Are CRISPR designed babies the future? Update 1 year after birth

The German news site n-tv.de interviewed me about a week ago about the possibilities and risks of the CRISPR gene-editing technology. The reason for this piece was the first anniversary of the CRISPR-designed babies, the twins (with the pseudonyms Lulu and Nana). 

In short, a Chinese researcher and former associate professor at the Southern University of Science and Technology (SUSTech) published an (in my opinion) somewhat uncomfortable video clip one year ago announcing the birth of the twins. The researchers used the DNA-cutting tool CRISPR/Cas9 on embryos, attempting to mutate one entry point of HIV. You can read more about the background and my thoughts here. 

We shared the interview through our social media platforms. Still, unless you read German or have the patience of a saint to translate the whole piece on your favorite translating tool, I guess you shamelessly clicked through that post. Here, we give you non-German, non-translating, and post-skipping people a second chance; a summary based on the interview. If you’re interested in the exact content, please ask one of your German friends to translate it. They’d love to help you out. Enjoy!

About my reaction to the announcement of the CRISPR-designed babies

A mix of thoughts crossed my mind when I found out. Since I know news media tend to exaggerate or draw premature conclusions, I was pretty calm. But I can’t pretend it didn’t surprise me to some level. After all, the time between the first CRISPR experiments on mammalian cells (not organisms) and this human experiment was about five years! Five years is a young age. [It still listens to Maroon 5 or whatever music triggers these kids nowadays.] But in all seriousness, five years is a short time before human testing – especially embryonic. 

And the questions follow: I honestly want to know, did these researchers manage to change the right gene and that gene alone? Have you seen any proof? If so, please send us the links. Was the experiment worth it, knowing that this gene is only one of two entry points for HIV and that we today have good treatment options? How realistic was the experiment, and what did we learn from it? I have many more questions, but I’ll leave you with these for now.

In short, regardless of the intentions, I believe CRISPR was not ready for the challenge yet, and I argue that we needed more confirming fundamental research before starting to change human embryos.

About CRISPR applications apart from treating human diseases

Here, I presented several potential uses of CRISPR apart from treating diseases. Keep in mind that no matter how unrealistic you might think the applications are, researchers are already looking into these:

• Accelerating animal breeding.
• Manipulating allergens to avoid an immune reaction.
• Improving biofuel efficacy by manipulating algae.
• Bringing back extinct animals. 

Yes, scientists are obsessively trying to bring the mammoth back to life apart from getting a smaller chihuahua by the end of the year, enjoying peanuts, and doing something good for the environment. They call it de-extinction.

The possibilities are almost endless, for better or worse, especially in agriculture or nutrition. Why? Because of legislation. Since these experiments don’t include human subjects, restrictions are looser, which means more experimental freedom. 

About protecting children from diseases and the disadvantages of CRISPR

Let’s be clear. We want to protect any child from diseases, and that’s a no-brainer. But, genetic changes at an embryonal stage can result in several complications, one of the big ones being that we not only change the genes of the embryo in question, but we also dictate the genes of its future generations. 

One gene can be responsible for several biological functions; in a different scenario, multiple genes may control one disease. On the one hand, the gene you’re changing to shield a future child may be responsible for crucial biological functions, and on the other hand, that gene change alone might not be enough to protect. Welcome to genetics! It’s a complex and confusing field that we’re still trying to figure out. Instead of linear, try to imagine biological interactions as networks. Each gene may be directly or indirectly influencing or depending on each other.  

Then, at an ethical or philosophical level, people without disabilities often underestimate the quality of life of people with disabilities. What is better for the future of children may be a misconception based on our (misguided) feelings and knowledge.

And, more importantly, who are you to decide how our future generations should look? Your present knowledge and world views have expiration dates. Whatever you’re sure about today may be ridiculous tomorrow.  

About the potential abuse of CRISPR considering countries with less restricted legislation

It’s worth mentioning that, here in the “western world”, we like pointing out the wrongdoings of other countries, especially the scientific misconducts of China and Russia. While I believe a vigilant eye is crucial to ensure proper and ethical research, Pink said it best when she asked: What About Us? 

Some scientists in “the west” have already shifted their research to other less restrictive countries. The approach, called ethics dumping, is a quite nifty strategy to push responsibilities to the other countries if the shit hits the fan, but claim responsibility when successful. It’s an interesting tactic worth writing about in the future. But back to the interview summary. 

Several institutions, including the World Health Organization (WHO), do good jobs in overseeing research and discussing regulations of gene editing procedures, including CRISPR. We have a large and influential scientific and medical community with good intentions and morals. With this in mind, given the current limitations of technology (for example, to change embryos, we’re limited to in vitro fertilization), I think it will be difficult to abuse them. We’ll see or hear of some rotten eggs, but I believe abuse will elicit outrage and reprisals. 

Of note, the research community (even the Chinese) opposed and severely criticized embryonic CRISPR research. 

About the future use of embryonic manipulation. Will these procedures increase in number?

It’s impossible to predict how close we are to normalized designer babies and CRISPR-designed babies, but I believe this will be increasingly accepted over time. Even things that we find outrageous today, such as creating CRISPR-designed babies that look like Kim Kardashian later in life, might be possible in the future. 

Keep in mind that not long ago, the news media debated whether in vitro fertilization was ethically correct. “Who are we to play God?” “In vitro fertilization, blessing or curse?” [note how the religious undertone seems to be a winning concept when headlining scientific doubts] Today, in vitro fertilization is a routine procedure. Still, please remember that I’m not drawing parallels between helping parents have children and human vainness or Kim Kardashian. The examples show how our ideas and values change with time and exposure.  

One thing that speaks against the standardization of CRISPR-designed babies (and designer babies in general) is that we still need to target the desired gene at an early embryonic stage to ensure we change all cells. With today’s technology, that means one approach: in vitro fertilization. In other words, you need to take good ol’ fashioned procreation (you know, the birds and the bees) out of the equation. And here’s where it becomes problematic:

• In vitro fertilization is not 100% efficient (about 40% for women below 35 years), which will most likely require multiple trials before a successful pregnancy.
• Adding CRISPR to the equation complicates things further, considering the low embryonic gene editing efficiency.
• The two procedures are also costly (yes, even ONE try will hurt some wallets.)    

With all these things in mind, you better be sure that you’re making the appropriate change, which means that changing the future shoe size of an embryo might not be worth the hustle in the end. 

Keep calm and CRISPR on

So, there you have it. A small sample of what’s going on in my head when I think about CRISPR and the future. At this point, it’s hard to say how things will develop. While I’m not freaking out right now, I realize that I might need to revise my opinions in a while. But that’s part of biology. And if a sports example helps you to realize the trap of certainty, check out people’s comments about breaking the 2-hour marathon limit pre-Eliud Kipchoge. I wonder how many post-deletions. We’ll keep this post even in the face of the apocalypse, so you’ll get your chance to tell me you told me so. 

Anyway, next time, we might talk about oil, vinegar, and water.

I want to thank Linn Rietze (n-tv.de) for a very interesting interview.