For many centuries, healthcare had evolved and advanced at a snail’s pace. Jane Metcalfe is the co-founder of Wired and the founder of Neo.Life. At a recent MedTech conference in San Diego, Metcalfe said, “The history of innovation is not that exciting—until you get to the 20th century.”
Since then, medicine has grown at a break-neck speed. The field’s knowledge base grew to encompass micro-organisms as well as molecular biology involving DNA. Better practices from more studies about this topic led to fewer diseases, deaths, and mistakes. Now, the next big advancement will be designing and manipulating our own biology using this deep knowledge we’ve acquired.
We’ll be engineering new biology in the near future, whether it be bacteria, viruses, animals, or people. In some places around the world, like China, testing of biological modifications is happening already.
Metcalfe says that biological design is the next big thing in healthcare and medicine. Imagine giving every embryo immunity to diseases. Humanity’s lifespan would improve, and it would greatly reduce infant and adolescent deaths. For Metcalfe, we’re nearly there.
“We can design embryos. We can edit genes in humans. We have synthetic biology. And so we really are looking at designing future humans,” she says.
Many people know about CRISPR, which is a tool used to edit genes. This tool is so precise that it can almost manipulate genes down to A/T C/G bases: the building blocks of DNA itself.
CRISPR’s reach and varied feature-set mean that CRISPR and systems based off CRISPR are always improving and expanding. One of the latest products featuring CRISPR is CRISPR prime editing, which is a minimally-invasive way to “search and replace” or modify DNA bases without causing much damage to the DNA.
The Topic of Ethics
In 2018, the world was surprised to find that Dr. He Jiankui, a scientist in China, used CRISPR to edit human embryos. He gave the embryos immunity against HIV and implanted the embryos for birth. Many scientists and experts disagreed about this use of CRISPR to edit human embryos, but another scientist, in Russia, has also announced his intentions to use CRISPR for embryo gene editing.
The ethics and consensus about gene editing still are murky. It seems to vary from person-to-person and nation-to-nation. At the base of the ethical discussion is the fact that these tools are still works-in-progress. Another topic of contention is the idea of permission. Do the parents give permission for embryo editing? What about the eventual child — could it cause problems that it was born with genes from human intervention?
Lastly, we don’t even know the true effects of editing one group of genes on the other genes. For example, once we’ve rid an embryo of the risk of Alzheimer’s, could it affect another gene group negatively?
For George Church, a bioengineer who’s identified 50 different alleles that are beneficial for humans, the possibility of healthier children may outweigh these ethical questions. Church has found gene groups that protect against Alzheimer’s disease, memory loss, aging, and cardiovascular disease risk.
Coding Our Future
Metcalfe adds that it’s not only our existing genes that will be edited and redesigned. Scientists around the world are creating new synthetic biological systems from scratch.
Andrew Hessel is the CEO of Humane Genomics and professor of nanotechnology/biotechnology at Singularity University. He says that scientists are quite experienced with writing DNA code now, and they’re getting really good at it.
Look no further than Twist Bioscience, says Hessel. The synthetic biology company creates short, custom sequences of DNA in large scales. Twist allows customers to design and order sequences for delivery to their homes.
Craig Venter, known for his work in sequencing the first human genome, created the first reproducing synthetic bacteria in 2010. In 2016, he developed a “minimal” synthetic cell, which has the smallest known genome. Another group in 2019 followed up Venter’s achievements with an announcement that they’d created synthetic E. coli. And right now, scientists are working to create the first synthetic eukaryotic cells using yeast.
Eventually, writing entire human genomes from scratch will be a 101-level course at universities, and Hessel has co-founded an initiative called the Genome Project-write (GP-write) to gather the world’s top synthetic biologists to accomplish this.
The Next Step in Our Evolution
This medical development still has a lot of work to be done, including better software to make designing more accurate and efficient and improved tools for longer sequences. But Hessel is aware of these issues and actively working on implementing solutions. Regardless, Hessel says, these updates won’t take more than 10 years to complete.
The rate of past progress is a good indicator of the pace of progress in the future. Hessel says, “Literally in 10 years we’ve gone from making proteins synthetically to making a eukaryote. As soon as we can start making whole chromosomes, well, we’ve only got 23 of them. It’s not going to take very long until you end up bumping up against the human genome.”
According to Metcalfe, it wasn’t so long ago that Dolly the sheep was cloned as the first cloned animal in 1996. Before that, the first in-vitro fertilization baby was born in 1978, and DNA’s structure was only discovered in 1953.
But in the last two decades, we’ve closed the gap in years between significant achievements. We even sell DNA-testing kits over the Internet now, and we’re able to see our results within days of mailing back the package.
It’s clear that we’ve got the tools to create our own biology. But do we have the right state of mind, a strong foundation of ethics and guidelines, and agreement about what’s acceptable and what isn’t? As with many emerging technologies, we mustn’t run too far ahead without discussing the consequences of these technologies.
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