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Perhaps the Slipperiest Slope

Some years ago a patient and her husband, both Ivy League-educated professors at a local university, presented to my office stating that they desired a “male heir.” They wanted him to be a least six feet two inches tall, dark-haired with blue eyes, athletic, and highly intelligent. It was explained to them that such Brave New World technology was not available and, even if it were, the ethics of developing such a ‘designer baby” would be questionable, at best. Three weeks ago, He Jiankui, a United States-educated Chinese physicist with training in bioengineering, reported that he had altered a gene in human embryos, before having them transferred into the mother’s uterus, with the goal of making the babies resistant to infection with H.I.V.

Breaking with longstanding scientific tradition, He has not published the research in any scholarly journal and did not share any information on his specific materials and methods. Although genetic engineering of human embryos is banned in many countries, the Chinese researcher claims that he had created the world’s first genetically modified babies, born November 2018.

Certainly his technique involved “CRISPR” (pronounced “crisper”, which stands for Clustered Regularly Interspaced Short Palindromic Repeats), a bacterial defense system that forms the basis for CRISPR-Cas9 genome editing technology. This system can be programmed to target specific sequences of genetic code and to edit DNA at precise locations. With these systems, researchers can permanently modify genes in living cells and organisms and, in the future, may make it possible to correct mutations at precise points in the human genome in order to treat genetic causes of disease.

Time will tell whether the recent CRISPR claims from China will prove fictional or factual; however, to mix a metaphor, the Rubicon has been crossed and our reproductive medicine stands at the top of what may be the slipperiest slope.

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