The State of In Utero Gene Editing

Ashley Nelson

For centuries expecting parents have worried about the health of their babies. Pregnant women often follow strict instructions from their doctors to keep their fetuses healthy, but no amount of special diets or exercise regimens can prevent genetic conditions if the fetus has the right genes. As our confidence in science has grown more and more people have looked toward scientists and their research as the saving grace for these families. And it’s looking like the scientists of the world have delivered.

For years the idea of editing the genes of unborn babies seemed like nothing but a pipe dream to some and an ethical nightmare to others, but now it is looking like this could be a real possibility in the future. So where are we with in utero gene editing? And what do we need to know?

A study that has encouraged many was released in April of 2019 by a group of scientists from the University of Pennsylvania which showed they were successful in increasing the survival rates of lab mice with the gene for a lung disease which, without editing, results in death within an hour of birth.

These scientists used CRISPR, a gene-editing technology that allows scientists to edit the genetic code of living things, to do this. CRISPR works by essentially “cutting” a specific gene and then “pasting” the desired gene variant in its place (Metcalfe, 2018). Specifically, this experiment used CRISPR-Cas9 which was injected into the placenta of pregnant mice whose unborn pups had the mutation that causes fatal lung disease. When the unborn pups took in the amniotic fluid, they also took in these CRISPR elements which then began to edit their DNA. Of the mice who were edited with CRISPR, 25% survived compared to those who were born with the gene who all died. This is promising. It has encouraged many of those who support the idea of in utero gene therapy, but the experiment also raises some concerns.

One major concern is that when the CRISPR-Cas9 was delivered in vitro there was a high mortality rate among the unborn mice pups. This may be due to the small size of mice in general but with so little data on how this affects larger animals, human testing would be ill-advised. The mice also did not need the gene the mutation was on to survive, allowing the researchers to simply remove the gene. Most human mutations we would look to “cure” in the womb are on genes that we still need and so a far more delicate and complex process would likely need to be undergone when using gene therapy on human fetuses.

There are other concerns for in utero gene editing in humans. One of the largest is that of the mother and her health. We do not know how the mother’s body could react to the introduction of this foreign agent, extreme immune responses are possible and could pose a danger.

Ultimately, we do not know enough about in utero gene editing for it to be a viable option anytime soon. The results we have are promising but they are far from conclusive and much more needs to be known before human trials begin. That being said in utero editing is looking for more possible now than it ever has before and the ethical questions that come with such a discovery are becoming increasingly relevant. As questions about genetic editing in utero are steadily changing from can we to should we, people are beginning to ask questions like: Could this technology be misused? Could it lead to a rise of Eugenics—which most associate with Hitler and his obsession with creating the “perfect” Aryan race? And perhaps the biggest question of all: Are we playing God editing the genes of unborn children?

At the same time that many are asking these questions, we must also think about the benefits of such technology. We do not know everything that CRISPR may or may not be able to do in the future, and some of these concerns may ultimately be unfounded. This technology could be revolutionary and save countless lives in the future and that must also be taken into account. While it is easy to think of the worst-case scenarios with any new technology there is also danger in letting our fears control us. Luckily for those of us attempting to understand the ethical implications of such technology it will be sometime before in utero gene editing becomes a viable option. In this time, we have we should continue to do research and discuss the questions and concerns we have so that when it does become a more realistic option we are not left floundering as to how to use and regulate such technology.

References

Alapati, D., Zacharias, W. J., Hartman, H. A., Rossidis, A. C., Stratigis, J. D., Ahn, N. J., … Peranteau, W. H. (2019, April 17). In utero gene editing for monogenic lung disease. Retrieved November 14, 2019, from https://stm.sciencemag.org/content/11/488/eaav8375.

Hou, C.-Y. (2019, April 19). Mice Gene-Edited While Still in the Womb. Retrieved November 14, 2019, from https://www.the-scientist.com/news-opinion/mice-gene-edited-while-still-in-the-womb-65767.

Metcalfe, T. (2018, December 31). What is CRISPR? Retrieved November 14, 2019, from https://www.nbcnews.com/mach/science/what-crispr-ncna952696.

This is a graphic depicting a gloved hand editing an enlarged DNA strand. (2018). Retrieved from https://geneticliteracyproject.org/2018/08/06/what-is-crispr-and-why-should-you-care/

Rivers Alive Cleanup

I did the River’s Alive Cleanup for my outreach project. Specifically, I worked at the MLK Greenway helping clean up the riverbank. There we searched for trash and materials that shouldn’t be near waterways. I went with a few of my classmates and we worked in pairs to find and bag the trash.

I was pleasantly surprised by how small the amount of rubbish we found was. That is not to say that there was nothing to find; there were still bags and bags of garbage but having been around other similar rivers I could really see the difference that Rivers Alive has made in the years it has been working on the banks. It was especially obvious as there was a private stretch of land in our area that we left alone which clearly had significantly more debris in the wooded areas. While we still found objects that frankly had no reason to be there, I could see the progress that had been made and was really proud of the people who have been working toward improving our river.

I think experiencing the process of cleaning up such important areas is useful for everyone in that it makes our effects on the environment easier to understand. I do not think that the experience required any special skills or knowledge, though I found having some personal experience in the woods helpful. While I did not run into any poison ivy or snakes, I found that being prepared for such situations helped put me at ease so I would suggest others have some short teachings on such things as well.

I found that I enjoyed the experience more than I expected and may consider doing it again in the future. The people who were in charge were really nice and appreciated everyone’s help regardless of skill level. I had the chance to speak with one of the men who had participated in Rivers Alive many times before and he told me about how in the 70s people used to use their trash to build up embankments, not knowing any better. I found this fascinating as I have never understood before how so much garbage ever began to accumulate by these rivers. In the future regardless of whether I am able to help with cleanup again, I plan to support the efforts of River Alive and encourage others to do the same and take care of the planet we have.

Climate Simulation Reflection

When I played my role in the policy exercise, I was a member of the developing nations. At times I felt slightly frustrated when other countries expected us to “contribute more” when at the point we were at there wan not much more we could. This particularly difficult in regards to carbon emissions as everyone seemed to forget how many people we had and that some form of carbon emissions was inevitable. Generally, though I was able to understand where they were coming from, though I think part of the issue is that while the design of the agreements worked for most nations in regards to decreasing climate emissions it did not in regards to us and India. As the two groups with the lowest per capita carbon emissions, we simply could not sustain any yearly percentage decrease. We could offer a one time decrease of a certain percentage over some years but that proposal could not be incorporated into any calculations. In some ways, our group was lucky in that we had so little that our ideas and requests stayed fairly consistent throughout the process. It was, however, heartbreaking to see that even with all of our aforestation and anti-deforestation efforts, ultimately it did little. I remain optimistic though that over time as though forests would build up they could have a greater impact, it just might be an impact that the people who start such campaigns would never get to see—I still believe it would be worth it.
Several issues arose in the simulation that I am sure are problems with these negotiations today. Mistrust between countries and fear of political corruption is one that we, in particular, had to deal with. This I completely understand. The developing countries of the world (particularly the regions we were given) are rife with corruption and greed in the places of power. These powerful but corrupt individuals are also proponents of taking advantage of their natural resources when they can—regardless of the long-term consequences (The Brazillian President Jair Bolsonaro and his attitudes toward protecting the Amazon being only one of many examples). These are issues that will not be easy to solve. In the simulation, we were able to work out arrangements that included other countries being able to oversee operations they were funding (so long as the jobs went to out people) but we are not blinded by greed or a lust for power the way many world leaders, unfortunately, are.
All in all, I am more optimistic now then I have been in the past about reducing emissions. There seems to be a growing base of support for the idea in the US as well as in China. Here I think we can continue to present the facts, and perhaps stop presenting climate-change deniers as if they have the same scientific backing that climate change itself does. I am not sure if we will realistically be able to get the average degree increased to 2 degrees celsius, but I have hope that more people will see the severity of the situation, and that if some countries who are committed to this are able to sustain themselves on more green energy that the more stubborn of the countries (in particular the US) may come around to the idea.

Blog Post Photo Reflection

Start basic: In this picture, I see a metal sculpture along the river bank.
What I notice in this picture: The sharp juxtaposition between the sculpture and its surroundings.
What this picture makes me think about: While the artwork itself is clearly well made it does not seem to fit into its environment and its sharp lines seem almost ugly next to the more organic and gentle ones of nature that surround it. In contrast, the stone walls don’t seem quite so intrusive. The picture makes me think about how we interact with our environment. There are two approaches in the photo: one is that of the metal which stakes a place for itself regardless of whether it belongs (which is even shown in the rusty look of the sculpture) and the other is the stonework which uses materials that feel more natural in the environment.
When I look at this picture, I feel: This picture makes me feel uncomfortable. The metal sculpture seems to be intruding on the serenity that surrounds it as well as seeming to deteriorate so much faster than its current habitat.
I think this picture is about: To me, this picture addresses a few issues. One it draws attention to the effect of industrialization on the environment: if this metal structure seems so wrong where it is shown, how well do our other metal contraptions belong? Are we just disturbing the natural beauty and serenity of the world? It also presents a commentary on the passage of time. The unnatural sculpture rusts and deteriorates while its surroundings flourish in comparison. There seems to be a metaphor about the importance of humanity in the life of the world in that. The third and perhaps most topical message seems not to discourage human interaction but rather to encourage careful thought before taking said action. There are two human structures shown and one clearly seems to be more natural in the environment as well as in better condition. This could be a message about how working with our environment can lead to more successful and enduring endeavors than stubbornly staking our place with no regard for the world around us will ever produce.

Ashley Nelson

Last semester I took a geology course for nonscience majors and I took IB SL Chem in high school.
I would like to gain an interest in biology. I have always loved chemistry but could not find the same fascination with biology, excepting genetics units which I have always found fascinating.
I really like the idea of working to educate people about the dangers of littering and contaminating watersheds. I feel like you always hear about how your trash goes to the ocean and not the other bodies of water (that are so crucial to our environment) that are affected. I think that focusing on more local issues may resonate more with people (we are more likely to act when immediately affected). I have worked on different community education projects in the past, though never any science-based ones.
I expect to learn more specifics on how our community and others are affected by these issues. I also believe it will teach me more about how to successfully interact with and educate the community.
I would really love to learn more about genetics, especially about the causes and effects of mutations. I think mutations like red hair and heterochromia (and not only total heterochromia) are particularly interesting as they seem to have little effect on survival (positive or otherwise) but still occur fairly often. I also think that learning more about biochemistry could be interesting though I have no specifics that I want to know more about.