In our last blog post ( https://dduffee.wordpress.com/2018/11/25/hiv-the-search-for-a-cure-continues/ ) and previously ( https://dduffee.wordpress.com/2017/05/23/update-on-medical-genomics/ ) we described the role of the CCR5 white blood cell receptor and its relationship to the progression of HIV in an infected person as well as a genetic tool that had been used in other gene therapies (crispr-cas9 platform). Now on the tail of these blog posts comes a disturbing case report from China that combines the concept of CCR5 based HIV therapy and the crispr-cas9 gene therapy platform. In this Chinese case (summarized in Nature but not yet confirmed, https://www.nature.com/articles/d41586-018-07545-0 ), 2 embryos were fertilized in vitro (a test tube) and genetically altered to have the CCR5 receptor removed from their white blood cells. These children did not have HIV but were “selectively bred” to have a “resistance factor” (ie lack of the wbc CCR5 receptor) to HIV.
While most likely well intentioned, the ethical issues raised in this Chinese case are legion. Will they purposely expose these children (now healthy and living back with their parents) to HIV to see if their experiment worked? Will doors open for other selective breeding of embryos soon to be real children for other characteristics? While disease based gene therapy is already here (tyrosine kinase based therapies in certain hematologic and bioactive amine based malignancies), these therapies are administered by pill or shot to a mature adult and do not involve embryonic manipulation. We certainly need to have a societal (read whole world) discussion on how manipulation of germ cell genetics can and will affect us as people. We can not let commercialism and aesthetics drive “mail order conception” for we are fearfully and wonderfully made at natural conception and there is a reason science should tread “fearfully” in the area of germ cell genetic manipulation.