CRISPR-Cas9 is a revolutionary method of gene editing, that allows scientists to selectively modify DNA in a much more cost-effective and efficient manner. The technology was originally found in bacteria as an immune evasion mechanism against viruses.
Before considering how CRISPR revolutionises surgery, let’s answer a simpler question - what exactly is gene editing? Gene editing is the modification of DNA - our instructions for making proteins - at specific locations. There are multiple ways to edit our genes, but perhaps the most well-known is CRISPR-Cas9, which acts like molecular “scissors” that cut DNA at precise points.
Currently, the technology is used in labs - editing the genomes of yeast, bacteria, mice etc. that scientists commonly study has led to countless discoveries about how the genome is connected to physical traits, like eye colour, and disease. Gene editing as a surgical tool is still developing, however, there are some exciting applications.
CRISPR could target and edit the DNA of cancer cells during surgery rather than the traditional way of removing the tumour that may still leave some cancerous cells behind in the body. The DNA within cancer cells could be modified to deactivate the genes responsible for tumour growth.
It can also provide an alternate treatment pathway for conditions with a genetic basis, such as epilepsy, and neurodegenerative diseases like Parkinson’s, in addition to inherited genetic disorders, such as cystic fibrosis or sickle cell anaemia. This approach may provide a way to halt the progressions of these conditions, and potentially even offer a permanent cure.
However, there is still a long way to go before modifying human genes. There are concerns about editing non-target genes. CRISPR is very precise, however, there is still a possibility of unintended changes in DNA, which could lead to new health problems or other harmful side effects. There are also some questions on how CRISPR could be delivered to the right cells, particularly inside the human body. Finding a method that is both effective and efficient proves to be difficult.
CRISPR also raises some complex ethical questions. Should we be altering human genes, even if it is to correct disease? It is possible to use CRISPR to correct genetic defects in embryos. Is that a possibility we should consider? Should we worry about what starts as a therapeutic tool contorted into creating designer babies - editing genes to enhance traits such as physical appearance? What are the long-term implications of gene editing? These questions underscore the importance of regulations and careful oversight as the technology develops.
Gene editing in healthcare is still in its early stages, but it has the potential to revolutionise the field. From cancer treatment to genetic diseases, the ability to edit genes could lead to more effective, personalised treatments. However, there are still significant challenges to overcome, including the risk of off-target effects, precise delivery, and the ethical considerations surrounding genetic modifications.
References:
"Gene Editing in Surgery: How CRISPR is Transforming Medicine." Nature Reviews Surgery, 2022.
Doudna, Jennifer A., and Emmanuelle Charpentier. "The New Era of CRISPR." Science, vol. 372, no. 6547, 2021, pp. 1164–1166.
"CRISPR and Cancer Treatment." Journal of Oncology Surgery, 2021.
Redman, M., King, A., Watson, C., & King, D. (2016). What is CRISPR/Cas9?. Archives of disease in childhood. Education and practice edition, 101(4), 213–215. https://doi.org/10.1136/archdischild-2016-310459
"How Genome Editing Works." Genome Web, National Human Genome Research Institute, 20 Apr. 2020, www.genome.gov/about-genomics/policy-issues/Genome-Editing/How-genome-editing-works. Accessed 6 Oct. 2024. Assessed and Endorsed by the MedReport Medical Review Board