Last November, news broke that a Chinese scientist had secretly altered the genes of the embryos of a pair of Chinese twins and shocked the world. However, while the use of advanced technology to alter the human gene pool was premature, it was a harbinger of how genetics will change our health care, how we treat children, and ultimately how we treat ourselves and our species. The genetic revolution has already begun, but we are not ready to responsibly treat these Promethean technologies.
By identifying the structure of DNA in the 1950s, Watson, Crick, Wilkins, and Franklin showed that the book of life is written in the DNA double helix. When the Human Genome Project was completed in 2003, we saw how this book on human life could be rewritten. Painstaking research combined with advanced computational algorithms has begun to discover more and more what genes do and how the genetic book of life can be read.
Now, thanks to the advent of precise gene editing tools like CRISPR, we know for sure that the book of life, and indeed all biology, can be rewritten. Biology has become another form of the read, write, and hackable information technology that we humans code.
The impact of this transformation is primarily felt in the health sector. Gene therapy, which involves extracting, altering and re-injecting a person's own cells that have been improved to fight, for example, cancer, is already working wonders in clinical trials. Thousands of applications have already been filed with regulators around the world for trials using gene therapy to treat a host of other diseases.
Not so long ago, the first editing of the genes of cells inside the human body was begun to treat a relatively simple metabolic disorder in terms of genetics - Hunter syndrome. Other uses will follow shortly. These examples are literally the very first steps in our transition from the existing system of generalized medicine based on population averages to precision medicine based on the individual biology of each patient, and predictive medicine based on artificial intelligence-generated estimates of the future state of human health.
This shift in our healthcare will ensure that millions, and then billions, of people will sequence their genomes, laying the foundation for their treatment. Big data analytics will help you scale up human genotypes (what genes say) to phenotypes (how genes are expressed throughout life).
Massive sets of genetic and medical information will allow you to go beyond simple modern genetic analysis and understand much more complex human diseases and traits that are affected by hundreds or thousands of genes. Our understanding of this complex genetic system in our vast ecosystems and our environment will transform healthcare for the better and help us heal the terrible diseases that plagued our ancestors for millennia.
But as revolutionary as this challenge is for medicine, the consequences of the genetic revolution in health care are just trans-shipment stations on the way to our final destination: a profound and fundamental transformation of our species.
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Changing the human species
The first glimpses of the future we are heading into can be seen in the consumer-centric genetic testing industry. Many people around the world have sent their inside cheek swabs to companies like 23andMe for analysis. The information that will be provided to them will tell about relatively simple genetic traits: the status of diseases associated with a mutation of one gene, eye color, whether they like the taste of cilantro, but will keep silent about complex traits: sports predisposition, intelligence, personality.
This will not always be the case. As pools of genetic and health data grow, analyzing large numbers of sequenced genomes will predict highly complex genetic disease risks and genetic traits such as height, IQ, temperament and personality style. This process, called "polygenic counting," is already being carried out by several companies and will become a more important part of our lives in the future.
The most interesting consequence of all this will manifest itself in our birth of children. Before deciding which fertilized egg to implant, women in IVF today can choose from a small number of cells that have been extracted from previously implanted embryos and sequence the genome. Modern technology makes it possible to see mutations in individual genes and relatively simple disorders. Polygenic counting will soon allow embryos to be seen at an early stage of development and to assess the risk of developing complex genetic diseases or even the possibility of inheriting complex human traits. The most intimate elements of human existence will soon be subject to strict parental selection.
Adult stem cell technology is likely to produce hundreds or thousands of a woman's own eggs from her blood sample or skin graft. This will open the door to reproductive opportunities and allow parents to select embryos with exceptional potential from a much broader range of options.
The complexity of human biology imposes some limits on the extent to which gene editing is possible, but all biology, including our own, is extremely flexible. How else did all this biodiversity emerge from a single cell four billion years ago? The limitations of our imagination will be the biggest obstacle to our biology.
But as long as we humans strive for the power of the gods, we are not at all ready to use it.
Games with your own biology
The same tools that will help us overcome our worst addictions, save our children, help us live longer and healthier lives, and they will also open the door to abuse. Prudent well-intentioned parents or states with weak regulatory structures or aggressive ideas that want to increase the competitiveness of a nation can plunge us into a genetic race that will undermine our essential diversity, dangerously divide society, lead to dangerous, destabilizing and even possibly fatal conflicts between us. will endanger all of humanity.
But if the development of genetic technologies is inevitable, then how it all unfolds can and should be controlled. If we don't want the genetic revolution to ruin our species, or lead to deadly conflicts between those with the right genes and the have-nots, or between the socially adapted and the socially unadapted, right now we need to make smart decisions based on our best individual and collective values. While the technologies that drive the genetic revolution are new, the value system we will need to optimize the benefits and minimize the damage in this massive transformation process has been developed for thousands of years.
And while some smart and well-meaning scientists have already gathered to discuss what will happen next, not even the wisest prophets are enough to make decisions about the future of our species. It will be necessary to lead the process of its formation at the national and even international level.
Each country will have to develop its own regulatory guidelines for human genetic engineering, based on both international best practices and the country's unique traditions and values. However, since we are all one species, eventually we will have to develop guidelines that apply to all of us.
The intersection of genomics and artificial intelligence may sound like science fiction, but it's closer than you think. Much sooner than most people admit, the benefits that new technologies offer and the competition between us will cause quick reactions. Before this spark ignites, we have very little time to come together as a species, to formulate and embody the future that we will see together.
Ilya Khel