CRISPR Babies: The Science Behind the Scandal.

In a controversial 2018 experiment, Chinese biophysicist, He Jiankui, went on to CRISPR-edit heritable genes in two embryos that were later implanted into a surrogate’s uterus. As with all medical ventures, this one also had a diagnostic reason. The fathers had been living with HIV and Jiankui had a solution. The CCR5 gene encodes an HIV co-receptor, the presence, absence, or mutation of this gene is inherited and that is the key word to land Jiankui a three-year sentence in a Chinese prison. The scientific community has strong opinions about this word. Inheritance.

Following this scandal, David Baltimore, a biologist and former President of CalTech, went on record at the International Summit on Human Genome Editing, “We have never done anything that will change the genes of the human race, and we have never done anything that will have effects that will go on through the generations.” The backlash Jiankui received showed how much scientists valued their ethical constraints. Fair, because something needs to check in the face of the uber technology we indulge in.

The ethics here might have been grossly overlooked. Still, Jiankui had certainly become a man of the people with outreach campaigns that had garnered wide support among a sample of 4,700 from a premier university, including a group of respondents who were HIV positive, “More than 60% favoured legalizing edited children if the objective was to treat or prevent disease.” The positive responses were in accordance with polls conducted by the PEW Research Centre in the US too.

Objectively speaking, all Jiankui was trying to do was embed a virus resistance into these babies but the technology behind this is such a slippery slope that nobody in power would actually sanction this and to this date, there is no information to confirm whether Jiankui had received special permission from the Chinese Government to conduct this experiment as using a genetically engineered embryo to establish a pregnancy would be illegal in China under a 2003 ministerial guidance to IVF clinics.

To establish an artificial virus resistance in these embryos, Jiankui did a bit of genome pooling to assess how some people had natural resistance to HIV. They either had host traits that hindered or prevented entry of the Human Papilloma Virus into their cells or their CCR5 gene was genetically mutated or disabled. This gene is widely agreed to be the main HIV co-receptor, involved in virus entry and cell-to-cell spread.

But if things had been so widely agreed and clear regarding CCR5, why had Jiankui been indicted? If anything, this man showed immense bravado in taking the first step towards the long-forecasted lineage of designer babies. The so-called ‘slippery slope’ of human genome editing is such that, even though the CCR5 gene was the gateway to HIV entry but the absence of it also showed increased susceptibility to some viral and bacterial pathogens, heightened in-vivo and in-vitro drug resistance, and a decline in virus control. This is just the pathological ‘slippery slope’. There is an entire array of bioethical ones too.

The recipients of germline edits are never the ones who give consent for it. The patients affected by the edits are the embryo and future generations. The idea of informed consent here would also be arbitrary because we truly do not know the entire assemblage of consequences pertaining to germline editing because we simply have not done it enough. Why? Read the paragraph again.

One could argue that parents already make these complicated choices for their unborn child with IVF and PGD but once again, we are aware of what the consequences might entail, at least a bit more than we do with genome editing. It is when we talk about these ethical considerations versus the potential of these experiments that we truly understand what breakthroughs are worth having. The philosophy behind it all suggests an emergence of new era eugenics and we might never reach a point where the science behind this is going to be iron-clad, but in the end, we have to question whether the risk can be justified by the potential benefit?