CRISPR: Crispy Fries Your DNA


Story at-a-glance

  • CRISPR gene-editing technology may have significant unintended consequences to your DNA, including large deletions and complex rearrangements
  • The DNA deletions could end up activating genes that should stay “off,” such as cancer-causing genes, as well as silencing those that should be “on”
  • The deletions detected were at a scale of “thousands of bases,” which is more than previously thought and enough to affect adjacent genes
  • As a result of CRISPR-Cas9, DNA may be rearranged, previously distant DNA sequences may become attached, or unrelated sections could be incorporated into the chromosome

By Dr. Mercola

CRISPR gene-editing technology brought science fiction to life with its ability to cut and paste DNA fragments, potentially eliminating serious inherited diseases. CRISPR-Cas9, in particular, has gotten scientists excited because,1 by modifying an enzyme called Cas9, the gene-editing capabilities are significantly improved. That’s not to say they’re perfect, however, as evidenced by a recent study that showed CRISPR may have significant unintended consequences to your DNA, including large deletions and complex rearrangements.2

Many of the concerns to date regarding CRISPR, or Clustered Regularly Interspaced Short Palindromic Repeat, technology have centered on off-target mutations. The featured study, published in Nature Biotechnology, looked at on-target mutations at the site of the “cuts,” revealing potentially dangerous changes that could increase the risk of chronic diseases like cancer.

Is CRISPR Scrambling DNA?

Researchers at the U.K.’s Wellcome Sanger Institute systematically studied mutations from CRISPR-Cas9 in mouse and human cells, focusing on the gene-editing target site. Large genetic rearrangements were observed, including DNA deletions and insertions, that were spotted near the target site.

They were far enough away, however, that standard tests looking for CRISPR-related DNA damage would miss them. The DNA deletions could end up activating genes that should stay “off,” such as cancer-causing genes, as well as silencing those that should be “on.” One of the study’s authors, professor Allan Bradley, said in a statement:3

“This is the first systematic assessment of unexpected events resulting from CRISPR/Cas9 editing in therapeutically relevant cells, and we found that changes in the DNA have been seriously underestimated before now. It is important that anyone thinking of using this technology for gene therapy proceeds with caution, and looks very carefully to check for possible harmful effects.”

The deletions detected were at a scale of “thousands of bases,” which is more than previously thought and enough to affect adjacent genes. For instance, deletions equivalent to thousands of DNA letters were revealed. “In one case, genomes in about two-thirds of the CRISPR’d cells showed the expected small-scale inadvertent havoc, but 21 percent had DNA deletions of more than 250 bases and up to 6,000 bases long,” Scientific American reported.4

The cells targeted by CRISPR try to “stitch things back together,” according to Bradley, “But it doesn’t really know what bits of DNA lie adjacent to each other.” As a result, the DNA may be rearranged, previously distant DNA sequences may become attached, or unrelated sections could be incorporated into the chromosome.5

Cas9, a bacteria enzyme that acts as the “scissors” in CRISPR, actually remains in the body for a period of hours to weeks. Even after the initial DNA segment had been cut out and a new section “pasted” into the gap to repair it, Cas9 continued to make cuts into the DNA. “[T]he scissors continued to cut the DNA over and over again. They found significant areas near the cut site where DNA had been removed, rearranged or inverted,” The Conversation reported.6

Does This Mean CRISPR Isn’t Safe?

It’s too soon to say what the long-term effects of gene-editing technology will be, and there are many variables to the safety equation. The findings likely only apply to CRISPR-Cas9, which cuts through the DNA’s double strand. Other CRISPR technologies exist that may alter only a single strand or not involve cutting at all, instead swapping DNA letters.

There are also CRISPR systems that target RNA instead of DNA and those that could potentially involve only cells isolated from the body, such as white blood cells, which could then be analyzed for potential mutations before being put back into the body.7

The Nature study did make waves in the industry, though, such that within the first 20 minutes of the results being made public three CRISPR companies lost more than $300 million in value.8

Some companies using CRISPR have said they’re already on the lookout for large and small DNA deletions (including one company using the technology to make pig organs that could be transplanted into humans). One company also claims it hasn’t found large deletions in their work on cells that do not divide often (the Nature study used actively dividing cells).9

The researchers are standing by their findings, however, which the journal took one year to publish. During that time, Bradley says, he was asked to conduct additional experiments and “the results all held up.”10 Past studies have also found unexpected mutations, including one based on a study that used CRISPR-Cas9 to restore sight in blind mice by correcting a genetic mutation.

The researchers sequenced the entire genome of the CRISPR-edited mice to search for mutations. In addition to the intended genetic edit, they found more than 100 additional deletions and insertions along with more than 1,500 single-nucleotide mutations.11 The study was later retracted, however, due to insufficient data and a need for more research to confirm the results.12

CRISPR-Edited Cells Could Cause Cancer

Revealing the many complexities of gene editing, CRISPR-Cas9 also leads to the activation of the p53 gene, which works to either repair the DNA break or kill off the CRISPR-edited cell.13

CRISPR actually has a low efficacy rate for this reason, and CRISPR-edited cells that survive are able to do so because of a dysfunctional p53. The problem is that p53 dysfunction is also linked to cancer (including close to half of ovarian and colorectal cancers and a sizable portion of lung, pancreatic, stomach, breast and liver cancers as well).14

In one recent study, researchers were able to boost average insertion or deletion efficiency to greater than 80 percent, but that was because of a dysfunctional p53 gene,15 which would mean the cells could be predisposed to cancer. The researchers noted, ” … it will be critical to ensure that [CRISPR-edited cells] have a functional p53 before and after engineering.”16

A second study, this one by the Karolinska Institute in Sweden, found similar results and concluded, ” … p53 function should be monitored when developing cell-based therapies utilizing CRISPR–Cas9.”17

Some have suggested that if CRISPR could cure one chronic or terminal disease at the “cost” of an increased cancer risk later,18 it could still be a beneficial technology, but most agree that more work is needed and caution warranted.

A CRISPR clinical trial in people with cancer is already underway in China, and the technology has been used to edit human embryos made from sperm from men carrying inherited disease mutations. The researchers successfully altered the DNA in a way that would eliminate or correct the genes causing the inherited disease.19

If the embryos were implanted into a womb and allowed to grow, the process, which is known as germline engineering, would result in the first genetically modified children — and any engineered changes would be passed on to their own children. A February 2017 report issued by the U.S. National Academies of Sciences (NAS) basically set the stage for allowing research on germline modification (such as embryos, eggs and sperm) and CRISPR, but only for the purpose of eliminating serious diseases.

In the U.S., a first of its kind human trial involving CRISPR is currently recruiting participants with certain types of cancer. The trial is going to attempt to use CRISPR to modify immune cells to make them attack tumor cells more effectively. As far as risks from potential mutations, it’s anyone’s guess, but lead researcher Dr. Edward Stadtmauer of the University of Pennsylvania told Scientific American, “We are doing extensive testing of the final cellular product as well as the cells within the patient.”20

Are ‘Designer Babies’ Next?

It’s easy to argue for the merits of CRISPR when you put it in the context of curing deafness, inherited diseases or cancer, and at least 17 clinical trials using gene-editing technologies to tackle everything from gastrointestinal cancer to tumors of the central nervous system to sickle cell disease have been registered in the U.S.21 Another use of the technology entirely is the creation of “designer babies” with a certain eye color or increased intelligence.

About 40 countries have already banned the genetic engineering of human embryos and 15 of 22 European countries prohibit germ line modification.22 In the U.S., the NAS report specifically said research into CRISPR and germline modification could not be for “enhancing traits or abilities beyond ordinary health.” Still, using gene editing to create designer babies is a question of when, not if, with some experts saying it could occur in a matter of decades.23

There are both safety and ethical considerations to think about. With some proponents saying it would be unethical not to use the technology. For instance, Julian Savulescu, an ethicist at the University of Oxford, told Science News he believes parents would be morally obligated to use gene-editing technology to keep their children healthy.

“If CRISPR could … improve impulse control and give a child a greater range of opportunities, then I’d have to say we have the same moral obligation to use CRISPR as we do to provide education, to provide an adequate diet …”24 Others have suggested CRISPR could represent a new form of eugenics, especially since it can only be done via in vitro fertilization (IVF), putting it out of reach of many people financially and potentially expanding inequality gaps.

On the other hand, some argue that countries with national health care could provide free coverage for gene editing, possibly helping to reduce inequalities.25 It’s questions like these that make determining the safety of CRISPR and other gene-editing technology more important now than ever before.

What Does a CRISPR-Enabled Future Hold?

We’ve already entered the era of genetic engineering and CRISPR represents just one piece of the puzzle. It’s an exciting time that could lead to major advances in diseases such as sickle-cell anemia, certain forms of blindness, muscular dystrophy, HIV and cancer, but also one that brings the potential for serious harm. In addition to work in human and animal cells, gene-edited crops, in which DNA is tweaked or snipped out at a precise location, have already been created — and eaten.

To date, the technology has been used to produce soybeans with altered fatty acid profiles, potatoes that take longer to turn brown and potatoes that remain fresher longer and do not produce carcinogens when fried. The latter could be sold as early as 2019.

The gene-editing science, in both plants and animals, is progressing far faster than long-term effects can be fully realized or understood. There are many opportunities for advancement to be had, but they must come with the understanding that unintended mutations with potentially irreversible effects could be part of the package.

Watch the video. URL:https://youtu.be/faSoxyiAAPE
Advertisements

CRISPR: Crispy Fries Your DNA


Story at-a-glance

  • CRISPR gene-editing technology may have significant unintended consequences to your DNA, including large deletions and complex rearrangements
  • The DNA deletions could end up activating genes that should stay “off,” such as cancer-causing genes, as well as silencing those that should be “on”
  • The deletions detected were at a scale of “thousands of bases,” which is more than previously thought and enough to affect adjacent genes
  • As a result of CRISPR-Cas9, DNA may be rearranged, previously distant DNA sequences may become attached, or unrelated sections could be incorporated into the chromosome

By Dr. Mercola

CRISPR gene-editing technology brought science fiction to life with its ability to cut and paste DNA fragments, potentially eliminating serious inherited diseases. CRISPR-Cas9, in particular, has gotten scientists excited because,1 by modifying an enzyme called Cas9, the gene-editing capabilities are significantly improved. That’s not to say they’re perfect, however, as evidenced by a recent study that showed CRISPR may have significant unintended consequences to your DNA, including large deletions and complex rearrangements.2

Many of the concerns to date regarding CRISPR, or Clustered Regularly Interspaced Short Palindromic Repeat, technology have centered on off-target mutations. The featured study, published in Nature Biotechnology, looked at on-target mutations at the site of the “cuts,” revealing potentially dangerous changes that could increase the risk of chronic diseases like cancer.

Is CRISPR Scrambling DNA?

Researchers at the U.K.’s Wellcome Sanger Institute systematically studied mutations from CRISPR-Cas9 in mouse and human cells, focusing on the gene-editing target site. Large genetic rearrangements were observed, including DNA deletions and insertions, that were spotted near the target site.

They were far enough away, however, that standard tests looking for CRISPR-related DNA damage would miss them. The DNA deletions could end up activating genes that should stay “off,” such as cancer-causing genes, as well as silencing those that should be “on.” One of the study’s authors, professor Allan Bradley, said in a statement:3

“This is the first systematic assessment of unexpected events resulting from CRISPR/Cas9 editing in therapeutically relevant cells, and we found that changes in the DNA have been seriously underestimated before now. It is important that anyone thinking of using this technology for gene therapy proceeds with caution, and looks very carefully to check for possible harmful effects.”

The deletions detected were at a scale of “thousands of bases,” which is more than previously thought and enough to affect adjacent genes. For instance, deletions equivalent to thousands of DNA letters were revealed. “In one case, genomes in about two-thirds of the CRISPR’d cells showed the expected small-scale inadvertent havoc, but 21 percent had DNA deletions of more than 250 bases and up to 6,000 bases long,” Scientific American reported.4

The cells targeted by CRISPR try to “stitch things back together,” according to Bradley, “But it doesn’t really know what bits of DNA lie adjacent to each other.” As a result, the DNA may be rearranged, previously distant DNA sequences may become attached, or unrelated sections could be incorporated into the chromosome.5

Cas9, a bacteria enzyme that acts as the “scissors” in CRISPR, actually remains in the body for a period of hours to weeks. Even after the initial DNA segment had been cut out and a new section “pasted” into the gap to repair it, Cas9 continued to make cuts into the DNA. “[T]he scissors continued to cut the DNA over and over again. They found significant areas near the cut site where DNA had been removed, rearranged or inverted,” The Conversation reported.6

Does This Mean CRISPR Isn’t Safe?

It’s too soon to say what the long-term effects of gene-editing technology will be, and there are many variables to the safety equation. The findings likely only apply to CRISPR-Cas9, which cuts through the DNA’s double strand. Other CRISPR technologies exist that may alter only a single strand or not involve cutting at all, instead swapping DNA letters.

There are also CRISPR systems that target RNA instead of DNA and those that could potentially involve only cells isolated from the body, such as white blood cells, which could then be analyzed for potential mutations before being put back into the body.7

The Nature study did make waves in the industry, though, such that within the first 20 minutes of the results being made public three CRISPR companies lost more than $300 million in value.8

Some companies using CRISPR have said they’re already on the lookout for large and small DNA deletions (including one company using the technology to make pig organs that could be transplanted into humans). One company also claims it hasn’t found large deletions in their work on cells that do not divide often (the Nature study used actively dividing cells).9

The researchers are standing by their findings, however, which the journal took one year to publish. During that time, Bradley says, he was asked to conduct additional experiments and “the results all held up.”10 Past studies have also found unexpected mutations, including one based on a study that used CRISPR-Cas9 to restore sight in blind mice by correcting a genetic mutation.

The researchers sequenced the entire genome of the CRISPR-edited mice to search for mutations. In addition to the intended genetic edit, they found more than 100 additional deletions and insertions along with more than 1,500 single-nucleotide mutations.11 The study was later retracted, however, due to insufficient data and a need for more research to confirm the results.12

CRISPR-Edited Cells Could Cause Cancer

Revealing the many complexities of gene editing, CRISPR-Cas9 also leads to the activation of the p53 gene, which works to either repair the DNA break or kill off the CRISPR-edited cell.13

CRISPR actually has a low efficacy rate for this reason, and CRISPR-edited cells that survive are able to do so because of a dysfunctional p53. The problem is that p53 dysfunction is also linked to cancer (including close to half of ovarian and colorectal cancers and a sizable portion of lung, pancreatic, stomach, breast and liver cancers as well).14

In one recent study, researchers were able to boost average insertion or deletion efficiency to greater than 80 percent, but that was because of a dysfunctional p53 gene,15 which would mean the cells could be predisposed to cancer. The researchers noted, ” … it will be critical to ensure that [CRISPR-edited cells] have a functional p53 before and after engineering.”16

A second study, this one by the Karolinska Institute in Sweden, found similar results and concluded, ” … p53 function should be monitored when developing cell-based therapies utilizing CRISPR–Cas9.”17

Some have suggested that if CRISPR could cure one chronic or terminal disease at the “cost” of an increased cancer risk later,18 it could still be a beneficial technology, but most agree that more work is needed and caution warranted.

A CRISPR clinical trial in people with cancer is already underway in China, and the technology has been used to edit human embryos made from sperm from men carrying inherited disease mutations. The researchers successfully altered the DNA in a way that would eliminate or correct the genes causing the inherited disease.19

If the embryos were implanted into a womb and allowed to grow, the process, which is known as germline engineering, would result in the first genetically modified children — and any engineered changes would be passed on to their own children. A February 2017 report issued by the U.S. National Academies of Sciences (NAS) basically set the stage for allowing research on germline modification (such as embryos, eggs and sperm) and CRISPR, but only for the purpose of eliminating serious diseases.

In the U.S., a first of its kind human trial involving CRISPR is currently recruiting participants with certain types of cancer. The trial is going to attempt to use CRISPR to modify immune cells to make them attack tumor cells more effectively. As far as risks from potential mutations, it’s anyone’s guess, but lead researcher Dr. Edward Stadtmauer of the University of Pennsylvania told Scientific American, “We are doing extensive testing of the final cellular product as well as the cells within the patient.”20

Are ‘Designer Babies’ Next?

It’s easy to argue for the merits of CRISPR when you put it in the context of curing deafness, inherited diseases or cancer, and at least 17 clinical trials using gene-editing technologies to tackle everything from gastrointestinal cancer to tumors of the central nervous system to sickle cell disease have been registered in the U.S.21 Another use of the technology entirely is the creation of “designer babies” with a certain eye color or increased intelligence.

About 40 countries have already banned the genetic engineering of human embryos and 15 of 22 European countries prohibit germ line modification.22 In the U.S., the NAS report specifically said research into CRISPR and germline modification could not be for “enhancing traits or abilities beyond ordinary health.” Still, using gene editing to create designer babies is a question of when, not if, with some experts saying it could occur in a matter of decades.23

There are both safety and ethical considerations to think about. With some proponents saying it would be unethical not to use the technology. For instance, Julian Savulescu, an ethicist at the University of Oxford, told Science News he believes parents would be morally obligated to use gene-editing technology to keep their children healthy.

“If CRISPR could … improve impulse control and give a child a greater range of opportunities, then I’d have to say we have the same moral obligation to use CRISPR as we do to provide education, to provide an adequate diet …”24 Others have suggested CRISPR could represent a new form of eugenics, especially since it can only be done via in vitro fertilization (IVF), putting it out of reach of many people financially and potentially expanding inequality gaps.

On the other hand, some argue that countries with national health care could provide free coverage for gene editing, possibly helping to reduce inequalities.25 It’s questions like these that make determining the safety of CRISPR and other gene-editing technology more important now than ever before.

What Does a CRISPR-Enabled Future Hold?

We’ve already entered the era of genetic engineering and CRISPR represents just one piece of the puzzle. It’s an exciting time that could lead to major advances in diseases such as sickle-cell anemia, certain forms of blindness, muscular dystrophy, HIV and cancer, but also one that brings the potential for serious harm. In addition to work in human and animal cells, gene-edited crops, in which DNA is tweaked or snipped out at a precise location, have already been created — and eaten.

To date, the technology has been used to produce soybeans with altered fatty acid profiles, potatoes that take longer to turn brown and potatoes that remain fresher longer and do not produce carcinogens when fried. The latter could be sold as early as 2019.

The gene-editing science, in both plants and animals, is progressing far faster than long-term effects can be fully realized or understood. There are many opportunities for advancement to be had, but they must come with the understanding that unintended mutations with potentially irreversible effects could be part of the package.

Watch the video.URL:https://youtu.be/faSoxyiAAPE

Boy Or Girl? It’s In The Father’s Genes


A study of hundreds of years of family trees suggests a man’s genes play a role in him having sons or daughters. Men inherit a tendency to have more sons or more daughters from their parents. This means that a man with many brothers is more likely to have sons, while a man with many sisters is more likely to have daughters.

A simplified diagram in which men either have only sons, only daughters, or equal numbers of each, though in reality it is less clear cut.
 

A Newcastle University study involving thousands of families is helping prospective parents work out whether they are likely to have sons or daughters.

The work by Corry Gellatly, a research scientist at the university, has shown that men inherit a tendency to have more sons or more daughters from their parents. This means that a man with many brothers is more likely to have sons, while a man with many sisters is more likely to have daughters.

The research involved a study of 927 family trees containing information on 556,387 people from North America and Europe going back to 1600.

“The family tree study showed that whether you’re likely to have a boy or a girl is inherited. We now know that men are more likely to have sons if they have more brothers but are more likely to have daughters if they have more sisters. However, in women, you just can’t predict it,” Mr Gellatly explains.

Men determine the sex of a baby depending on whether their sperm is carrying an X or Y chromosome. An X chromosome combines with the mother’s X chromosome to make a baby girl (XX) and a Y chromosome will combine with the mother’s to make a boy (XY).

The Newcastle University study suggests that an as-yet undiscovered gene controls whether a man’s sperm contains more X or more Y chromosomes, which affects the sex of his children. On a larger scale, the number of men with more X sperm compared to the number of men with more Y sperm affects the sex ratio of children born each year.

Sons or daughters?

A gene consists of two parts, known as alleles, one inherited from each parent. In his paper, Mr Gellatly demonstrates that it is likely men carry two different types of allele, which results in three possible combinations in a gene that controls the ratio of X and Y sperm;

  • Men with the first combination, known as mm, produce more Y sperm and have more sons.
  • The second, known as mf, produce a roughly equal number of X and Y sperm and have an approximately equal number of sons and daughters.
  • The third, known as ff produce more X sperm and have more daughters.

“The gene that is passed on from both parents, which causes some men to have more sons and some to have more daughters, may explain why we see the number of men and women roughly balanced in a population. If there are too many males in the population, for example, females will more easily find a mate, so men who have more daughters will pass on more of their genes, causing more females to be born in later generations,” says Newcastle University researcher Mr Gellatly.

More boys born after the wars

In many of the countries that fought in the World Wars, there was a sudden increase in the number of boys born afterwards. The year after World War I ended, an extra two boys were born for every 100 girls in the UK, compared to the year before the war started. The gene, which Mr Gellatly has described in his research, could explain why this happened.

As the odds were in favour of men with more sons seeing a son return from the war, those sons were more likely to father boys themselves because they inherited that tendency from their fathers. In contrast, men with more daughters may have lost their only sons in the war and those sons would have been more likely to father girls. This would explain why the men that survived the war were more likely to have male children, which resulted in the boy-baby boom.

In most countries, for as long as records have been kept, more boys than girls have been born. In the UK and US, for example, there are currently about 105 males born for every 100 females.

It is well-documented that more males die in childhood and before they are old enough to have children. So in the same way that the gene may cause more boys to be born after wars, it may also cause more boys to be born each year.

How does the gene work?

The trees (above) illustrate how the gene works. It is a simplified example, in which men either have only sons, only daughters, or equal numbers of each, though in reality it is less clear cut. It shows that although the gene has no effect in females, they also carry the gene and pass it to their children.

In the first family tree (A) the grandfather is mm, so all his children are male. He only passes on the m allele, so his children are more likely to have the mm combination of alleles themselves. As a result, those sons may also have only sons (as shown). The grandsons have the mf combination of alleles, because they inherited an m from their father and an f from their mother. As a result, they have an equal number of sons and daughters (the great grandchildren).

In the second tree (B) the grandfather is ff, so all his children are female, they have the ff combination of alleles because their father and mother were both ff. One of the female children has her own children with a male who has the mm combination of alleles. That male determines the sex of the children, so the grandchildren are all male. The grandsons have the mf combination of alleles, because they inherited an m from their father and f from their mother. As a result, they have an equal number of sons and daughters (the great-grandchildren).

Editing Out Blood Disease


Gene therapy successful in 22 patients with severe form of the blood disorder beta-thalassemia

 

In a powerful example of bench-to-bedside science showing how observations made in the lab can spark life-altering therapies in the clinic, an international team of investigators has announced that gene therapy can be safe and effective for patients with a severe form of the blood disorder beta-thalassemia.

Led by Philippe Leboulch, lecturer in medicine, part-time, at Harvard Medical School and a sponsored collaborator in the Brigham and Women’s Hospital Division of Genetics, an international research team reports that a one-time treatment with the gene therapy known as LentiGlobin BB305 vector reduced or eliminated the need for blood transfusions in 22 patients with severe beta-thalassemia.

The results have been published in The New England Journal of Medicine.

“It was always our hope to bring our research findings to patients,” said Leboulch, whose primary appointment has transitioned to the University of Paris as professor of medicine and institute director. “We have taken our work from the lab, through preclinical models and past the proof-of-principle stage and are now able to gauge its effectiveness in patients with this disease. It is immensely gratifying.”

Restoring hemoglobin production

Beta-thalassemia is a genetic disorder that impairs the body’s ability to produce a key component of hemoglobin, the protein in red blood cells that carries oxygen to organs and tissue. Beta-thalassemia and sickle-cell disease are related disorders—both hamper hemoglobin production and can have lifelong repercussions.

From toddlerhood on, people with the most severe forms of beta-thalassemia require monthly blood transfusions to replenish their red blood cell supplies along with iron chelation to remove extra iron from the body.

As a postdoctoral fellow at Massachusetts Institute of Technology, Leboulch began researching a therapeutic approach to compensate for the genetic mutations that lead to both sickle-cell disease and beta-thalassemia. In the 1990s, Leboulch joined HMS and Brigham and Women’s, where he continued his work to develop a viral carrier, or vector, that could insert genetic instructions into a patient’s own blood stem cells and restore hemoglobin production.

Leboulch and colleagues hoped that introducing the altered stem cells back into people would allow the cells to make enough hemoglobin, eliminating the need for blood transfusions.

Leboulch and colleagues studied the vector, LentiGlobin, in pre-clinical models, publishing results from mouse studies in Science. In 2010, Leboulch and his collaborator, Marina Cavazzana of University Paris-Descartes, published a paper in Nature detailing the success of using LentiGlobin to genetically correct cells and transplant them into a single beta-thalassemia patient. Last year, they published in NEJM on a successful gene therapy of the first sickle-cell anemia patient using the same vector.

Blood transfusions no more

In the newly published NEJM study, Leboulch, Cavazzana and their colleagues teamed up with a second group of U.S. and international clinical investigators in Australia and Thailand to share data and results from their respective phase II clinical trials.

In total, the two teams treated 22 patients at six different sites around the world. Among nine patients with the most severe form of beta-thalassemia, the one-time treatment reduced the need for red-blood cell transfusions by 73 percent. Three of the nine subsequently discontinued transfusions altogether. Twelve of the 13 patients with a slightly less severe form of the disease no longer needed any blood transfusions after treatment.

The team reports no safety concerns—treatment-related adverse effects were typical of those seen in patients who receive transplants of their own stem cells.

“When you have an anecdote of a single patient, you never know if it will be confirmed. Here, with a multi-center trial in a larger number of patients, we see a convergence of results, and we can measure the magnitude of the therapeutic effect,” said Leboulch.

“There is room for improvement, as we’d like to see the elimination of dependency on transfusion even for patients with the most severe form of the disease,” he added. “But there is also hope with protocol modifications we have introduced in our phase III trials.”

Based on these results, two pre-drug marketing phase III clinical trials have begun.

Patents on the LentiGlobin BB305 vector are owned by Bluebird Bio, which also sponsored the study. Leboulch is one of the co-founders of Bluebird Bio.

Motherless, designer baby specter increases


Two developing reproductive technologies — one that could facilitate motherless babies and another that could open the door to so-called designer babies — have drawn warnings from Christian ethicists.

In one experiment, researchers at the UK’s University of Bath altered unfertilized mouse eggs so they took on properties like “ordinary” cells, such as skin cells, the BBC reported. Then they created mouse embryos by fertilizing the altered eggs with sperm cells, leading scientists to speculate that two human men, or even one man, may one day be able to conceive a child with similar technology using sperm and another donated body cell.

A separate experiment in Sweden has achieved genetic modification of “healthy human embryos,” which were then destroyed, NPR reported. Lead researcher Fredrik Lanner said he is seeking to help treat infertility, prevent miscarriages and treat diseases. But critics say the research could lead to genetically made-to-order babies and the introduction of new diseases into the human genepool.

Both experiments have troubling ethical implications, Union University bioethicist C. Ben Mitchell said.

“The biblical ideal for procreation is one man, one woman, in a one-flesh relationship, in which children are received as a gift,” Mitchell told Baptist Press in written comments. “Every violation of that ideal results in human trauma and heartache, whether through adultery, divorce or death.

“The use of reproductive technologies that end up destroying unborn human beings is a clear harm. If we defy the procreative relationship by creating parentless babies, there is likewise clear harm. Even if we could justify the outcome, think of the human carnage on the way to the goal. Countless human beings — generated at the hands of researchers — would die in the process of trying to perfect the techniques. The end does not justify the means when the means are immoral,” said Mitchell, Union’s provost and Graves Professor of Moral Philosophy.

Conception without eggs?

The British experiment, reported Sept. 13 in the journal Nature Communications, is only a first step toward motherless human babies, with researcher Tony Perry calling such a prospect “speculative and fanciful” at present, according to the BBC.

Still, Charles Patrick, a Southwestern Baptist Theological Seminary vice president who holds a Ph.D. in chemical and biomedical engineering, warned of skewing God’s plan for procreation described in Genesis 1-2.

“Just because we can develop a reproductive technology does not mandate that we must develop the technology,” Patrick told BP. “It seems unwise to develop reproductive technologies that preclude the use of sperm or eggs.”

“First, and to be scientifically honest, much of what occurs when a sperm and egg unite continues to be a mystery. There are potential errors with dangerous consequences that may occur when cells are ‘tricked’ into functioning in a manner not natural for them,” he said in written comments. “Second, reproductive technologies that remove either the egg or the sperm open the cultural door further to a genderless society.”

Additionally, creating babies without either egg or sperm cells “would provide childless couples yet another ‘extraordinary means’ distraction from adoption. Adoption is clearly espoused and modeled throughout Scripture,” Patrick said.

R. Albert Mohler Jr., president of Southern Baptist Theological Seminary, said the University of Bath research illustrates society’s quest to redefine “everything about sex and reproduction and marriage and gender.”

The sexual revolution, Mohler said Sept. 22 on his podcast The Briefing, has necessitated “a technological revolution” whose proponents seek reproduction “without marriage, and in this case … without women.”

Genetically made to order?

The Swedish research uses a genetic engineering innovation to “edit” healthy embryos’ DNA for what NPR deemed the first time ever. British scientists have said they will begin similar experiments later this year.

Thus far, at least 12 embryos — which were donated by couples who generated them as part of the in vitro fertilization process — have been modified, and researchers have vowed to destroy all modified embryos no later than their 14th day of life.

Patrick called any “use and destruction of human embryos” unethical because it “does not preserve the worth, dignity and value of human life defined in Genesis 1-2.” Yet “even if there were not a sanctity of life issue, there are other issues to consider in opening the epigenetic black box.”

“For instance, although there is the promise of correcting devastating diseases, there is equally the specter of creating designer babies or other non-therapeutic modifications and of introducing unintended consequences in the human germline,” Patrick said.

“Man was mandated in Genesis to be a steward of creation, and emphasis throughout Scripture is placed on restoring what God originally purposed in His creation. Hence, there is a general biblical warrant for scientific advances and technologies that restore,” he said.

“However, there is not clear biblical permission to manipulate genes toward perfection. Gene editing cannot reverse what sin and resulting human depravity wrought to God’s perfected creation. There is a flesh-spirit aspect that gene editing does not and cannot incorporate,” Patrick said.

Mohler wondered aloud Sept. 23 in The Briefing, “How long will it be before the bumper sticker on the back of the SUV says, ‘My child is genetically enhanced?’ … That day might after all not be so far in our future.”

5 Things To Know About In-Home Genetic Testing


Recently,  in-home genetic testing kits, such as 23andMe and Color, were granted FDA authorization to provide direct to consumer, no prescription needed, in-home genetic testing. On the surface, this seems very attractive. Genetic mutations are thought to account for 5-10% of all cancer diagnoses (cancer.gov). As we learn more about how genetics influence our cancer risk, more individuals may want to learn about their own genetic make-up and how to reduce their risk for developing cancer. These tests offer the convenience of performing the test at home. Here are five things you should think about BEFORE undergoing ANY kind of genetic testing.

1. Genetic testing should NOT be taken lightly.

It isn’t just a simple “spit into a vial” process. Assessing genetic risk also includes taking a complete family and personal health history, as well as counseling and education about the test results, after the test is completed. Genetic counseling and genetic testing go hand in hand. It is essential that you receive education associated with your results, as well as counseling about talking to your family about your results. 23andMe only offers referrals to genetic counselors in your geographic area, not actual counseling services. Color offers “professional genetic counseling.”

2. Genetic testing is complex.

There are over 50 hereditary cancers, each with multiple potential gene mutations. For example, BRCA is associated with a higher risk of ovarian cancer, breast cancer and prostate cancer. These in home kits only test for only three genetic variants associated with BRCA mutations – yet many more exist. The mutations that are included in this test tend to be associated with individuals with Ashkenazi Jewish heritage. While these tests may be helpful for people from this population, others who undergo the test may receive a false sense of security with a negative test result. It doesn’t necessarily mean the test is negative and you don’t have the mutation—it just means you don’t have one of these three mutations. These tests do not test for any other cancer related gene mutations.

3. Genetic testing IS typically covered by insurance, if you have a strong family history that suggests higher cancer risk. 

23andMe and Color are not covered by insurance. The current cost for 23andMe is $199 (this includes more than just cancer targeted genetic testing for BRCA mutations), for Color it is $99 (this is only for BRCA mutations).

Under the Affordable Care Act (ACA), genetic testing for BRCA 1 and 2 must be covered by insurance plans when there is a strong family history of BRCA associated cancers.

4. Privacy and confidentiality guidelines for health protected information may be questionable with in-home testing kits.

The test results generated by 23andMe and Color are maintained by these companies. They are not part of your medical record and thus MAY NOT be covered under HIPPA guidelines. While this company does not share your genetic test results, they can sell your personal information to third parties who may want to include you in research or market other products to you.

5. Genetic testing results are protected under the Genetic Information Nondiscrimination Act (GINA).

GINA protects family health history, the results of genetic tests, the use of genetic counseling/genetic services and individuals participating in genetic research from being discriminated against by health insurers or employers. This includes results from in-home testing kits. However, genetic testing information is not protected by GINA if you are attempting to purchase life insurance. Genetic information CAN be used during the medical investigation/under-writing process for a life insurance policy..

Talk to your healthcare provider before undergoing ANY genetic testing. Ask questions about your risk, your family history, and your own personal behaviors that may influence your cancer risk. While 23andMe and Color may offer a “jumping off point” or introduction to testing for genetic mutations, they are hardly foolproof and may produce false negatives and/or misinformation. Ultimately, it is buyer beware with in home genetic testing and an educated consumer “is the best customer.”

For more information about genetic risk and cancer, visit Facing our Risk of Cancer Empowered (FORCE).

Synesthesia’s Molecular Roots Traced Back to Rare DNA Mutations


For people with auditory-visual synesthesia, striking a piano key may ignite visions of turquoise geometric patterns or a twanging guitar string could create the sensation of billowing orange foam. Many aspects of life may feel like a sober LSD trip for people who experience this neurological phenomenon, and in a study published Monday in the Proceedings of the National Academy of Sciences, scientists came one step closer to characterizing exactly who these people are.

In a statement released Monday, scientists from the Max Planck Institute for Psycholinguists and the University of Cambridge report a discovery that they hope will eventually “explain the biology of synaesthesia.”

Previous brain-imaging studies have demonstrated that the visual areas of synesthetes’ brains are more active and that synesthetes have altered cortical wiring at the embryo stage, but until now scientists haven’t been able to trace the phenomenon back to its molecular roots. In the new paper, they show that auditory-visual synesthetes — one of at least 60 known sense variants — carry variants of genes related to the development of neural connections and cell migrations. Characterizing these genes, the authors write, is the first step in understanding how a person’s genes influences these extrasensory associations.

synesthesia, Pharrell Williams
When Pharrell Williams listens to Earth, Wind, and Fire he sees baby blue.

Synesthesia is known to run in families, so the scientists examined DNA samples belonging to several generations of three families with multiple cases of auditory-visual synesthesia. Using genomic sequencing, the scientists searched the DNA for changes that altered the way genes code for proteins. There were consistent variations on genes associated with cell migration and axogenesis, the process that enables brain cells to wire up to their correct partners — a consistent theme across all three families. Six genes were altered within these synesthetes: COL4A1, ITGA2, MYO10, ROBO3, SLC9A6, and SLIT2.

“These results are consistent with the neuroimaging-based hypothesis about the role of hyperconnectivity in the etiology of synesthesia and offer a potential entry point into the neurobiology that organizes our sensory experiences,” the scientists write.

Frank Ocean
Lorde says her synesthesia helped her write “Melodrama.”

Now that these genes have been identified, the scientists hope to better understand how and when they turn on during development and affect the way the brain is wired. Of course, there’s still a huge amount to learn when it comes to understanding how people can experience something as spectacular as the blending of color and sound. That’s why the team behind this study has put out the call for other synesthetes — especially families of them — to come and participate in future studies. The scientists have also created this short quiz that people can use to test for the ability: If you pass, you join the just one percent of folks who pulsate with the involuntary cross-activation of their senses.

7 Traits Kids Get From Their Fathers


7 Traits Kids Get From Their Fathers

Scientists Are Annoyed by This Pretty Big Flaw in The New DNA Emoji


They had one job (╯°□°)╯︵ ┻━┻

Unicode, the standards body that decides which emojis we all need on our phones and laptops, is finally adding a bunch of science emojis to the mix, including DNA – but there’s confusion over the style of the doodle that will eventually get used.

That’s because one of the samples shown by Unicode and Emojipedia shows DNA strands twisting to the left, as they do on the less common Z-DNA.

For the most common B-DNA structure, the one that is responsible for the origins of life, the twists should be right-handed.

The difference isn’t easy to spot at first, but it’s crucial in dictating the way the ladders of DNA are structured – it’s like going down a spiral staircase clockwise or anticlockwise, with one state the complete mirror image of the other.

dna emojis 2The new emoji, as imagined by Emojipedia.

Scientists love accuracy more than most, and so the new symbol sample has caused some frustrated reactions on Twitter, as Gizmodo reports.

Researchers have been quick to point out that Unicode and Emojipedia has gone for a spiral that twists in the wrong direction – or at least in the more obscure, less common direction.

However, the original draft of the new emojis for 2018 had the DNA emoji twisting in the correct way, so it seems there’s some confusion about which one will eventually get used.

dna emojis 3The original Unicode draft.

If you’re struggling to understand what we mean, point your index finger away from you, push out your hand and rotate your finger in a clockwise direction – you’re drawing DNA in the air. If you rotate your finger anticlockwise, you’re drawing Z-DNA.

All is not lost though: Apple, Google, Microsoft, Samsung and the rest all design their own emoji styles on top of whatever Unicode puts forward – that’s why emojis look different from device to device and app to app.

So there’s still hope these tech giants may not totally stuff up, and the final emoji designs on our devices will end up spiralling the right way.

In the meantime, scientists are busy pointing out the mistake. It may not matter too much in the grand scheme of things, but if you’re going to have a DNA emoji, you might as well make sure you get it right.

Other science-related emojis in the list of 157 new ones rolling out this year include a magnet, a test tube, and a petri dish (there’s a full list at Emojipedia). Before too long then, you should be able to have much more meaningful emoji-based science conversations with your friends.

DNA’s double-helical structure, which creates the twisting pattern, was discovered way back in 1953, with a right-handed spiral.

Since then scientists have wondered what caused that right-handed bias. One idea is that cosmic rays destroyed the left-handed ancestors of DNA on the early Earth, but at the moment we really don’t know for sure.

What we do know is that DNA should have a right-handed spiral, and flipping it over to show a mirror image is wrong – just as wrong as trying to exactly duplicate the actions of a right hand with a left hand.

This isn’t the first time this mistake has been made – the same error has appeared in textbooks and in graphics many times in the past – and we can’t get too angry when we’re getting skateboards and kangaroos added to our emoji vocabulary.

Now though, you should all know what to look out for. When the emojis eventually land on your phone, take a close look to see which way the DNA strand is twisted.

Debating Whether Next-Gen Sequencing Should Be Applied Universally in Metastatic Breast Cancer


Large list of potentially targetable genes, but what about outcomes?

Interest is great in genomically informed targeted therapy, with the goal of identifying genomic alterations that (1) are drivers of tumor growth and progression in individual patients to individualize therapy; and (2) are targetable directly or indirectly with approved or investigational agents.

But should all women diagnosed with metastatic breast cancer undergo next-generation sequencing (NGS)? The question was debated by two experts at the most recent San Antonio Breast Cancer Symposium.

Yes, said Funda Meric-Bernstam, MD, chair of Breast Cancer Research at the University of Texas MD Anderson Cancer Center in Houston. Genomic testing should be part of the clinical management, and should be considered in all patients with metastatic breast cancer and adequate performance status who have an interest in clinical trials.

A large list of genes are potentially targetable in breast cancer, she said, pointing to PIK3CA, Akt, HER2, TRK and other rare alterations.

Several PI3K inhibitors are in clinical trials to target PIK3CA, with “emerging hope in upcoming inhibitors such as alpelisib in combination with fulvestrant” in PIK3CA-altered advanced breast cancer, she said. Activating Akt mutations, usually E17K, are most commonly found in hormone receptor-positive breast cancer. Objective responses have been elicited with the catalytic inhibitor AZD5363 as monotherapy in patients with estrogen receptor-positive AktE17K-mutant breast cancer and is now being studied in combination with fulvestrant. Ipatasertib, another Akt inhibitor, combined with paclitaxel in patients with PIK3 pathway aberrations increased progression-free survival to 9.0 months, compared with 4.9 months with paclitaxel alone in a phase II study.

HER2 is a proven genetic target, Meric-Bernstam said, noting that some patients who are HER2-negative on initial screening are subsequently found to be HER2-positive on NGS of another or newer sample. “We’re not sure if this is genomic evolution or heterogeneity or technical issues with the first testing, and we’re not as sure of the therapeutic sensitivity in this context, especially if it represents heterogeneity.”

If the tumor is HER2 amplified on NGS, validation is not needed to institute HER2-directed therapy. If the tumor is not amplified on NGS, the patient may still have a lower level of amplification or overexpression. “There’s a lot of enthusiasm about exploring HER2 mutations as a target.”

A few years ago, activating HER2 mutations were discovered in HER2-negative breast cancer. In a series of 5,605 women with breast cancer who underwent genomic profiling, 10.6% had HER2 amplifications, 2.4% had HER2 mutations, and 0.7% had co-occurring HER2 amplification and mutation, she continued. A few agents have already been approved in the HER space, with neratinib being the most prominent.

A very rare alteration found in several tumor types including breast cancer is TRK fusions. As presented at the 2017 ASCO annual meeting, in a phase I/II basket trial of patients with TRK (tropomyosin receptor kinase) fusions, almost all patients treated with the pan-TRK inhibitor larotrectinib had an objective response, which proved durable. Meric-Bernstam explained that TRK fusions are pathognomonic in secretory breast cancer, which constitutes less than 1% of breast cancers. “Because they are rare in breast cancer, I am not going to advocate for TRK fusion testing across the board for this reason, but if you do have a secretory breast cancer patient, please do TRK fusion testing.”

Not performing NGS means that patients with rare alterations cannot be entered into genotype-selected clinical trials, she argued.

ESR1, another current clinically relevant mutation, is rarely found in primary breast cancer but is commonly found in the metastatic setting. Evidence suggests that as ESR1 mutations accumulate with further treatment, there may be some value in retesting or performing liquid biopsy. An ESR1 mutation may affect the choice of therapy; an improved PFS was obtained with the use of fulvestrant compared with exemestane in breast cancer patients with ESR1 mutations, which was not the case in the patient who were ESR1 wild type.

Outcomes Not Altered, Potential Pitfalls Remain

The debater taking the other side at the symposium, Fabrice André, MD, of Gustave Roussy Cancer Center in Villejuif, France, said the key question is whether in the context of routine practice, NGS should be considered for detection of somatic mutations. At least as of yet, he said, no such rationale exists.

At present, no drug approved for use in the treatment of breast cancer requires a genomic test, he reminded listeners. “The reason is because the current way of interpreting DNA sequencing is not useful in metastatic breast cancers, and is potentially deleterious.”

Although NGS has been able to detect alterations in PIK3CA, Atk1, ERBB2, and ESR1 for which objective responses have been observed with the use of targeted therapy in early phase study, their detection did not improve outcome. Progression-free survival in these studies ranged from 5 to 8 months, which was not superior to standard of care. Further, these alterations can be detected by polymerase chain reaction (PCR) assays on circulating tumor DNA, which would be less expensive than NGS, he said.

In the case of sensitivity to PD-1 inhibitors such as pembrolizumab, accelerated approval of the agent was granted in those patients with microsatellite instability-high or mismatch repair-deficient solid tumors. The companion diagnostic for this purpose is immunohistochemistry or PCR, not NGS, said André. “Keep in mind that breast cancer with microsatellite instability is extremely rare — something like 1% and mostly in triple-negative breast cancer.”

The largest commercially available NGS panel can detect about 300 targetable genomic alterations. The issue here is that large gene panels report targetable alterations that are not relevant or for which the wrong drug may be recommended. Therefore, NGS reports can be deleterious because they recommend ineffective therapy and deny effective therapies, he said — one illustration of the wrong target, for example, is fibroblast growth factor receptor (FGFR)1/2 amplification for which an FGFR may be recommended. Nogova et al reported an objective response rate of 0% in patients with breast cancer and FGFR1/2 amplification.

Two large clinical trials in which large gene panels were used had efficacy as the primary endpoint, and in both cases, the targeted drugs matched to the genomic alteration detected by NGS failed to improve PFS.

Finally, said André, the reporting of large panels of genes leads to major ethical, regulatory, and financial issues that have not yet been sorted out. For example, in comparing results obtained from different NGS vendors, the overlap in genomic alterations is sometimes poor. Another pitfall is that somatic genetic testing in patients with advanced cancer may also detect previously unrecognized pathogenic germline variants.

Furthermore, he said, with genomic testing the likelihood of finding a drug matched to a genomic alteration is low. Although sequencing is inexpensive, it generates additional cost for biopsies and potentially the off-label use of expensive drugs.

%d bloggers like this: