The first known experiment using the CRISPR-Cas9 gene editing technique with live human embryos was reportedly conducted in China last month. The joy of hearing that it is possible that babies now have been born with potential immunity to the HIV/AIDS virus was drowned out by a chorus of critics of the Chinese scientist who claims to have edited genes in embryos, creating the first gene-edited babies. What was not said is that the potential for good is unlimited and that the first real success will launch a thousand ships carrying weapons capable of killing off the diseases of old.
Yes, the genetics experiment reported to have been carried out in China raises many questions. Yes, it could have been done with more transparency, more consent, and more protections. No, in my opinion, it does not represent the dawn of unnatural selection, leading to super races that will dominate the world—but yes, it does open the possibility that every disease with genetic origins is now a fair target. From my point of view, the diseases that afflict my patients—arthritis in particular—may be partially eradicated in the remarkably near future.
Here is how it could play out.
There are diseases, and there are proclivities. The diseases of arthritis (osteo, psoriatic, and rheumatoid), while varying widely in their clinical presentation and mechanism of joint destruction, may have common pathways in genetic alterations. Obesity, diabetes, and hemophilia have already been shown to have associations in genetic patterns and susceptibility to target interventions. The possibility that diseases like arthritis could be eliminated before birth opens up vast potential for increased human performance, health, and happiness.
The proclivity of one person to develop a syndrome or a late-in-life manifestation of a systemic weakness presents another set of ravages to the human species. We are on our way toward understanding how and why such cardiovascular diseases, loss of hearing and eyesight, skin sensitivities to sunlight, and subsequent cancer development are predictable from certain genetic patterns and inheritance. Knowing who has these proclivities, and when these afflictions will occur, may not be far away. Changing the epigenetics—the proteins and messengers that deliver both the bad news effects of the genetic patterns or the good suppression of unwanted genetic expressions—could lead to an increase in human longevity only dreamed of a few years ago.
All of this depends on safe alterations of the genetic makeup of humans. In fact, we do this kind of genetic suppression and stimulation every day. When you take a simple supplement like glucosamine, it upregulates the cellular machinery that produces hyaluronic acid, the lubricant in joints. This effect then diminishes stiffness, a complaint of many arthritic patients. The effect of this supplement works largely through its effects on the patient’s genes. Up and down regulation occurs millions of times per day, sometimes intentionally, sometimes beneficially, but not randomly. What you do and what you eat makes you who you are.
Some research shows that you are constantly genetically modifying yourself—and your loved ones, as well. Your interactions with them, the transfer of your microbiome by a handshake or a kiss, has real genetic ramifications, according to these studies. The more we understand these mechanisms, the more intentional we will be in our transference.
Soon your doctor will give you drugs and surgical interventions that are specific for your receptivity to these therapies based on your genetic patterns and may alter your epigenetic expressions to make these more successful.
You may suggest refinements to the process researchers are taking in the area of gene editing, and even engage in ethical explorations, but I believe our ability to survive our planetary pollution, and our disease-spreading behaviors depend on our ability to evolve faster than natural evolution alone permits.
Dr. Kevin R. Stone is an orthopedic surgeon at The Stone Clinic and chairman of the Stone Research Foundation in San Francisco. He is a guest columnist.