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Using the CRISPR/Cas9 technology will certainly advance the field of genome engineering. But will it resolve public concerns regarding long-term safety and will it change our way of living?
GMO foods
Genome sequencing with the CRISPR can help, due to its specificity in editing desired traits, which results in potentially fewer off-target effects. But the problem remains that when an unexpected negative outcome happens, outcrossing could spread to non-altered crops, by nature or by man. Outcrossing could impact hundreds of millions, or even billions, of people in our global economy. Measures can be taken to minimize the occurrence of mishaps, but precipitating incidents would be nearly impossible to control on a large scale.
A recent survey conducted by North Carolina State University and University of Minnesota polled 1,117 U.S. consumers nationwide about their preference for choosing nanotech foods and GMO foods with qualifiers such as price, nutrition and taste. Survey responses showed that in general, consumers are willing to pay more to avoid these technologies in their food. However, they are more willing to buy these foods if there are health and safety benefits.
When we alter our foods, will we encounter the same issues with wheat (gluten), where we have difficulty digesting the grain completely? This partial digestion triggers the release of the protein Zonulin, that opens the tight junctions of our intestinal lining and leads to a leaky gut, which may affect our immune system.
Research and developing new drugs
This is an area where genome engineering could advance basic research and our understanding of disease tremendously and promote the development of more effective drug therapies. Developing the right models for researching diseases and evaluating various drug therapies with speed and accuracy are the biggest hurdles in the pharmaceutical and biotech industry. Being able to knock-in or knock-out genes in mice with accuracy and speed and limit off-target effects with well- designed gRNA, are the ultimate goals. The mouse model is not a human model, but perhaps genome editing can get us a little closer.
Gene editing in curing single genetic disorders
It may be a while before we advance to gene editing in humans and we should proceed with extreme caution. Diseases involving more than one gene are so complex, implementation may require more advanced technology.
Life scientists are mindful that once gene editing is done, it's permanent and can't be undone. We can't predict with certainty the long-term effects. Should an unexpected negative outcome happen, we may not know how to correct it and this altered gene will be passed down for generations until scientists can figure out how to correct it.
When we cure diseases, patients live longer. The rising cost of healthcare would be reduced, but the financial burden would shift to the already cash-strapped social security system. Today, Americans are living longer and retirees are collecting social security payments for a longer period of time than originally anticipated. If the retirement age is raised, will there be enough jobs to sustain all the people entering the work force each year? For several years now, it has been documented that recent college graduates are having difficulty finding gainful employment. We must anticipate and plan for the impact that scientific discoveries might have on society.
Medicine will change. Physicians will learn more efficient methods of diagnosing and treating diseases and many now common diseases might be eliminated. Prevention would be defined as editing a gene for a particular disease once it is diagnosed. Insurance providers will be more likely to pay for reimbursement of this new and highly specific preventive medicine because once a disease is cured, expenses will drop both short-term and long-term. The one area that science won't be able to change anytime in the extended future is the normal aging process.
Regenerative Medicine
With the introduction of 3D bioprinting using stems cells, the area of regenerative medicine has advanced significantly and scientists have been able to print tiny living kidneys, blood vessels, and livers in hopes of making organs available for transplant. Bioprinting organs from a person's own stem cells will eliminate the risk of organ rejection and render organ transplant waiting lists obsolete.
But when we perfect the technology, at what point do we cross the line from practicing medicine to printing organs as if they are consumer goods? Currently, 3D models are used to strategize the best approach for repairing a defected heart or knee. Will the mindset of practicing medicine change from repair to replacement? If so, would surgeons still need specialized training?
Researchers at the University of Toronto have discovered that the Sox2 gene, an on-off switch for a stem cell gene, is critical for determining the fate of the cell when it matures in mice. A major discovery for regenerative medicine. Could we get to the point where we can generate our own body parts should we lose a limb due to an accident, or regenerate damaged tissue in the heart? Scientists at the Gladstone Institute have found a way to transform non-beating cells into heart muscle cells after a heart attack with assistance from three genes, known together as GMT, in mice.
If technology eventually enables us to regenerate our own body parts, the impact on human life would be enormous but there could be negative consequences in tandem with the positive. The positive impact is that we could replace lost or damaged limbs or organs. But will the mindset of how we currently care for our bodies change? Will we still be cautious about not touching a hot stove or an electric saw to avoid getting burned or cutting off our fingers if we can regenerate? I think there will be those who would avoid getting burned and those who won't.
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