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CRISPR gene-editing breakthrough opens door to treating broad array of diseases (npr.org)
600 points by hassanahmad on June 26, 2021 | hide | past | favorite | 234 comments



>Doctors infused billions of microscopic structures known as nanoparticles carrying genetic instructions for the CRISPR gene-editor into four patients in London and two in New Zealand. The nanoparticles were absorbed by their livers, where they unleashed armies of CRISPR gene-editors. The CRISPR editor honed in on the target gene in the liver and sliced it, disabling production of the destructive protein.

this is one of the coolest paragraphs I've read in a while. if it's accurate, serves as a great reminder that we're in the future as we speak


Note that the liver is perhaps the easiest target since it filters the blood.

See: https://blogs.sciencemag.org/pipeline/archives/2021/05/20/cr...


I expected we would be doing this using viruses, and there are viruses targeting various tissues/organs. The nanites though are just really Star Trek cool.


While nanoparticles could correspond to viral like carriers. The reason you probably wouldn't want to naively use viral particles is because any viral particle that would likely attack the body naturally would also trigger the immune system. That would decrease the efficacy and could actually increase the likelihood of side effects.


https://en.wikipedia.org/wiki/CRISPR_gene_editing

Delivery of Cas9, sgRNA, and associated complexes into cells can occur via viral and non-viral systems. Electroporation of DNA, RNA, or ribonucleocomplexes is a common technique, though it can result in harmful effects on the target cells.[43] Chemical transfection techniques utilizing lipids and peptides have also been used to introduce sgRNAs in complex with Cas9 into cells.[44][45] Types of cells that are more difficult to transfect (e.g. stem cells, neurons, and hematopoietic cells) require more efficient delivery systems, such as those based on lentivirus (LVs), adenovirus (AdV), and adeno-associated virus (AAV).[46][47][48]


Are these nano particles similar to the Pfizer vaccine ones? Those lipid nanoparticles do trigger the immune system.


Is this a one-time treatment? Does it remove all of the offending genetic material, and then when those cells divide they are cured? Or does it require ongoing treatment?


It’s editing the genes of the cells of the liver, so presumably when those liver cells divide and multiply, the change would also be copied along as well.

What isn’t clear to me is that if this is targeted at the liver cells in particular, or splicing it for every cell in the body. In other words, this could be a germline mutation (passed to children) or it could be a somatic mutation (no change to future children), it depends on how targeted the treatment was.


When administered IV, most LNPs of this type are highly selective for hepatocytes. This edit cannot be passed on as no germ cells will be transfected.


Even if it is not specific, I would believe gametes are not affected/can be easily excludes due to the blood-testis barrier.


Patient will need to do it once per 1,5-2 years.

See https://www.youtube.com/watch?v=aoczYXJeMY4 .


100%, the mRNA vaccines fall into this future category too. Being able to use RNA to direct cells to do what we need is mind blowing.


A new world is beaconing upon us. Much like computers in 70s. We are in the real early phases of this technology and this would most probably make the world completely different from what it is now.

Mind you, this is just the beginning. First we would have all kinds of diseases being cured using this, 1. It would change the whole medical diagnostics industry to correctly diagnose the pathogen, 2. Then destroy the pathogen using DNA cutting 3. It would cure cancers of many kind by enabling the T-cells to fight the cancer cells effectively

Then we would start with reprogramming cells to do what we want. For instance, we can cure baldness, completely regenerate cardiac cells after heart attack.

However, it would not stop at this. We would have bio-machines which can capture carbon dioxide, generate medicines, make clothes/cotton and food. We would have bio solar cells. We would bio light bulbs which ingest light during the day and glow at night. We would have artificial meat produced using this technology. We would have carbohydrates produced using this. Plastic and sewage eating bacteria would be a reality soon.

Next 30-40 years is going to be biotechnology as last 30-40 were computing.


I am bullish on the tech, but don't forget about how swords have two edges...there are going to be some crazy new exploits in our biology this technology will be able to take advantage of. Slipping genetic information past immune sentinels is going to have some crazy downstream risks we are just beginning to fathom.


I watched a pretty good PBS-NOVA special on CRISPR recently that covered this.

It seems like the scientists interviewed (some of them leaders in CRISPR) were of the opinion that we should stay the hell away from editing the human germ line (not sure if I used the right term, but basically stuff that would be passed to offspring).


I'm not even just talking about CRISPR. mRNA-LNP is like a flash drive that bypasses anti-virus software. The opportunities are...dramatic.


The problem is that cat is out of the bag. There will be much more potentially dangerous stuff which will come out in future. There is no stopping it....like it or not


Blowing the other horn, as an engineer I can imagine sorts of mistakes that can be made while editing DNA. We don’t fully understand life yet, but already cutting it in pieces, for a good purpose as it may be


True, I've read stories where researchers have done analysis of the DNA after the use of CRISPR and found that parts other than the target had been affected.

But like all decisions, you weigh the good vs the bad and you make a decision. In many cases it will be the best choice by far. Additionally, the more we use it the more we will understand the down side and we can plan for it.

Yup, it has a down side but we'll be able to balance the good and bad parts. Techies love to focus on the good of technology but I think it's good to point out the bad as loud as possible so we can plan for it. The fact is that the genie is out of the bottle and it won't go back in. So CRISP is part of our future.


CRISPR is highly targetted AFAIK and read. Unintended effects will actually kill it or slow it down.


Out of the sudden, the sci-fi movies where the E.T.’s look like insects and their gadgets look biological are much more realistic.

Why would you manufacture anything if you can grow it? This’ll probably remove great deal of the maintenance too.


to me it sounds like McCoy from Star Trek telling our doctors that they are from the dark ages. https://www.youtube.com/watch?v=_R_WbAhKyAk


Wasn't there a recent HN article about another genetic splicer that's 1000x faster than CRISPR?


If eating GMOs has you scared, this should be absolutely terrifying


Yeah I bet the dude in the article is scared shitless about nanoparticles now that he's not gonna die.


All crops are GMO. The only difference is how fast they were modified.


> All crops are GMO. The only difference is how fast they were modified.

This is often said in defense of GMO, but surely cross-breeding and hybridization - a farmer or gardener attempting to combine the entire genetic entity of one plant with another one (which must therefore be naturally compatible), to increase the potential utility of the result - is totally different to inserting a single gene from a totally arbitrary source (which can therefore be a completely separate life-form)?


With enough time that trait would show up by simple selective breeding too. GMO does it faster. (Of course so much faster that there is an argument that it's qualitatively not the same as good old breeding. And if someone comes up with some kind of killer trees that release anthrax in the spring that too counts as GMO too, but they are unlikely to be deterred by labeling requirements or GMO bans.)


If I make a sandwich (wheat genes + chicken genes + cow genes + yeast genes) and cover it with honey (insect genes), what will happen to me when I will eat it?


And then there's Atomic Gardening which has been done for ages and does not officially count as producing GMOs, IIRC.


Are you saying that's not a significant difference? It seems to me.


Not really any more alarming to me than the initial domestication I guess. Manipulating the world around us is kinda our whole deal as a species.


It seems to you what?


Probably that letting the slow-GMO survive in a natural environment for hundreds of years does wonders for ironing out the really bad bugs.

I'm not anti-GMO but i've been more wary ever since I realized it will inevitably be used to make better citizens (and not by making them better humans).


It depends. There's a number of dog breeds with known genetical issues.

GE is a double edged sword just like nuclear energy. With great power comes great responsability.


Those are mostly innovations of the latest century or so, bred "scientifically", regulated by dog breed foundations and chasing dog-show metrics.


This is false. The distance between selective breeding and GMO is horizontal vs vertical gene transfer.


So if I'm fine with GMO food (and medicine), by extension I'll fine with this.

... Or is that a logical fallacy?


The statement was "If A, then B". You're not A, so it doesn't apply. The statement doesn't say anything about the "Not A" case.


That’d be a logical fallacy: Denying the antecedent.

If your program won’t compile, it has a bug somewhere.

If your program will compile, it almost certainly still has a bug somewhere.


The inverse of a conditional is not logically equivalent.


[flagged]


There are populated areas whose livability is threatened by climate change. These are in very poor, low-latitude regions like Northern India. Sorry to burst your bubble, but PNWers will have the privilege of surviving and thriving with relatively minimal issue.

As always, the consequences of the environmental sins of the global wealthy, like you and me and most HNers, will be borne by the global poor in other places. We are all responsible for what they will endure in the coming decades.

Eco-despair is, as always, a facile psychological defense mechanism and a luxury of the most privileged. We are responsible for the problem, and we also have the most power to solve it. We need to act accordingly. Starting with a calm, rational, comprehensive reckoning of our options, including nuclear (which has made France the low-carbon leader of the developed world).

Instead of letting guilt paralyze us with delusional fantasies of a well-deserved universal doom, we should use our privilege to advance no-carbon energy and carbon capture to hopefully protect the less fortunate people whose futures truly are threatened.


Northern India has always been this hot. I remember in 90s and early 2000s and god it was so freaking hot in May and June. There is this thing called loo in India (not the toilet) but this is warm westerly winds which start in the afternoons. It sucks your soul (and hydration and sodium out) and leaves you fully dehydrated. Many people die of that heat stroke caused by this loo.

But then monsoon comes in July and it is hot and sweaty! People don't die anymore of heat stroke but it is uncomfortable like anything. Once we reach september, we are back to normal and it is festival time! This continues till Novemeber when more festivals come like diwali, christmas etc along with wedding season (yes we have those).

Then with a zip in the air, Cold season starts and soon it is freaking cold in Dec and Jan. Like really chilly winds but no snow. We have our rajai (quilts) which save us. Poor people on streets die again but rich ones have their rajai, sweaters, tea and warm bonfires and heaters. Then comes feb and it is really beautiful again. Flower bloom. And it is festival time again. April comes which tells us that we are in for a May & June again. :)


From the maps I’ve seen, Northern India itself is only a bit warmer than it used to be; However, if I understand correctly, the problem is the effect on the Himalayas and the subsequent consequences to the Northern India water supply: https://www.downtoearth.org.in/news/water/crisis-in-the-hima...


I'm not sure your calm and comprehensive reckoning of your options will be comprehensive enough to have any effect on where we as a species are heading.

Because I don't shy away from facts, I am paralyzed? I disagree. If anything, I am less paralyzed than people who refuse to see where this path leads. I vote for green policies and try to inform others, even when I know there is no hope.


Nah, you don't know the technology well enough to say if there is no hope. This is just the fashionable moralistic eco-despair of the privileged: "we are doomed because we deserve it." No, we're not doomed, maybe some poor people of the global South are because of what we do, but we're not.


The science agrees with me. What is this "the technology" that you refer to? Carbon capture?


"The" science, whatever that is supposed to be, doesn't say we are all doomed.


I don't know if you've noticed, but the political process is completely fucking broken. Good fucking luck getting any of that passed in any meaningful form.


You're not going to have to worry about that.

Once rich people are inconvenienced, the problem will be taken seriously.

Case in point, there was no "opioid crisis" in America until some rich Senator's daughter overdosed on heroin. Then all of a sudden it's a crisis.


Yes, life is hard.

Yes, we have to live through it anyway.

Just like everyone else who lived before us.


Stop with the doom trolling and get busy inventing solutions.


We have solutions, there's an entire field with solutions, it's called climate engineering[0]. The problem is that currently it's not politically supported because the thought of humans actively editing the climate to suit our needs makes the wildly vast majority of environmentalists start foaming at the mouth and, ironically, doom trolling any solutions because the current thought paradigm is "we have to interfere less", ignoring that it's way too late for that. Also because with climate engineering there's very little need to reduce emissions, which again makes current environmentalists get aneurysms.

In other words, nowadays climate change is no longer an engineering problem, only a political one.

[0] https://en.wikipedia.org/wiki/Climate_engineering


That's a simplistic take and unfair to those who are cautious about it.

Most opposition to climate engineering is based on the risks of introducing more instability to a complex system we already don't completely understand. For instance experiments to fertilize oceans with iron to supposedly stimulate phytoplankton production had all kinds of unexpected side effects and failed to produce the hoped-for outcome.

We will certainly be forced into climate engineering solutions of some sort, as emission reductions alone are no longer sufficient to solve the problem even if we drop to net zero immediately, but they should be treated with caution and skepticism because of the inherent risk involved.

It also varies by the type of engineering. CO2 sequestration is widely accepted and desired because of its low risk, but it's difficult and expensive.


Heck yeah, this why I keep coming back the HN community. But if you gotta get that doom trolling out too its all good as long as it reminds us all how hard we gotta keep workin :^)


In hackerrank I was expecting post like

"Show:HN I injected chameleon DNA to my dog"


Technical solutions are often ineffective when faced with obstacles of politics or cutting corners to make money.


Unfortunately I think technical solutions are the only thing that will save us. Most countries would rather invade others then give up their standard of living.


Here's my controversial opinion - the best individual solution is to do less stuff. To me, it doesn't make sense that a problem caused by over-zealous production will be solved by over-zealous production. We can't really expect making more stuff to solve our problems caused by making too much stuff. The new stuff we make should be targeted at increasing the efficiency of production, but, while helpful, I can't help but view that innovation as only part of a solution. Another part of the solution is individuals trying to change the functions of corporations, and the only way I can think to do that is by doing and demanding less overall. Still, though, individual change feels like it's meaningless at this point. The building I live in is run on solar, and climate awareness has been baked into my school curriculums since elementary school, but if Exxon Mobil doesn't sort its shit out, I don't think my house is going to do much.

The rest of the solution, and this is controversial opinion number two, is that we need to reorient the purpose of corporations, and the economy as whole, from profit to humanity. Only 20 companies produced 35% of GHG emissions, and 100 produced 70%[0]. This isn't an individual issue, and it won't be fixed by individual solutions. Corporations, driven by innovation as an extension of profit, caused this problem. If we just request more innovation, I feel like we're going to be fucked.

I agree that climate despair is unhelpful, but so is the "let's let innovation sort it out" attitude - we need real structural change that innovation within capitalism can't provide. I'd suggest Marxism, but I doubt that's something most people want to hear.

0: https://climateaccountability.org/pdf/CAI%20PressRelease%20D...


And this is a reason we're really up against it in facing this challenge. Every ounce of advertising being thrown at people is trying to convince them to do the opposite - buy more, eat more, travel more, etc. And no government can work against that or they'll be reverted by lobbyists or destroyed by industry campaigns.

Same reason people struggle to manage their weight. There's no money in convincing people of the cheap/easy solution to buy and eat less. The pitches are always gyms and diets of specific foods and quick fixes. You don't see an article about a very reasonable size of hamburger or normal steak pancakes - it's always the 1kg steak or world-record pizza or a burger that you go on the honour wall if you complete. We're unsatisfied by small meals, they don't seem like value for money; tiny meals at high-end restaurants get ridiculed by the masses.


By doing less stuff you're ultimately decreasing your evolutionary fitness, benefiting those who don't have such qualms.


I'm also asexual. I'm well past worrying about that, even if I did follow your logic there.


Without doom trolling nobody will vote for the people who want to implement the costly solutions.


There's a curve to most people's response to levels of advocacy. The response rises with advocacy to a point, but then past a certain point, the response drops precipitously. When the advocacy turns into over-the-top vehemence, people tend to stop responding and may even respond negatively (i.e. rebel and go full anti-whatever).

As an example of a similar drastic falloff at the top of a response curve, I recall reading that people who live right next to a dam report near zero concern about the dam collapsing, but as you go further away people are very concerned, then somewhat concerned, than only little concerned.

So anyway, we need more carrots, fewer sticks.


Hmm, that's interesting about the dam, though I wonder whether only the people who wouldn't fear a dam collapse would live next to one.


Or if living closer to a dam means you are more likely to be better informed as to the construction and safety margins and thus less likely to think catastrophic failure is likely.


This++


Everyone will move to Canada and similar places. Only the poor will be left behind to die in the heat and most of the world won't care and will feel like "good riddance."

Edit:

In case anyone thinks this is just snark, no. I'm in the PNW and I grew up in Georgia and lived in California for a lot of years, including the High Desert where I was south of Death Valley and 115 in July was not unusual. I'm dirt poor and have been for years. I spent years homeless.

The heat wave per se is not a big deal to me. But it's late in the month and I'm nearly broke.

If the heat kills me, it will be because I'm out of funds, not because 107 is a big damn deal per se. The world has spent a lot of years making it clear to me that it doesn't care about my welfare at all and no amount of virtue, hard work, yadda is ever enough to adequately remedy my problems.


I think you are correct. Unchecked climate change will send the wealthy and middle classes North. If History is any indicator, they will close the borders of their regions as tightly as possible and commit a pitance to "humanitarian aid" leaving the poor piling up in refugee camps on their borders.

We have the examples of the U.S. border, Australia's camps on Naru, the various permeant refugee camps spread across the Eastern Mediterranean and many more as examples.

As the situation becomes more intense, migrants will become more desperate and bold. The reaction from the wealthy enclaves will become more and more repressive. (Who themselves will be seeing a diminished standard of living).

In my opinion, the only thing that could spare us this future is a global commitment to universal rights and more equal resource distribution. But this would require countries like the United States to write rights of non-citizens deeply into their constitutions. And that is likely unattainable at this time.


Animals are already migrating to more northerly climes as recent articles on Svalbard attest.* What prevents people from doing the same is mostly international borders, politics and money.

Before we had international borders, plenty of humans lived migratory lives as well.

* https://news.ycombinator.com/item?id=27479739


Absolutely. Even recorded history is full of migrations of large groups of people (anglo-saxons, repeated migrations out of the Asian steppe, mass migrations of the Native Americans after European arrival, etc). If we could reach high enough state of moral development we might even come to see migration as a human right. Though I believe impending material poverty will make that unlikely.


In spite of my own personal challenges, I'm actually more hopeful than many people seem to be. (Edit: at least for humanity. Not necessarily for myself.)

https://news.ycombinator.com/item?id=22028732


So what then? We should throw our hands in the air and give up? Take the good news as it comes.


It’s not impossible to speculate the possibility that in 50-100 years, climate change could be reversed through a CRISPR-like technology (e.g. something that can be released and replicate in the environment, thereby changing it).

Or at the very least, I can see a future where gene editing could relieve your suffering from heat by raising the threshold your body can tolerate :)


You want something that replicates in the environment and removes carbon? We have those. They're called "plants."


> They’re called “plants.”

Incidentally, CRISPR + plants is one of the most promising solutions to climate change: https://www.ted.com/talks/joanne_chory_how_supercharged_plan...


Anytime I see a TED talk, I just automatically assume the technology is at best overhyped and at worst completely fraudulent.


If food crops are engineered to grow big, carbon sequestering roots, how will we determine whether the quality and safety of the food is unaffected?


Mass spectrometry and similar analysis methods to look for unexpected proteins in the food parts, followed by feeding the food parts to animals and seeing what happens.


Thank you for your patronizing response to the above poster.

The problem is to do with things called "numbers".

1. There is no spare land to devote to CC. You could do this only at the cost of poor people's food supply.

2. The rate at which plants remove CO2 from the air is very low. Far too low to solve the problem.


1. Can be solved with phytoplankton, and separately also by more land-area-efficient farming e.g. greenhouses, 2. Can be improved with genetic engineering.

Do the right generic engineering and you even get the oil feedstocks you need for plastics. You could even put the algae in a tube on a rooftop as an alternative to PV, if you could resolve the issue of unwanted other phytoplankton getting in and gumming it up.


A lot of agricultural land is wasted growing crops to feed to animals. If we were to lower meat consumption, agriculture land could be freed for other uses without taking away poor people’s food supply.


Even if we reforested every possible area, the current rate of carbon outlay exceeds capacity to absorb.

Well explained in the Economist video: https://youtu.be/EXkbdELr4EQ


If we could convert Sahara back into a savannah or farms, the amount of carbon required for the new soil and plants would exceed the amount of extra carbon we have added to the atmosphere so far. And there are many viable routes to do that. E.g. building large number of ocean thermal energy conversion plants [1] to reduce temperature of the north hemisphere, recreating conditions that have caused green Sahara in the past. There are numerous possibilities to use engineering to revert adverse effects of climate change, and to actually improve the climate. The only scenario when we are doomed, is if population declines significantly so that we get runaway effect from carbon we have already produced melting permafrost, and not have large enough economy to use geoengineering on a large enough scale.

[1] https://en.wikipedia.org/wiki/Ocean_thermal_energy_conversio...


So there’s one minor problem with the Sahara…


There was a minor problem with stating in air, having plants with large edible parts, talking with people far away. Science and engineering have helped with all these minor problems, and they can help with the new one if we spend money on geoengineering research instead of wasting it on inefficient "clean energy".


Does this include ocean farming based carbon capture? That sounded like a pretty positive route in terms of land use limitations when I heard about it.


Too bad for the millions of people who will die because of the changes during these 50 years...


Looking at the world right now, I hope for the best with that gene therapy against sociopathic billionaires.


At current rates of carbon outlay, there won’t be much of a world left to save in 100 years.


That statement isn’t backed by science


“We are currently on track for a rise of between 6.3° and 13.3°F, with a high probability of an increase of 9.4°F by 2100”

https://www.climatecentral.org/news/ipcc-predictions-then-ve...


Not unless we all work our asses off! Engineers can do anything :^)


... except politics, engineers are usually not very good at politics, and climate change is, in large part, a political problem.


again, I love me some doom trolling but only if it helps motivate work, and if software engineers can build platforms that undermine democracy I gotta believe its at least possible they can undermine bad politics too


Yes, but what we can do is try to invent things which are better then the status quo in terms of both money and the environment — if people use those inventions for purely selfish reasons, they’re still helping the world.


It's a technology problem unless you want condemn most of the world to an incredibly low standard of living.


Reminds me of this guy that cured himself of lactose intolerance. https://www.popularmechanics.com/science/health/a17804128/sc...


His YouTube channel The Thought Emporium, is amazing. He just moved into a new lab and I really appreciate what he’s working on and how he communicates it. The robot painting fluorescent proteins is neat and recently he dropped a video demonstrating his adventures making synthetic opal.

Apparently the edit made him totally lactose tolerant for over a year and now he has very mild lactose intolerance. He says he hasn’t redosed because he wants to improve the plasmid (I think that’s the right term, BUGFIX probably isn’t right) before he takes another run at it.

Here’s his update video from last year on that endeavor. https://www.youtube.com/watch?v=aoczYXJeMY4


Technically a plasmid is kind of like a software patch, but generally they're employed by bacteria and not eukaryotes like humans.


Interesting. I have watched nearly all of The Thought Emporium’s videos (so clearly I’m an expert, lol) and I think he uses the term plasmid to describe DNA he’s working on in the crazy bio IDE he uses. I think in this instance he applied it to a yeast that he cultured and put into pills and swallowed.

He really is doing some neat stuff though. He’s inspired me to do some small bio hacking experiments and it ALMOST makes me want to go back to college.


Plasmid is the correct term!


I am not being sarcastic when I say thank you for confirming that. If someone didn’t confirm it it would pop back in my head for days, “maaan, you fucked it up and now some other nerds are gonna use the term wrong and that’s really not helping anyone.” heh. Cheers. :)


I recently watched the two videos on this (that I'm aware of) and it's the first time gene therapy didn't strike me as macabre Frankensteinian experiments on vulnerable people who will say "yes" to all kinds of crazy stuff out of desperation.

Cystic fibrosis significantly impacts gut function and many people with it do poorly with dairy products. I could see this and/or some variation of this being valuable therapy for the CF community while we wait for better answers.

Although best known as a deadly lung disorder, the impact on gut function is a major problem that just gets less press but is something people with CF and their loved ones fret about a whole lot. I think if you could do something to improve gut function fairly quickly and semi permanently, you would likely reduce a lot of their other issues as well because people with CF are typically underweight, sometimes severely underweight, and their chronic malnourishment is a major underlying source of their inability to fight off infection.


> it's the first time gene therapy didn't strike me as macabre Frankensteinian experiments on vulnerable people

That's because it has barely begun to become viable IRL while science fiction writers have been using it as a convenient punching bag for decades -- without ever stopping to ask if they should.


No, that's because I have a form of cystic fibrosis and I know what I and others like me have been willing to do in the face of that and because I'm aware of real world experiments done on people who were seen as less than human for some reason, such as the Tuskegee syphilis experiments done on Black Americans and horrifying experiments done on people in concentration camps in Nazi Germany.

https://en.m.wikipedia.org/wiki/Tuskegee_Syphilis_Study

https://encyclopedia.ushmm.org/content/en/article/nazi-medic...


CFTR modulators have completely transformed CF treatment for +90% of patients. Gene therapy is a possibility, however, with there being +1000 possible mutations that can lead to CF, it’s not the clear cut candidate that some of the other rare genetic disorders are right now. The cynic in me also thinks that with CFTR modulators costing ~350k/year, drug companies may not feel incentivized to run the risky gene therapy trials and patients may not want to participate given the dramatic improvement in their lives with current therapy options.


That honestly doesn't fit with my understanding of how life, the universe and everything works. I did some searching and this source says that 85 percent of people with CF have at least one F508del mutation:

https://pediatricsnationwide.org/2019/11/25/a-major-mileston...

And this source agrees with your statement:

The triple therapy, known as Trikafta, could effectively treat 90% of people with cystic fibrosis.

https://pediatricsnationwide.org/2019/11/25/a-major-mileston...

When I was on CF lists, I was hearing that the first drug in this class that had recently come out only helped five percent of people with CF (I was specifically hearing that it helped people who were double F508del and that was only five percent of all CF patients, IIRC) at a cost of at least $250k annually, so "if you can afford it or live in a country that covers that for you."

I was also hearing people say that some of the stats were dummied up and exaggerated because so much money was at stake.

I left all the CF lists years ago. The figures I'm seeing today don't fit with what's in my head and I don't know how to sort out what's true and what's PR nonsense and it doesn't really matter to me personally. I and my son with CF are both off all drugs and have lived on very little money for years.

Good for them. I'm sure this makes me even more irrelevant, "crazy" and stupid in the eyes of the world than I was already. Which is no big deal. I don't really care. I'm just leaving this comment because I asked you for a citation and then found my own and deleted my comment.

I don't want people to think I'm being a weasel or anything. The articles I'm finding seem to agree with you. I don't know what to make of that and it's not really relevant to my life. I will never have the money for these drugs and don't really care.

Have a good day.


I think it's annoying people get upset that people who do this potentially damage their bodies. First of all, it's that individuals body. They can take whatever risks they want. I don't see how trying to alter your own DNA is any worse for you than skydiving. Both have inherent risks, none of which affect others. Secondly, because there is no red tape or ethical scientific practices required, this gives us the opportunity to study some anecdotal evidence and (hopefully) these people donate their bodies for research after death. We can't truly know these affects if we constantly just act so tepid about the procedures.

Imagine if we had the scientific process about literally every aspect in human life since the dawn of civilization? We'd still be making bricks with straw, manure, sand, and water because there wasn't a government sponsored test of the quality of "Roman Cement" therefore we should not use it. Some of these people who criticize a lot of science do so just for the sake of disputing it. It's a good thing this stuff happens. The more anecdotal evidence we have, the more likely it can be subject to legitimate scrutiny and understand certain pitfalls that these individuals encountered and why. Just telling these people "you're stupid, it's bad for you!" is an ultimate waste of time and just stagnates data collection.


I think it’s sometimes a gatekeeping behavior, instinctual and unconscious.

If writing software required being a licensed engineer then you would without a doubt see reactions to open source, calling it deeply irresponsible and dangerous.


> Both have inherent risks, none of which affect others.

If you make germline edits, this does potentially impact others - you can have children who inherit the edit. They don't have any choice about that (depending on the edit they might randomly not receive a copy of the edited material, but that's luck) and its consequences in them may be undesirable even if the outcome for you, an adult, was fine and anyway your choice.


In the particular context of Though Emporium this wasn't going to happen. It used an adenovirus that couldn't reproduce so it was only going to alter a limited number of cells in his intestine.

The technical requirements to this kind of limit the number of people that are going to really mess themselves up. I would be more worried about people accidentally releasing edited bacteria or viruses.


> releasing edited bacteria or viruses.

From what I understand it’s hard to order the sequences of DNA or RNA you’d need for this without someone noticing. It’s probably not impossible, but not something anyone is going to bungle into.


I am 100% pro bio hacking, I would go as far as to say that I think the bio hacking community might be the only place I can see solutions to our largest problems coming from. I mean the bio hacking community too, not acedemia. Not that acedamia isn’t crucial to that process.

Anyway, Maybe a few years ago the barrier to entry was too high for most people but that is so not the case anymore. Even just this year a friend sent me a link to a $2000 gizmo that was about the size of a pack of gum that could do desktop sequencing. Generating your own custom DNA in your bedroom is considerably harder (but not impossible) but it is not at all difficult to order a custom sequence from a half dozen different retailers. The file you send them is just a big chunk of a few letters. It’s assembly code with no comments (yes I know folks do put in comments in text sometimes and sometimes biologically but just like always comments lie more than not), they functionally cannot be checking for what it could do if what you’re working on is even remotely novel. For the price of a playstation you can have it delivered to your door next day air.

There are very real risks here for our entire planet. Possibly one of our largest risks. To hide behind “it’s too difficult for a malicious actor” is not helpful. I think genetic literacy is maybe the only thing we all can do as we might be entering very weird territory as a closed system that has a bent towards global narcissism and self harm.

Something that gives me some comfort is that to be good at it you really have to do a gross and difficult deep dive into how all life works and I think there are very few people that could do that and still feel like it’s ok to do harm at even a small scale. The things we are going to see in the next few years will be pretty fucking weird. I guess when you get down to this level, the only thing to have is something like faith. Eeeek.


I think the key here is that you have to be doing something novel, which seems like a high bar. Like you can order the DNA for small pox. No one will fulfill that. But it does seem like a determined, over-educated would-be bioterrorist could pull this off with COTS equipment in the very near future, maybe.


Yeah, I guess if you just send them this specific genome for smallpox DNA[0] they might tell you to get lost. What I'm saying is that anyone who was awful like that would probably just go get a different disease in person. Historically people have managed that fine without having to learn version control. I mean, we have treatments for smallpox and a vaccine. My point being is that it's not useful to say "oh, it's too technical and I'm sure the DNA providers have some checks in place." I have never seen a god damned thing about what checks they are doing, and I'm nearly certain they are not that well regulated. I for sure know that there isn't a public accountability portal for these companies.

What makes me feel alright is that I think to do some damage is not a technical or money issue but an issue with taking a dive on the closest thing we have to the meaning of life and I'd hope that that study would be the sort of thing that keeps someone from being the worst kind of monster. I mean, we have a ton of tools out there to be awful, why this?

I guess what I'm saying is that to look at this set of problems and say "someone else probably has it handled" or assume anything we know is even slightly predictive of the future is silly. I think it's important for those that care to get an understanding of biology as we are now at an unprecedented point in existence where there's just not a way to feel too comfortable. Added benefit, the more people that get that understanding the closer we might get to yeast that eats plastic or mushrooms that make insulin.

[0] https://www.ncbi.nlm.nih.gov/nuccore/NC_001611.1


That's what is usually said. I don't think I've actually heard of this getting triggered. I'd like to think that global governments have this totally under control. Maybe the US does, but does China? In any case so far it's seemed like a whole "this rock keeps away Tigers" sort of thing.


I think it more a result of companies that synthesize the raw material being unwilling to whip up things like SARS variants, and it being quite difficult to figure something out like that from scratch. That may change or turn out to be incorrect, this is just my understanding at the moment.


That is the line of reasoning that leads to banning abortions*. People have a right to alter their bodies.

EDIT: and preventing young women from choosing sterilization.


Precisely. Otherwise if we're going to walk the line of "well even though it's your body, 'us smarter people' say it's bad for you there for you cannot do it" will inevitably lead to the logic of dictating abortion rights as well. This is exactly the logic conservatives use with the Covid Vaccines but because liberals "know what's good for everyone," people shouldn't be allowed to make the "my body my choice" when it comes to a vaccine. Regardless of who is more logically correct in the scenario, the current stance of American liberalism is "my body my choice" only applies in terms of abortion. Which conservatives when they get in power again, will utilize as rationale to make it illegal as many have been doing for the past decade.


I didn't say you have the right to not alter your body, the public health requirements for contagious diseases seemed reasonable until people have started lumping gun control and "possibly altering your non-existent children"... maybe I'll one day feel as you do.


And those restrictions should only apply to people in the public; if you choose to live off the land somewhere isolated, then those requirements should not apply to you.


It isn't about knowing what's best for you, but what's best for others. So where ethics come into play is when what you're seemingly doing to yourself could actually have impact on others as well.

For abortion, you can claim it impacts others both ways, are you impacting a new born from having its life, or are you preventing a yet to be born child from having a troubled life, and saving family, parents and society its burden.

For a vaccine, are you putting others at risk of a disease by not taking the vaccine?

For bio-hacking, are you possibly creating dangerous virus or bacterias that could harm others, are you making modifications to yourself which will put a tole on the medical system if you later need assistance or special treatment if you mess up, etc.

This is the same reasoning with drugs often, will your modified behavior cause harm to others if you consume them?

Etc.

None of this is black and white, but I think having these discussions on "what harm to others it can cause" is justified.


"Otherwise if we're going to walk the line of "well even though it's your body, 'us smarter people' say it's bad for you there for you cannot do it" will inevitably lead to the logic of dictating abortion rights as well."

The first problem is that you are claiming that the child's body is the woman's body. It isn't and you know that. You know that is it an entirely distinct human being with it's own DNA, etc, etc. In order to justify abortion, you would need to argue that murder (which is the direct, intentional killing of an innocent human being) is justifiable. The logical consequences are devastating. For example, if murder of the most innocent, powerless, dependent, and vulnerable, by those with power over them no less, becomes justifable, then it becomes impossible to argue for the legitimacy any human rights whatsoever. You can't just make up moral principles out of thin air or assign arbitrary boundaries to them according to taste.

The second problem is that this logic seems to put the cart before the horse. In other words, you've decided that abortion is a right axiomatically and you've decided to dismiss anything that would undermine that belief. But the moral acceptability of abortion is not axiomatic and must be judged according to prior moral principles.

"This is exactly the logic conservatives use with the Covid Vaccines but because liberals "know what's good for everyone," people shouldn't be allowed to make the "my body my choice" when it comes to a vaccine."

See my first point above. Here conservatives are indeed speaking of just their own bodies, so this is a false equivalence.


"an entirely distinct human being with it's own DNA, etc"

What makes us human beings is our personalities, our brains. Chop off my hand, I'm still me. Destroy my brain, I'm deceased regardless of how long you keep my other organs going.

A fetus does not become human, IMO, until it can have a personality and sentience. Women have the power to create without consent of the created; the power to destroy their not-yet-human equally lacks the consent of the created. If the latter is prohibited than so should the former.

From a societal view, we have enough people. Every way to support people consensually choosing to not have children should be encouraged.


> "you know that is it an entirely distinct human being"

You know that it isn't entirely distinct, it is inside and completely dependent upon another human.

> "In order to justify abortion, you would need to argue that murder (which is the direct, intentional killing of an innocent human being) is justifiable."

How do you feel when a woman has a miscarriage? The child is dead, the mother's body deliberately killed it. Is she culpable? Is it different if her brain cells are involved in the rejection of the child? Isn't that you assigning arbitrary boundaries according to taste?

There have to be arbitrary boundaries, the universe is a single thing, the idea of there being separate things inside it is a human convenient fiction, it's not real. The boundaries between things are fuzzy and disappear the closer you look at them. There's "just" atoms and energy, everything else is concept, if we want morals in the universe we have to make them up, and if we want them to apply to people, we have to make those up too.


Exactly and why vaccines should never be mandatory.


How do you reason that people have the (presumably absolute) right to alter than bodies however they please? How do you justify that claim? It makes very specific assumptions which are very problematic. For example, do you have the right to lobotomize a perfectly healthy brain? It is immoral? Can you say you have the right to do something immoral? How about altering your uterus during pregnancy to prevent nutrients from feeding the child?

I think it's pretty obvious that right implies morally acceptability. You can't claim to have a right to something evil. (The reverse is not true. It is morally acceptable to own a Tesla, but you don't have the right to one.) Alterations can be harmful and any harm that is not a justifiable side effect is by definition immoral. That it's your body does not somehow negate the immorality of self-harm. Indeed, direct self-harm is even worse morally than harm of others because it is in direct opposition to one's own good (arguably, harm of others is also a form of self-harm, specifically harm of one's character and will and habitus, of one's intellect because of the harm of one's reasoning faculties it entails, and harm of the common good). So you cannot say you have the right to self-harm. This is just a strange consequence of the incoherent ideology of absolute autonomy.

Now, if you have, say, a defect in your body that is preventing the proper functioning of your body, then we may correct this defect through intervention. This is restorative, that is, it seeks to restore the function due to the body by virtue of how it ought to function. This is the basis of medicine.

Another false view that can nudge people toward the view that any modification is acceptable is metaphysical materialism, also incoherent. In that case, crude metaphors between artifacts and living things are elevated to the status of the truth and since it doesn't matter what we do to an artifact per se. We can modify a computer any way we wish because there is no fact of the matter about what a computer is or how it should be apart from human intent. It is just a collection of things arranged in a particular way incidentally that puts them in a series of incidental causal relations, but there is no inherent tendency for these things to exist in these relations and no accounting for one in terms of the others except through the lens of human intent. Living things aren't like that.


If you don't have the right to your own body, then there aren't rights. It's the axiom.

I'm in favor of drug use (at least almost all), tattoos, body modifications, trying experimental medicine, everything that affects your body. I can see drawing the line at "doing this thing could become a contagion so you can only do it in BSL-4 isolation". But it's your body, your life, you want to spend it stoned or a voluntary amputee or whatever so long as don't take from me, then you should be free to do so.


> I think it's pretty obvious that right implies morally acceptability. You can't claim to have a right to something evil.

I think it's pretty obvious that right does NOT imply moral acceptability, and that you can have a right to something evil. In our societies, we have a great deal of disagreement about what things are morally acceptable/permissible. For a good liberal society, we may allow many things that we think are actually immoral, even evil. You need look no further than, say, the religious arena (including atheists) for such disagreement. People disagree about the moral acceptability of worshiping different gods (or about worshiping any 'gods'), calling someone an asshole, teaching your children one thing or another about sex, about engaging in particular sexual acts, about giving charity (or refraining from giving charity) to certain causes, and so on.

We grant people rights to do certain things (and I'm glad we do), but that does not entail that those things are therefore morally acceptable/permissible. You have a right to do them, but maybe you ought not.


> "How do you reason that people have the (presumably absolute) right to alter than bodies however they please? How do you justify that claim?"

If you couldn't gouge out your right eye and cast it from thee (Matthew 5:29), would you still have freedom of religion?

> "So you cannot say you have the right to self-harm. Now, if you have, say, a defect in your body that is preventing the proper functioning of your body, then we may correct this defect through intervention. This is restorative, that is, it seeks to restore the function due to the body by virtue of how it ought to function. This is the basis of medicine."

What about vaccination and such where the intent is to cause a small amount of harm now, to prevent a problem you don't have - and may have never faced in any future. This is not restoring a defect, it's augmentative and preventative. Do you not have the right to cause that small harm? And yet that's in opposition to your "direct self-harm is even worse morally than harm of others because it is in direct opposition to one's own good". It's in alignment with one's own good. So, for example, are the torn muscle fibres when weight lifting, or the buildup of lactic acid causing muscle burn when running, or working through the night with no sleep in an emergency.

Less seriously, piercings for jewellery are self-harm and for one's greater happiness in appearance. Do people have no right to wear small pointy uncomfortable high-heel shoes? Is that immoral?

> "I think it's pretty obvious that right implies morally acceptability."

I think it's pretty obvious that there isn't a single "moral acceptability" which everyone agrees on. For example some have the right to eat animals and others consider that morally inacceptable. Some US states have different rules on public nudity than others, and some groups of people have different opinions on the morality of it.

> "You can't claim to have a right to something evil"

Not sure I follow this one; you can't really have a right to murder others, but in the sense of self-harm is it really "evil" to hurt yourself? What is evil and also doesn't involve harm to anyone else?

> "For example, do you have the right to lobotomize a perfectly healthy brain?"

One could argue whether a "perfectly healthy" brain would choose to lobotomize itself, but let's say it does - why do you say that's "very problematic"? The main objection I have - assuming the person is considered sane and healthy - is who is going to pay for the care afterwards, i.e. the harm rolls over onto others and is not purely self-harm. If you could sign that away - it's basically a slow and horrible suicide method.


Here’s his YouTube channel: https://youtube.com/c/thethoughtemporium

Amazing and alarming what a smart and dedicated person can do with limited funds.


That’s really cool, thanks for sharing! I just watched his video on the WiFi camera and I loved his presentation style


This is insane. I love it and it terrifies me at the same time.


Off topic: are there any central repositories tracking gene therapy progress for various genetic conditions, with a similar UX to Moderna’s mRNA pipeline tracker?

https://www.modernatx.com/pipeline


All FDA trials are listed here: https://clinicaltrials.gov/, I believe you can search by gene. It's not as nice as the moderna pipeline though.


Thanks for that!


A lot of times you hear about these breakthroughs in medical papers or in mice, but this really feels different.

Like an actual breakthrough with an actual cure for a specific disease. It's remarkable.

Here's to more cures.

God bless.


Crazy genetics ideas I would like explored

A modified tree that drops nuts of (nearly) pure graphite or some other form of nondecomposable carbon which we can easily harvest and sequester.

Photosynthesis in humans to supplement our energy consumption. Shoutout to Knights of Sidonia.

I understand the ethical issues surrounding the second one.


I believe the graphite nut proposal is too inefficient to work. A single large tree absorbs around 30 kg of CO2 per year. If it was able to put 10% of that into graphite nuts (which would be a very good efficiency), you end up with 0.8 kg of graphite nuts per tree per year.

To match the IEAs projections for carbon capture (7.5 gigatonnes CO2 captured per year in 2050) you would need around 3*10^12 trees. That's about the same as the total number of trees in the world. So you need to replace all of the worlds trees, with the corresponding destruction of many of the biggest ecosystems on earth.


Thats a pretty solid breakdown, but that 3x10^12 was a little more hope-inspiring than I was expecting. Seems like a workable part of a larger multi-pronged solution if you streamlined the plants metabolism (?). Then again I dont know what in the h*ll Im talking about so theres that...


As someone who knows next to nothing about genetics, it's interesting to me that we haven't engineered a tree that grows faster than a hybrid poplar but thicker than a oak or sequoia (for carbon sequestration, and lumber).

An added benefit would be if the wood after harvested lasted longer than a cedar.

I'm guessing the reason this isn't possible is more due to the fact that it's just not financially worth the investment than it being too difficult.

But I'd love to hear from someone who knows more about this stuff.


> A modified tree that drops nuts of (nearly) pure

Well, we sort of have that in the form of specifically engineering bacteria to create some drugs, notably insulin. Though I’m sure graphene require additional biological structure and that is a much harder problem them adding/removing a few genes.


How about a fast growing bamboo variant that is denser than water, so that it can be grown and then dumped into the deep ocean to sequester carbon.


You may -or may not, of course- enjoy Daniel Suarez's Change Agent [1]. Probably not his best but still entertaining and interesting.

[1] https://isbn.nu/978-1-101-98466-6


Kudos on this comment. Had never considered the Bosch process (using hydrogen) for sequestering CO2 into graphite until reading this.


... or turning people into monadic supermen.


So this is editing liver cells, which I read somewhere is the easiest to do, since the liver absorbs foreign elements from the bloodstream.

The success of this should mean that many genetic liver conditions can soon be treated this way.

For other organs, I expect a longer wait.


The brain is particularly hard due to blood/brain barrier, crispr is too big a molecule to go through. So might need injections into cerebral spinal fluid for that


The lung epithelium has also recently been transfected in humans (see Translate Bio cf drug; this and similar vehicles can deliver editing tools)


The fact that we can apply these sort of therapies to an adult human who consists of millions upon millions of cells blows my mind. Having the ability to fix our "buggy" genetic code while we are alive is amazing.


You're off by a _couple_ orders of magnitude. There are trillions of cells in a human body.


10^6 * 10^6 = 10^12


Monkey patching in production.


I think targetting tbe liver is far easier than most other tissues though, unfortunately.


Gotta start somewhere...


I feel like I missed something, and now everywhere I look we have headlines like this.

What's wrong with "CRISPR gene editing shown to cure Transthyretin amyloidosis in patient study"

Maybe I'm now one of the old people who doesn't understand new usage of language. But I understand that usage dictates grammar rules, but I feel I missed something.


The paper linked in the article is titled "CRISPR-Cas9 In Vivo Gene Editing for Transthyretin Amyloidosis." That's close enough to your proposed title. If what you're looking for is a technical research paper meant for people intimately familiar with the field, then that's a great title.

But it's a terrible title for an article meant for laypeople like us. The words "transthyretin amyloidosis" are utterly meaningless to me and most HN/NPR readers, but "He Inherited A Devastating Disease" tells me what kind of disease it is (devastating, heritable) and why CRISPR gene editing might be a big deal.

It also helps clue me into the contents of the article. Because it is as much a summary of a key research result, as it is a profile of Patrick Doherty, a man affected by the disease. That's entirely missing from your title.

None of this is new. "Write for your audience" is as old as writing itself.


> What's wrong with "CRISPR gene editing shown to cure Transthyretin amyloidosis in patient study"

I understand your asking a rhetorical question but in the interest of having a discussion about this I’ll try to give you an answer. Imagine a title like “Xonuicfixs shown in zenocttkike to cure Xclatngt”

Reading that you might thing “wrf are they talking about?” But imagine I just change the title to be more like:

“A breakthrough in Xonuicfixs shows promise as a cure for a range of decided.”

Have I lowered the information content of the title? Yes, certainly. However I have also made it very apparent to you an others who don’t know the subject matter why this is a worthwhile achievement, and this might therefore just become the first article that you read and learn about Xonuicfixs.

And really shouldn’t that be the job of a title? To convey to potential readers why the content might be with their time. And I would note that this is entirely different from clickbait which tires to lure you into content with no information about what the content is.


I know what you mean. These headlines read less like titles and more like lyrics in a song ("He was a skater boy. She said see you later boy."). It feels a bit condescending, as if it was aiming at children. I'd much prefer a title with a "person with thing does action" style.


In my opinion, and it seems in the NPR editor’s opinion, the most exciting angle to this story isn’t the cure of one relatively rare disease (TAA), but rather the seemingly imminent cure of many/most inherited diseases which affect cells of the liver. Indeed, we can even make edits that confer protective benefits to people at risk for diseases due to mutations OR lifestyle (see a similar approach by Verve Therapeutics). This is a big story which deserves the attention grabbing headline.


I believe the metaphore of the inverted pyramid used in journalism plays a part here.

edit: Strike that, hadn't realized that the article title and the HN link differed so much.


I think it’s just an oddity of newspapers. Even before it was called “going viral”, they’ve been a bit like that.


NPR isn’t a research paper, or a researcher focused website.


Please do familial hypercholesterolemia soon! I know it would be harder but getting started on targeting specific mutations could be fruitful.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681164/


It's coming very, very soon. Verve just IPO'ed and you check out their S1 to see their data on using the exact same idea (N1mΨ mRNA + gRNA inside LNP) to treat hypercholesterolemia! The data look amazing in non-human primates, which based on the Intellia data, suggest 10-fold lower dose in humans should work just fine.

https://www.biospace.com/article/releases/verve-therapeutics...


That's amazing! How does one register as a potential patient for the trials?


www.clinicaltrials.gov once their IND is open, you'll be able to find it there! My guess is it's a year or so away before they start recruiting.


I want the CRISPR research that focuses on CIP accelerated. I have a minor chronic pain issue that will get worse over time (think sciatica). By the time I’m 60 in 25 years, it’d be great if we had that. No more need for opiates or drugs that barely make a dent. https://en.m.wikipedia.org/wiki/Congenital_insensitivity_to_...


Wikipedia says that they first used viruses as delivery agents; now it's nanoparticles, aparently to avoid destruction by the immune system. Also interesting that CRISPR gene editing was also the subject of a patent war. Amazing stuff... (also it took them less than a year to adopt the nanoparticle trick to CRISPR gene editing. Things are moving fast)

https://en.wikipedia.org/wiki/CRISPR_gene_editing

https://news.harvard.edu/gazette/story/2020/11/coated-nanopa...


here is a better link: https://www.sciencemag.org/news/2021/06/crispr-injected-bloo... they say that they are using lipid nanoparticles, that's the same stuff that is used in the Moderna and Phizer covid vaccines. https://www.sciencedirect.com/science/article/pii/S037851732... We are living in the twenty first century...


It's only a matter of time before we use this to cosmetically modify our bodies. I predict that at the very least we'll use this technic to change our hair color and eye color. I will even say skin color too, with-in the next 50 years.

Most people won't use it but there will be an active market , legal or illegal, for the modifications. The Sci-Fi future is here.


On the contrary, I think most people will use it and those that don’t will likely do so out of religious reasons.

This is really great. Being born into the wrong set of genes seems like an incredibly silly thing to restrict humans to. Allowing humans to choose their appearance seems like it could resolve a bunch of psycho social issues and hopefully people can live more happy lives (although I am aware that these things often lead to as yet unknown problems of their own…)


You... might want to read the story of the Sneeches by Dr. Seuss.


Hair and eye color is bare minimum. You're gonna see cat girls and wolf boys and dragonkin and all kinds of weird ass shit. People making themselves intentionally disabled, people giving themselves a third arm, the sky's the limit!


We have tried every imaginable remedy. In some instances there has been brief recovery, followed always by a still worse relapse. Physicians who are familiar with alcoholism agree there is no such thing as making a normal drinker out of an alcoholic. Science may one day accomplish this, but it hasn't done so yet. -- Alcoholics Anonymous Chapter 3, More About Alcoholism

I may soon be able to drink again after having my genes edited, but I'm not sure I would do it


The word “always” in this passage doesn’t sound very scientific. Makes me wonder if the rest of the content has the same tone.


Yes it does have this tone. It's not science. It was written in 1935 by Bill Wilson, a former stock market speculator and salesman. It's designed to be inspirational, as in, you may think you are a hopeless drunk, but I have a solution for you right here in this book. Give it a try.

Edit: Something not often discussed is that Bill Wilson was hoping to make money from this book, being dead broke in the middle of the Great Depression. The first people he helped sober up convinced him that he had to give it away freely.


The period missing from the title makes this very hard to parse what is being said.


Agreed. NPR never used to use clickbait titles like this ("He ..." is pure clickbait). It's sad to see them doing it regularly now. I imagine the latest generation of journalists grew up thinking this is normal. I know HN prefers original headlines, but I wish these would be edited down when posted here.


"well then stop clicking on them!"


I often say the same thing myself. I expect it on CNN, and I do passively protest by ignoring links like this most of the time. NPR usually has good articles behind the links, and I'm more inclined to hold my nose and click if they make it to HN. In this case, the actual article is good. I'm lamenting the negative trend.


Wow...this is a really big deal. Congratulations to this team and to the patients who were treated. I hope the treatment continues to keep the disease at bay.


Original paper: https://www.nejm.org/doi/full/10.1056/NEJMoa2107454?query=fe...

This is the first published IV-administration of a gene-editing CRISPR payload. Interesting convergence with the nanoparticles used in mRNA vaccines. Sickle-cell and immune reprogramming edits have been made on cells removed from the body. Josiah Zayner infamously injected himself with CRISPR at a conference years back, but (1) unpublished, AFAIK and (2) he had been drinking which likely attenuated the payload [and (3) he wanted bigger muscles, not to treat a disease]



Turning medical science from a technical problem into an ethical one would be a massive epoch boundary for humanity, I’d say. More so than the Internet.


This is just mind blowing.

What are some good investment opportunities if you think this is going to revolutionize the world in the next 30-50 years?


From another comment here, Verve? https://finance.yahoo.com/quote/VERV

Any more suggestions?


This is awesome but I'm curious why they tried it first on this super-rare disease instead of something more common?


Extremely rare diseases and diseases that have no known treatment options are given more lax rules for testing. Without that, there would be no way to develop treatments for them, but it comes with a side benefit of providing a method to attempt new treatment modalities.


Wild guess: it's because he's 65. Many of these severe genetic diseases kill their victims at relatively young ages.

Ethical researchers are thus far being super-cautious about modifying the genome of someone who's likely to have children. While the article doesn't say, I wouldn't be surprised to learn that he has explicitly agreed not to have any (more?) children.


My 2 cents:

a) need to edit liver cells only, not the entire organism, b) the disease is deadly, so the patients do not have much to lose if anything goes wrong.


I'm very hopeful that someday these techniques will cure diseases like Huntington's


I must be out of the loop. Last I heard trials with CRISPR were making not only the desired genetic changes but also dozens of others at random points in the genome. Did they solve that problem?


Humans improve technology all the time, CRISPR gene editing would be no exception.

Straight from Wikipedia: https://en.wikipedia.org/wiki/LEAPER_gene_editing

I bet a dip into the specialized papers will show a multitude of these techniques.


Wow, it worked...This uses LNPs similar to the recent Moderna and BioNTech/Pfizer vaccines, and N1m-pseudouridine mRNA, just like the mRNA vaccines. This is incredible.


Can anyone explain how this survives being in the blood stream and then how it actually gets into the nucleus of the cell?


Very similar to how a virion (virus particle) and its "payload". Here a lipid nanoparticle coats the genetic material. The exact chemistry used is highly selective to liver cells (so most of the particles will end up fusing with a liver cell), then inside the cell some enzyme or similar but more complicated molecular machinery (these usually have names ending in -ase, like protease, nuclease) unwraps it. Then it has special markers which signal that it needs transport to the nucleus. See NLS [0]. There CRISPR does its magic. The guide is the genetic pattern matcher. The big limitation is the length of this guide. The longer it is the safer it can be.

[0] https://www.researchgate.net/post/How-does-the-CRISPR-guideR...


Wonder how long it will be until this is used to enhance rather than just to cure.

Eg selective fast twitch / slow twitch muscle fibres.


Probably already happening


Presumably it would be damn hard to detect if it was!


Usain Bolt would be my number 1 candidate. His meteoric rise lines up perfectly date wise with the emergence of this technology and it is well documented that athletes have been using themselves as guinea pigs for various pre-commercial drugs due to the ability to avoid positive tests.



Haha. What could possibly go wrong?


What are the limits of gene editing?


Before getting too excited, let's not forget the stories where gene therapy went horribly wrong.

https://www.sciencehistory.org/distillations/the-death-of-je...

> Doudna expressed similar concerns about CRISPR.

> “I hope that we don’t get ahead of ourselves with this technology. As exciting as it is, I really would like to see . . . people take a very measured and responsible path forward, where there’s careful vetting along the way,” she said. “Of course, the challenge is that patients are waiting, so you don’t want to delay unduly. But you also want to be safe.”


> “We were all very much aware of what happened there and what a tragedy that was,” she said in a recent interview. “That made the whole field of gene therapy go away, mostly, for at least a decade.

Damn this sucks to read. To think of how much progress we might have made in a promising field if we could just get over one person dying. Yes it's awful, and we shouldn't be flippant, but we're talking about work to help _humanity as a whole_. This isn't the same as saying "the means justify the ends." This is just saying, "Shit, we fucked up there, let's not do that again, but let's keep learning." I don't know how you ever advance without making mistakes.


Well, in some situations we are doing this. For example even when some vaccines happen to kill some small number of people, it has been argued that in current situation it is still net positive.


I don’t think there are any aside from money, time, and experience. If you’d like to give yourself glowing purple eyes, huge muscles, and make it so you fart clouds of illegal street drugs you can but it’s much more difficult and messy than deleting ‘node_modules’, rebuilding, and doing a `git push —force` into prod at 5PM on a Friday before you take a long weekend.


We're constrained by the subset of physics that can be implemented by proteins. Plus, the genetic code can't be too big, or it won't fit, but I doubt we'll ever hit that limit (provided we don't go the software route and build a giant tower of massive abstractions that gets copied everywhere).


Proteins and things built by proteins. Teeth aren't very protein-y.


Why can’t we hardwire genes to continue growing teeth?


Because we have specialized diverse teeth. Of course it's possible but that would be novel genetic programming which we just can't do.


Could we hack our genes to need less oxygen and eat less?

That could be useful in the future.


Stupid question: If he were to have kids, would they inherit this fix?


No. Sperm would not be edited by this method.


Want to try chameleon color changing dna to pomerian dog


[flagged]


You would not need CRISPR to do that. If something like that ever occurred they would probably use other methods that have been very well studied for much longer and are considerably easier to apply. Including just taking blood samples from bats (or pangolins or whatever) and archiving a great compelling virus and culturing it in a lab. If you wanna add CRISPR into the mix you could also make a virus like that make someone grow some horns and get hiccups that sound like a kazoo though.


They could also use normal editing with PCR since the genomes are small. Also CRISPRs are in tons of organisms (I’ve amplified it from yogurt), so the box is already out there.


Knives can kill and save people. Almost anything can be used for bad purposes in the wrong hands.


Not that I agree we should bury our heads in the sand like luddites, but to be fair to OP, knives can only hurt or help in a tiny human radius. It's hard to make an extinction-level weapon (or extension level accident) out of them.

Being able to edit genes at will is a different story.


Viruses are an extinction-level weapon. CRISPR? Not so much. (And neither are likely to result in an extinction-level accident; you'd have to deliberately deploy potent bioweapons in multiple places to extinct us.)


Yes but the CRISPR engine is passed on to offspring which raises massive ethical questions.

As I understand it (and hopefully I'm not way off base here) there is a technique that creates a "gene drive" which is kinda like an SDK that is inserted into the patients genome which improves the efficacy of CRISPR.

This code finds its way into the gametes which is then passed on to children. The children did not ask for this SDK, but now they have it and it potentially becomes immortal in human DNA.

On the one hand, cool: the SDK is there and possibly makes it even easier to alter DNA>

On the other hand, holy shit: there's a ticking timebomb in the populations DNA now.

It's called CRISPR-cas9:

https://wyss.harvard.edu/media-post/crispr-cas9-gene-drives/

https://scicomm2020.wordpress.com/2020/02/24/controversial-g...


The really great thing about us knowing how to read and edit genes now, is that if that happened we would notice and could switch it off. The stuff we want to wipe out using gene drives — e.g. Malaria — can’t.

There are things to worry about with cheap gene engineering, but that particular possibility won’t affect us.


Not if you're 65 it doesn't...


Excellent point!


It will not stay in the box.

The allure of armies of supersoldiers without sense of emotions, conscience, and remorse is irresistible for dictators. I bet Chinese, or Russian militaries are already working on that.


Humans still have to be fed. Killer robots dont


Not reading the entire article - I believe this is going the wrong way…


So the religious right decided that we do not own our bodies, god does. Just as software companies issue a EULA, all children born since 2032 are required to have their parents sign a EULA. Genetic modification is strictly prohibited and punishable by reduction of the government stipend that everyone receives in fedcoin every month. Underground genetic modification labs are run by organized crime but unfortunately those using these labs also get an unplanned genetic modification in addition to the one they want. They are made dependent on a drug that only those labs can provide, for a price. In addition, there are monthly vaccination programs for citizens to protect them against genetic terrorists, carriers of lethal protoviruses who are engineered to carry and disseminate Covid derivatives that target HLA SUBTYPES common in Northern European and South American genotypes.

Yes genetic modification is another wonderful technology that humans will weaponize….like atomic energy, like the internet…


Cool, we can only show stories where it worked


Human clinical trials are pre-registered, in order to prevent exactly what you are describing (the 'file drawer problem').


Not in all countries, just ask CCP


Coming from a genetics background, I can tell you the fact that it worked once is a massive achievement in itself. This is science fiction.




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