Gene Editing and Healthcare Applications
An outline of how CRISPR-Cas9 serves to advance healthcare
DOI:
https://doi.org/10.58445/rars.461Keywords:
CRISPR-Cas9, Gene-editing, Genetics, Genetic engineering, Bioethics, Sickle Cell Anemia, Cystic Fibrosis, Gene ResearchAbstract
The advances in the field of genetics and gene editing have led to fascinating applications of gene modification technology in the work of healthcare research. Genetic mutations and genetic diseases can be impacted by the therapies and treatments that have progressed due to CRISPR-Cas 9. CRISPR-Cas9 consists of a guide RNA (gRNA) which contains a section of the target DNA and an endonuclease that cuts DNA. CRISPR-Cas9 is great at knocking out gene expression and especially useful for autosomal dominant disorders because if CRISPR-Cas9 disrupts the function of a dominant, disease-causing allele, only the recessive allele is expressed (Kathleen et al. 2020). It is imperative to keep in mind gene therapy progression as well. Gene therapy is the oldest form of genetic medicine and is based on gene transfer technology, such as insulin bacteria. Insulin bacteria are the result of the human insulin gene being inserted into a bacterial plasmid. DNA can be delivered by a virus shell by inserting the appropriate replacement DNA (Petrich 2020). All forms of gene therapy in humans must undergo clinical trials in order for treatments to be approved by the FDA. Clinical trials must also follow criteria that all involved must adhere to: trials must have strict eligibility criteria, researchers must communicate about serious adverse events in other participants, and participants must show informed consent (Gupta 2013). Lastly, because tempering with genetic material can be such a risky method for healthcare professionals to resort to, ethical and safety considerations of using gene editing for human health and disease must be considered. Overall, how genetic mutations cause diseases such as cystic fibrosis and sickle cell anemia, how CRISPR tools can be used to combat it, and what the bioethical considerations are of using gene editing treatments can all be better understood through gene editing research.
References
“About Cystic Fibrosis.” Cystic Fibrosis Foundation, www.cff.org/intro-cf/about-cystic-fibrosis. Accessed 22 Aug. 2023.
Akinyanju, O O. “A profile of sickle cell disease in Nigeria.” Annals of the New York Academy of Sciences vol. 565 (1989): 126-36. doi:10.1111/j.1749-6632.1989.tb24159.x
Almeida, M., Ranisch, R. Beyond safety: mapping the ethical debate on heritable genome editing interventions. Humanit Soc Sci Commun 9, 139 (2022). https://doi.org/10.1057/s41599-022-01147-y
Arishi, W. A., Alhadrami, H. A., & Zourob, M. (2021). Techniques for the Detection of Sickle Cell Disease: A Review. Micromachines, 12(5), 519. https://doi.org/10.3390/mi12050519
Arroyo-Olarte, Ruben D et al. “Genome Editing in Bacteria: CRISPR-Cas and Beyond.” Microorganisms vol. 9,4 844. 15 Apr. 2021, doi:10.3390/microorganisms9040844
Ballas, S K. “Ethical issues in the management of sickle cell pain.” American journal of hematology vol. 68,2 (2001): 127-32. doi:10.1002/ajh.1164
“BCL11A: A New Gene Therapy Target in Sickle Cell Disease?” Ashpublications.Org, ashpublications.org/ashclinicalnews/news/4883/BCL11A-A-New-Gene-Therapy-Target-in-Sickle-Cell. Accessed 22 Aug. 2023.
Chatterjee, Nimrat, and Graham C Walker. “Mechanisms of DNA damage, repair, and mutagenesis.” Environmental and molecular mutagenesis vol. 58,5 (2017): 235-263. doi:10.1002/em.22087
“Ethical Considerations When Using Gene-Editing Treatment for Sickle Cell Disease.” Relias Media, 1 June 2023, www.reliasmedia.com/articles/ethical-considerations-when-using-gene-editing-treatment-for-sickle-cell-disease.
Fadare, JO. “Some Ethical Issues in Teh Prenatal Diagnosis of Sickle Cell Anaemia.” Annals of Ibadan Postgraduate Medicine, 2009, www.ajol.info/index.php/aipm/article/view/64084.
Funk, C. (2020, August 20). Public views of gene editing for babies depend on how it would be used. Pew Research Center Science & Society. https://www.pewresearch.org/science/2018/07/26/public-views-of-gene-editing-for-babies-depend-on-how-it-would-be-used/
Gene editing for cystic fibrosis. Cystic Fibrosis Foundation. (n.d.). https://www.cff.org/research-clinical-trials/gene-editing-cystic-fibrosis#:~:text=The%20CRISPR%20gene%20editing%20tools,the%20site%20of%20the%20mutation.
Giralt, Sergio, and Michael R Bishop. “Principles and overview of allogeneic hematopoietic stem cell transplantation.” Cancer treatment and research vol. 144 (2009): 1-21. doi:10.1007/978-0-387-78580-6_1
Gupta U. C. (2013). Informed consent in clinical research: Revisiting few concepts and areas. Perspectives in clinical research, 4(1), 26–32. https://doi.org/10.4103/2229-3485.106373
Hanssens, Laurence S et al. “CFTR Protein: Not Just a Chloride Channel?.” Cells vol. 10,11 2844. 22 Oct. 2021, doi:10.3390/cells10112844
Kathleen A. Christie, Louise J. Robertson, Caroline Conway, Kevin Blighe, Larry A. DeDionisio, Connie Chao-Shern, Amanda M. Kowalczyk, John Marshall, Doug Turnbull, M. Andrew Nesbit, C.B. Tara Moore, Mutation-Independent Allele-Specific Editing by CRISPR-Cas9, a Novel Approach to Treat Autosomal Dominant Disease, Molecular Therapy, Volume 28, Issue 8, 2020, Pages 1846-1857, ISSN 1525-0016, https://doi.org/10.1016/j.ymthe.2020.05.002.
Kevin R Smith, Gene therapy: theoretical and bioethical concepts, Archives of Medical Research, Volume 34, Issue 4, 2003, Pages 247-268, ISSN 0188-4409, https://doi.org/10.1016/S0188-4409(03)00070-5.
Ly, Sarah, "Ethics of Designer Babies". Embryo Project Encyclopedia (2011-03-31). ISSN: 1940-5030 http://embryo.asu.edu/handle/10776/2088.
MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); [updated 2020 Jun 24]. “How Does Gene Therapy Work?” MedlinePlus, U.S. National Library of Medicine, 2022, medlineplus.gov/genetics/understanding/therapy/procedures/.
Naso, M. F., Tomkowicz, B., Perry, W. L., 3rd, & Strohl, W. R. (2017). Adeno-Associated Virus (AAV) as a Vector for Gene Therapy. BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy, 31(4), 317–334. https://doi.org/10.1007/s40259-017-0234-5
Nwabuko, O. C., Onwuchekwa, U., & Iheji, O. (2022). An overview of sickle cell disease from the socio-demographic triangle - a Nigerian single-institution retrospective study. The Pan African medical journal, 41, 161. https://doi.org/10.11604/pamj.2022.41.161.27117
Patrick, M., Gearing, M., Mork, C., & Stroik, S. (2023, January 24). CRISPR 101: Homology directed repair. Addgene blog. https://blog.addgene.org/crispr-101-homology-directed-repair
Petrich, J., Marchese, D., Jenkins, C., Storey, M., & Blind, J. (2020). Gene Replacement Therapy: A Primer for the Health-system Pharmacist. Journal of pharmacy practice, 33(6), 846–855. https://doi.org/10.1177/0897190019854962
Psatha, N., Reik, A., Phelps, S., Zhou, Y., Dalas, D., Yannaki, E., Levasseur, D. N., Urnov, F. D., Holmes, M. C., & Papayannopoulou, T. (2018). Disruption of the BCL11A Erythroid Enhancer Reactivates Fetal Hemoglobin in Erythroid Cells of Patients with β-Thalassemia Major. Molecular therapy. Methods & clinical development, 10, 313–326. https://doi.org/10.1016/j.omtm.2018.08.003
Rothschild J. (2020). Ethical considerations of gene editing and genetic selection. Journal of general and family medicine, 21(3), 37–47. https://doi.org/10.1002/jgf2.321
Sanger, W. (2017, February 17). What is genetic engineering?. yourgenome. https://www.yourgenome.org/facts/what-is-genetic-engineering/#:~:text=The%20genetic%20engineering%20process&text=The%20gene%20for%20human%20insulin,rapidly%20and%20starts%20making%20insulin.
Sankaran, V. G., & Orkin, S. H. (2013). The switch from fetal to adult hemoglobin. Cold Spring Harbor perspectives in medicine, 3(1), a011643. https://doi.org/10.1101/cshperspect.a011643
Serjeant G. R. (2013). The natural history of sickle cell disease. Cold Spring Harbor perspectives in medicine, 3(10), a011783. https://doi.org/10.1101/cshperspect.a011783
Sickle cell disease. Johns Hopkins Medicine. (2019, November 19). https://www.hopkinsmedicine.org/health/conditions-and-diseases/sickle-cell-disease
Sundd, P., Gladwin, M. T., & Novelli, E. M. (2019). Pathophysiology of Sickle Cell Disease. Annual review of pathology, 14, 263–292. https://doi.org/10.1146/annurev-pathmechdis-012418-012838
Sternberg, S. H. (2017). The biological breakthrough of CRISPR-based gene editing. OpenMind. https://www.bbvaopenmind.com/en/articles/the-biological-breakthrough-of-crispr-based-gene-editing/#:~:text=Today%2C%20scientists%20can%20use%20CRISPR,on%20or%20off%2C%20and%20more.
Sturm, Noel. “DNA Mutation and Repair.” DNA Mutation and Repair, 2019, www2.csudh.edu/nsturm/CHEMXL153/DNAMutationRepair.htm.
Therapeutics, CRISPR. “CRISPR/Cas9.” CRISPR, crisprtx.com/gene-editing/crispr-cas9. Accessed 22 Aug. 2023.
Uddin, F., Rudin, C. M., & Sen, T. (2020). CRISPR Gene Therapy: Applications, Limitations, and Implications for the Future. Frontiers in oncology, 10, 1387. https://doi.org/10.3389/fonc.2020.01387
Veit, G., Avramescu, R. G., Chiang, A. N., Houck, S. A., Cai, Z., Peters, K. W., Hong, J. S., Pollard, H. B., Guggino, W. B., Balch, W. E., Skach, W. R., Cutting, G. R., Frizzell, R. A., Sheppard, D. N., Cyr, D. M., Sorscher, E. J., Brodsky, J. L., & Lukacs, G. L. (2016). From CFTR biology toward combinatorial pharmacotherapy: expanded classification of cystic fibrosis mutations. Molecular biology of the cell, 27(3), 424–433. https://doi.org/10.1091/mbc.E14-04-0935
Zhu, Youmin. “Advances in CRISPR/Cas9.” BioMed research international vol. 2022 9978571. 23 Sep. 2022, doi:10.1155/2022/9978571
Zu, H., Gao, D. Non-viral Vectors in Gene Therapy: Recent Development, Challenges, and Prospects. AAPS J 23, 78 (2021). https://doi.org/10.1208/s12248-021-00608-7
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