can you point me towards more info on GJB2 therapies? This is
         | the cause of my son's hearing loss.
        
       | throwaway9911d wrote:
       | I'm hopeful we will be able to cure retinitis pigmentosa with
       | CRISPR one day.
        
       | unsupp0rted wrote:
       | Every time I hear about a new medical discovery or treatment, I
       | think "yeah right, maybe in 15 years".
       | 
       | Well, here we finally are.
       | 
       | Our ancestors, and I mean great-grandparents and grandparents,
       | would call us gods.
        
         | dotnet00 wrote:
         | It is interesting to wonder if they'd call us gods in a good
         | way though. Perhaps they might see it as 'playing god' instead.
         | HN being a techie crowd tends to skew this a bit, but it's
         | worth remembering that genetic engineering is still pretty
         | controversial to the average person:
         | https://www.pewresearch.org/internet/2022/03/17/americans-ar...
        
           | dekhn wrote:
           | When I was 18 (early 90s) and applying for university, the
           | admissions office asked me what I wanted to do and I said
           | "play god with DNA". Sure it sounds arrogant, but I knew that
           | gene therapy would become a thing and if it worked,
           | eventually people would apply it recreationally (by which I
           | mean, to change your phenotype, or your future children's
           | phenotype, for non-disease purposes).
           | 
           | I went into that field and spent a couple decades learning
           | how to do it. My only conclusion at the end was that it would
           | only be considered societally acceptable for diseases, not
           | recreation, for the foreseeable future, and even things that
           | seem "easy" (like fixing retinitis pigmentosa) are in fact
           | fractally challenging. As much as I would like to have
           | chromatophore tattoos, we're just not in a place where we can
           | justify this (even self-experimentation) because it's really
           | hard to know if your intervention had the effect you desired,
           | and no other effects.
        
             | devilbunny wrote:
             | I'm about your age, but holy hell, if I had been an
             | admissions officer, that would have sold me on you.
             | 
             | I'm an anesthesiologist, though, so "likes to play god"
             | sort of goes with the territory. It's not common, but there
             | are surgeries where you go on heart-lung bypass, chill the
             | patient down to 30 C, and then stop the pumps. No blood
             | flow. The surgeon does the critical part, you turn the
             | pumps back on and warm them up, and then the body takes
             | over again.
             | 
             | It is absolutely magic.
        
           | unsupp0rted wrote:
           | Those who suddenly got eyesight or hearing would call us gods
           | in a good way.
           | 
           | Everybody has a problem with people "playing god" until they
           | get paralyzed or a serious illness. Then "playing god" is all
           | they wish for.
        
         | jimnotgym wrote:
         | Caveman brains, mediaeval institutions, and godlike technology.
         | What could possibly go wrong.
         | 
         | That is a quote I heard somewhere and paraphrased.
        
         | qkeast wrote:
         | I have profound hearing loss (sensorineural) in both ears, and
         | I've been following gene therapy in all of its fits and starts
         | for almost two decades. I was lucky enough to have _not
         | horrible_ hearing at my youngest, and then lost it
         | progressively up until I rely entirely on lip reading for
         | conversation.
         | 
         | I was eligible for cochlear implants probably more than 15
         | years ago, but I was getting by, and I heard that getting
         | implants would almost certainly preclude any future therapy
         | like this. I'm ecstatic to finally hear an actual "it worked,
         | in a human" outcome, and can't wait for something that works
         | for my hearing to reach maturity.
        
       | alsetmusic wrote:
       | Medical science is about the only thing in modern life that
       | consistently delivers hope. While all the other terrible things
       | are going on, something like this comes along and I'm just
       | extremely happy to be alive right now.
        
         | highwayman47 wrote:
         | It would be nice if people at these companies were rewarded the
         | same way as food delivery app employees.
        
           | weakfish wrote:
           | huh?
        
             | lucianbr wrote:
             | Maybe they meant "food delivery app developers"?
        
           | Petersipoi wrote:
           | You want the people at these companies to get a 3 dollar tip
           | each time they restore someone's hearing?
        
           | HaZeust wrote:
           | ... Food delivery app employees get shitty rewards in
           | proportion to their work as well?
        
           | oxguy3 wrote:
           | ???? I would imagine the average surgeon is much happier with
           | their compensation than the average DoorDasher. It's a
           | reliable fixed-rate salary vs wondering if you'll get enough
           | $3 tips to make rent this month.
        
             | lizardking wrote:
             | Maybe gp was referring to the coders who work at said
             | companies. I don't even think the individual dashers are
             | employees.
        
           | zaphod12 wrote:
           | I can assure you that regeneron pays very well, including
           | significant equity and has absolutely fantastic benefits.
           | Software developers probably get more at door dash (it isn't
           | bad by any means, but they aren't "the talent" at regeneron
           | after all), but folks involved in the science and trials are
           | doing very well.
        
         | jajko wrote:
         | Astronomy is cool too, nothing anchors you back in reality like
         | realizing how absolutely microscopic and insignificant our
         | entire mankind's existence was and is.
         | 
         | Solid perspective and understanding of bigger picture is
         | important, then nothing can surprise you much.
        
           | harimau777 wrote:
           | Personally, I find astronomy quite depressing. Learning that
           | humanity is stuck on this rock; at least for my lifetime if
           | not forever. As a kid I dreamed of exploring space. As an
           | adult I learned that is impossible.
        
         | antegamisou wrote:
         | Yet LLM grift research proposals receive 100x the funding for
         | therapies similar to this.
        
         | contingencies wrote:
         | Serious suggestion: try gardening.
         | 
         |  _To plant a garden is to believe in tomorrow._ - Audrey
         | Hepburn
        
         | downWidOutaFite wrote:
         | Funny because I feel the opposite. Health care is so broken
         | with all the politics, insurance, bureaucracy,
         | financialization, etc that the vast majority of people are not
         | able to reap the rewards of progress. Even the science is
         | perverted because of bad incentives and only potentially
         | lucrative research is funded.
        
       | ForrestN wrote:
       | As a disabled person, I admit to being made slightly
       | uncomfortable by the uncritical framing of genetically modified
       | people as "therapy" that all people should want. Where is the
       | line between "gene therapy" to eliminate differences (such as
       | deafness) and eugenics? If we have statistics that taller people
       | have better outcomes in life, should we do gene therapy to make
       | sure everyone is taller than 6'? How much diversity of human
       | experience is too much?
       | 
       | Obviously, there are easy cases: this kind of technique to
       | prevent conditions leading to abject suffering, for example. But,
       | knowing and admiring deaf people makes me unsure about the idea
       | of "curing" deafness, for example, as a goal of medicine.
        
         | virissimo wrote:
         | Perhaps we should have different words for voluntary (choosing
         | to regain your hearing, etc...) and coercive (forced
         | sterilization, etc...) "eugenics", since almost all of the
         | negative connotations of the word are (rightly, IMO) attributed
         | only to the latter.
        
           | commandlinefan wrote:
           | That was my first though, BUT... to play devil's advocate,
           | people choose gender reassignment surgery (including young
           | children) and that choice continues to be very very
           | controversial.
        
             | ImJamal wrote:
             | The controversy is due to cutting off perfectly good and
             | functioning body parts. Correcting a body part that is not
             | working correctly isn't all that controversial.
        
           | ImJamal wrote:
           | Parents are going to choose these things for their kids
           | though?
        
         | spondylosaurus wrote:
         | Also disabled, and this is a topic I've been chewing on a lot
         | lately--I started writing up a longer comment but deleted it,
         | lol. What I really want to say is that I have a few problems I
         | would 100% cure in a heartbeat, and a few that I'm less sure
         | about, so I get it.
         | 
         | Some disabilities only have one true cure: fix the part of your
         | body that's bad at its job. No amount of accomodation or
         | acceptance is going to mitigate the worst parts of, say, liver
         | disease. But other disabilities have two paths forward: cure
         | the body, or create a world that's more accommodating to people
         | with that disability. Deafness seems like it falls in that
         | category, which is tricky, because both paths have salient
         | points but are also at odds with each other.
        
           | silverquiet wrote:
           | I'm actually in this position a bit. I'm still young(ish)
           | with a serious hip condition that causes me some disability.
           | There are options for replacement that could get me to near
           | full function, but there are drawbacks and the shear fear of
           | surgery and replacing part of my body with metal and plastic.
           | If I was wheelchair-bound, I don't think it would be a hard
           | choice, but I am able to essentially do most of the things I
           | need to do at least as I am. And so I put it off and put it
           | off.
        
             | spondylosaurus wrote:
             | Hip problems are brutal, been there before :( Mine (mostly)
             | resolved when I addressed some other underlying issues but
             | I was also seriously considering joint replacement for a
             | bit!
             | 
             | The surgery and downtime are no joke, but everyone I've
             | talked to who went through with a replacement was glad they
             | did. I even know at least one guy who now works on his feet
             | all day. Not saying to just take the plunge now, but if you
             | ever do, the outcomes seem pretty damn good.
        
             | jamiek88 wrote:
             | Do you have significant pain?
        
         | eklavya wrote:
         | Am I reading it wrong or are you admiring deafness which
         | shouldn't be cured? Or the deaf people who are admirable?
         | 
         | Why should curing deafness not be a goal of medicine?
        
           | sertgert wrote:
           | I'm reading it like the hedonist's treadmill. Why be happy
           | with a 6 figure salary when there's people with 7 figure
           | salaries? Are you content with your current situation, or are
           | you missing a part of what it means to be human by not having
           | better eyesight, better teeth, better hearing?
           | 
           | I think what OP was referring to was how rich the lives of
           | the deaf can be, and how discouraging it might be to hear
           | "y'know, you're not /really/ experiencing life until you can
           | hear"
        
         | dandanua wrote:
         | In the current state of the world ethics is faked. Survival is
         | everything. AI will be used for weapons and for power grab by
         | politicians and billionaires (e.g. through mass manipulation).
         | Gene "fixing" will be used by those who can afford it, 100%.
         | Today everyone wants to be better, stronger and smarter.
         | Otherwise you and your offspring (if any) are doomed to stay in
         | lower castes of society for ages. Be sure the top castes will
         | arrange that.
        
         | legohead wrote:
         | Designer babies are fine with me. If I could make a handsome,
         | strong as an ape, genius, healthy baby, I'd do it! I'd do the
         | same for me.
         | 
         | If there's a moral sticking point, for me it would be about the
         | cost and privilege it assumes. We still have a very long ways
         | to go before that is figured out...but if we have genius level
         | babies, maybe they can do it for us.
        
         | ImJamal wrote:
         | I think there is an easy line. We know what should occur with
         | certain parts of the body. Ears should be able to hear so when
         | they don't we know there is a problem.
         | 
         | There isn't a height in order to function properly or something
         | like that. If somebody is 5 feet or 6 feet they are still
         | capable of having their whole body function. Yes, they may have
         | issues due to their height but their body still works
         | correctly. (Extreme heights, both tall and short, may cause
         | issues and there could be conversations around that, but within
         | the normal range there isn't any sort of function of the body
         | that doesn't work)
        
           | vsuperpower2020 wrote:
           | It's crazy to me that we even need to explain the difference
           | between variation in height and a non-functional organ. I
           | don't know if people are just so open minded that their
           | brains fell out, or if it's some new idea where everyone gets
           | their own personal perception of reality and nothing is real,
           | maaan.
        
         | dotnet00 wrote:
         | At the same level, it's worth considering the effect on
         | society. Western society (and increasingly global society) has
         | grown a lot more accommodating for certain disabilities because
         | it is understood that the condition was not the person's choice
         | and cannot be fixed. But if the condition is capable of being
         | cured/managed with no serious side effects, and the cures are
         | easily accessible, what is the right amount of effort society
         | should put into being accommodating?
         | 
         | These are all difficult questions, but it feels like we're
         | going to eventually have to put aside our well founded fears
         | over eugenics and confront these serious questions properly.
         | For instance, many places offer the option to test
         | fetuses/parents for markers of serious genetic disease and
         | offer the option to terminate the pregnancy with the argument
         | that the child would either not be viable or would have a
         | horrible quality of life. On one hand this sounds reasonable,
         | on the other hand it's pretty much a level of eugenics.
        
         | foxyv wrote:
         | > Where is the line between "gene therapy" to eliminate
         | differences (such as deafness) and eugenics?
         | 
         | The difference is usually a matter of informed consent.
         | Eugenics tends to be non-consensual. Sterilization or forced
         | birth control for unwanted individuals. Murder of unwanted
         | individuals. Involuntary genetic modification of unwanted
         | individuals will probably pop up eventually.
         | 
         | Typically gene therapies are on living, consenting people with
         | all the information to make a choice. It also doesn't usually
         | result in germline modification. The sticky part is when you
         | get to babies and fetuses. Can a mother consent for her fetus?
         | What about germline modification? In-vitro gene therapy? Then
         | you are getting into Brave New World territory.
        
         | skybrian wrote:
         | Here is a framework for thinking about it: raising population-
         | level concerns and using them to justify laws restricting what
         | children parents can have (or not have) seems like the pro-
         | eugenics side. The reproductive freedom side is to take a
         | laissez-faire attitude on how the human population changes. Let
         | parents choose the children they want to have and it will
         | probably work out.
         | 
         | That doesn't make the issues easy. There are some forms of
         | state coercion that people are sympathetic to. For example, in
         | India, there is unfortunately a strong preference for male
         | children, and there are laws to prevent sex selection. This is
         | obviously reducing people's reproductive freedom because
         | there's a state interest in a balanced sex ratio.
         | 
         | Another example of state coercion that people are unsympathetic
         | to is China, where the state had an interest in reducing
         | population growth and imposed a one-child policy. Seems like
         | that's eugenics? It's imposing personal hardship for a
         | population-level concern.
         | 
         | Along these lines, I'm wary of population-level concerns like
         | "will deaf people die out." What could the state do about it?
         | At the individual parent level, nobody should have to raise a
         | deaf child if they don't want to, when it's unnecessary.
         | 
         | But a tough case for the reproductive freedom side is: can deaf
         | parents use prenatal testing to select for deaf children, if
         | that's what they want? That's not a population-level concern,
         | it's personal: specific parents want a deaf child. A lot of
         | people have trouble with _that_ kind of reproductive freedom
         | when they wouldn 't have an issue with wanting a boy or girl,
         | because deliberately causing deafness sure seems bad _for that
         | child._
        
         | santoshalper wrote:
         | Here's the problem with slippery slope arguments. You could
         | substitute all medicine and your point would still stand. Do
         | people with a limp need to be "fixed" or does it add character?
         | You know who is the right person to decide that? The person
         | receiving the therapy, or if they are a minor, their parents.
         | Nobody else is well equipped to make the decision for them.
         | 
         | I suppose I could be wrong, and this could be the start of
         | Gattica, but I highly doubt it. I think far more likely is that
         | over the next few decades, millions of people will be able to
         | hear who otherwise would not have.
        
       | dekhn wrote:
       | Gene therapy has been an extremely slow game. Part of that is
       | ethics, and part of that is technology. A single death in a
       | single trial slowed down gene therapy for decades
       | https://en.wikipedia.org/wiki/Jesse_Gelsinger I dedicated much of
       | my biology training to learning how to carry out gene therapy
       | only to conclude that it will continue to be the underdog in
       | disease therapy for a long time. I do not expect to see large-
       | scale germline modification for non-disease purposes in my
       | lifetime (another 20-30 years).
        
         | financetechbro wrote:
         | Do not underestimate the entrepreneurial spirit when there is a
         | profit to be made
        
         | CSSer wrote:
         | I expected to read that and find it was a fluke accident.
         | Instead, it reads like the scientists shrugged before the
         | injection and said, "What's the worst that could happen?"
         | 
         | That's unreal. It killed monkeys under similar circumstances
         | and the kid wasn't at his healthiest at the time of treatment
         | either. Did they not care or was there some reason to believe
         | that outcome was virtually improbable?
        
           | dekhn wrote:
           | I honestly don't know what they were thinking.
           | 
           | BTW, most gene vectors today are based on lentiviruses...
           | specifically, from HIV. It took a few tries before they found
           | a method to reliably remove all the bad bits from the vector.
           | See https://www.nature.com/articles/s41375-018-0106-0 and
           | other articles on the evolution of HIV as a gene therapy
           | vector.
        
         | DarkNova6 wrote:
         | > I do not expect to see large-scale germline modification for
         | non-disease purposes in my lifetime (another 20-30 years).
         | 
         | Could you please share what makes you think so?
        
       | verisimi wrote:
       | I'm glad this little girl can hear. But I don't understand how
       | this can possibly work.
       | 
       | We can read:
       | 
       | > "So basically, we find the inner ear and we open the inner ear
       | and infuse the treatment, in this particular case using a
       | catheter, over 16 minutes," he said.
       | 
       | Genes are in cells, right? It seems like what is being said is
       | that this therapy goes in and alters all the cells. The altered
       | cells then keep the alteration. Whatever it is that creates these
       | cells, also knows to create this new type of cell - cos this is
       | not an ongoing treatment.
       | 
       | Anyway explaining whatever technical thing is going on here with
       | the word 'infuse' is a bit simplistic. Can we not have some more
       | detailed information?
        
         | bglazer wrote:
         | It's a virus that adds a bit of genetic code to cells in the
         | ear. The new genetic code is the instructions for the protein
         | that is broken in the the little girl (and other similar
         | patients). The cell can then use the newly introduced DNA to
         | make a protein. This protein restores the link between the
         | auditory sensory cells and the auditory nerve cells.
         | 
         | Regarding the word "infused", the viral particles are carried
         | in an aqueous solution into the inner ear. The viral particles
         | then do their work on the cells that the solution flows over.
         | So it is literally infused, although that sort of elides the
         | bit about the virus actually delivering the active bit of the
         | treatment: the new gene.
        
       | arjie wrote:
       | My wife and I are selecting which embryos to implant because we
       | have a related condition (this one is a mutation in OTOF, we have
       | one in GJB-2). Being able to implant the embryos affected with
       | this condition (carrying two copies of the gene - mine and my
       | wife) would increase the number of viable embryos we have by 50%.
       | 
       | It won't be in time for us to actually implement unless we're
       | down to our last few embryos through failure. We were able to
       | detect ours because we used Orchid Health to scan the embryo
       | genome for monogenic conditions. But it's exciting to think that
       | novel gene therapies might be accessible if we somehow fail to
       | implant with the other embryos we have.
       | 
       | All this stuff is very futuristic and it's definitely rescued us
       | since my wife and I started dating and got married within the
       | last year, by which time we were quite old.
       | 
       | Very cool stuff from Regeneron.
       | 
       | EDIT: I actually looked this up and got a reading list which I
       | went through over lunch. There's quite a lot of work on this
       | front.
       | 
       | Regeneron/Decibel Therapeutics have DB-OTO and are developing a
       | GJB-2 (the one we have) gene therapy too
       | https://www.decibeltx.com/pipeline/
       | 
       | Akouos has AK-OTO https://akouos.com/our-focus/
       | 
       | There's a Chinese group that claims they had success in older
       | patients (search for AAV1-hOTOF)
       | 
       | The April issue of Molecular Therapy has a few of these. For a
       | quick read look at the Oral Abstracts from the Presidential
       | Symposium. Molecular Therapy Vol 32 No 4S1, April 2024
        
         | 2dvisio wrote:
         | You are lucky to know ahead of time about your respective
         | mutations. We didn't (no family history and both asymptomatic
         | carriers) and my son was born bilateral profoundly deaf
         | (connexin 26). We have chosen the path of cochlear implant
         | (which is an amazing technology). We are both looking forward
         | to seeing advancements in therapies for GJB2 mutations sparing
         | many parents (and children) what we have been through. However,
         | corrective therapy for GJB2 might require much earlier
         | discovery of the issue and earlier administration I believe, as
         | usually those variants affect actual physical growth of hair
         | cells in the cochlea.
        
       | xyst wrote:
       | As a person that's not deaf. It's great to hear scientific
       | breakthroughs can help people experience life with this important
       | sense.
       | 
       | Although I think there's a train of thought that think being deaf
       | is not a genetic deficiency.
       | 
       | Would deaf parents raising a child that is not deaf struggle?
       | Would assimilation into the family unit be difficult?
       | 
       | Personally, I think the level of isolation as a child from their
       | parents would have a certain degree of impact on mental health.
        
         | lapetitejort wrote:
         | There's some good movies based around deafness:
         | 
         | https://en.wikipedia.org/wiki/CODA_(2021_film)
         | 
         | https://en.wikipedia.org/wiki/Sound_of_Metal
         | 
         | And a bad video game:
         | 
         | https://en.wikipedia.org/wiki/The_Quiet_Man_(video_game)
        
           | tnorthcutt wrote:
           | I strongly endorse both of the mentioned movies. They're both
           | excellent.
        
         | _whiteCaps_ wrote:
         | Anecdotally, I know of one hearing person raised by deaf
         | parents, and he's fluent in sign language. There's no isolation
         | between them.
        
       | codeulike wrote:
       | How it actually works (from
       | https://www.fiercebiotech.com/biotech/little-protein-factory... )
       | 
       |  _DB-OTO is a cell-selective AAV gene therapy for children with
       | hearing loss stemming from a mutation to the otoferlin gene.
       | 
       | The otoferlin protein is expressed in the sensory hair cells of
       | the ear, which have tiny cilia that move as vibrations come into
       | the ear. These cells help signal between the auditory nerve and
       | the hair cells, passing information from the ear to the brain.
       | Children born with this type of genetic hearing loss have the
       | hair cells and can detect the signal coming into the ear.
       | 
       | "But they can't get that message from the ear to the brain,
       | basically, because otoferlin is critical to enable that
       | communication," Whitton explained.
       | 
       | That's where DB-OTO comes in. The adeno-associated viral vector
       | delivers the gene therapy to the ear to provide a payload of cDNA
       | that expresses the protein in the hair cells that are missing it.
       | The hypothesis was that if they provided the gene, patients could
       | eventually begin to hear on their own.
       | 
       | Regeneron does not yet know how long the effect will last, but
       | "rigorous" preclinical tests were done to get a sense of
       | durability, according to Whitton. Since those hair cells targeted
       | by the gene therapy do not turn over during a person's lifetime,
       | they believe the effect should be persist once restored.
       | 
       | "The ones that you're born with are the ones you will have the
       | rest of your life, so if we can create a little protein factory
       | in those cells, make the protein that's missing, there's reason
       | to believe that you could have long-term benefit," Whitton said._
       | 
       | Note this is not CRISPR, its more like just adding little chunks
       | of DNA into the cell (which I think is called upregulation).
       | 'Gene Therapy' can mean many other things apart from Crispr,
       | there's a whole complicated pipeline of processes that can be
       | targeted.
        
       | causality0 wrote:
       | _"As a charity, we support families to make informed choices
       | about medical technologies, so that they can give their deaf
       | child the best possible start in life."_
       | 
       | A pleasantly measured response. For those in the know, has the
       | deaf community calmed down in recent years? I remember a time
       | when they were radically opposed to anything that smelled like a
       | "cure" for something they considered more of an identity than a
       | disability, though I haven't read anything on it in a long time.
        
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