Why genetically edited babies have aroused a worldwide fury

It was after the Chinese researcher He Jiankui revealed that he had used the technique to alter human embryos. Infobae spoke with international experts who object to this type of experimentation. Some propose that the UN should ban the technique, but others believe that regulation would be more effective

A serious researcher knows that he must follow guidelines for experimentation with human beings. You must report truthfully to volunteers who participate in clinical trials, and then you must submit your findings to the review of other scientists. The scientist He Jiankui, born in the south of China in 1984 and the son of peasants, ignored these steps, and if that was not enough, he says that he had altered embryos and produced the first babies by genetic editing. Instead of publishing in refereed journals, Dr. He posted videos on YouTube to claim that Lulu and Nana are “cute little twins” and “as healthy as any baby.”

His announcement sparked a worldwide fury, and now there are experts – who spoke with Infobae – who advise that the use of genetic editing be regulated, and others that directly demand its prohibition on the United Nations.

He Jiankui, the Chinese doctor of controversy

The genetic edition allows to “cut and paste” the DNA without adding genes from other species. One of the techniques of genetic editing is called CRISPR and since 2013 it is developed to benefit patients, pets, agricultural producers. Another purpose has been the design of babies free of a disease , a goal that has been questioned by the scientific community because of the possibility that the modification of the embryos produces undesirable effects that could cause health problems even in descendants.

In December 2015, during the first world summit on the subject in Washington DC, the United States, the risks of the embryo application were analyzed and it was concluded that it would be “irresponsible” to proceed to use the genetic edition until it was shown to be safe and effective. However, He Jiankui would have done it, and says he was “proud” of having collaborated with the birth of the first babies by genetic editing.

After publishing the videos on YouTube, the Chinese scientist spoke at the second world summit of genetic editing, which took place between 27 and 29 November last in Hong Kong, organized by the Hong Kong Academy of Sciences, the academies of Science and Medicine of the United States and the Royal Society of England. He -who returned to his native country in 2012 as part of the Mil talents program, and founded two startups related to genetic testing- justified his questioned experiment by saying that he had used genetic editing to prevent infection with the AIDS virus.

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In his experimentation, seven heterosexual couples would have participated. In each case, men are people living with HIV. One of those couples would have had the twins Lulu and Nana, and there would be a pregnancy on the way to another of the couples, according to what he told during his presentation at the summit in Hong Kong.

Last Thursday, China’s Ministry of Science and Technology announced that it had suspended Dr. He for “blatantly violating” norms. Although the country does not have a specific law for genetic publishing, since 2003 a rule that only allows the use of viable embryos until the 14th day in scientific experiments has been in force . The decision was made after 122 Chinese scientists pronounced themselves in a joint statement against what Dr. He would have done, and after a hail of criticism at the global level.

Interviewed at a distance by Infobae , one of the members of the organizing committee of the second world summit, R. Alta Charo , professor of law at the University of Wisconsin, United States, and specialist in reproductive health and bioethics, told: “I heard the doctor I can and I can conclude that the use of genetic editing in embryos was wrong, premature, and largely useless. ”

And he developed: “The babies were practically not at risk of acquiring the AIDS virus, because it was their father – and not the mother – who was infected.” The participants were given a consent form that falsely stated that it was a vaccine trial. for AIDS, and that research was merged with therapy because it would have a likely benefit. Indeed, not only is there little chance that those babies need a benefit because of their low risk, but there is no way to evaluate whether the experiment conferred any If they continue HIV-negative, there is no way to show that it had to do with genetic editing. ” In addition, Dr. Charo commented that He said there are more embryos from other couples, all frozen, and that he stopped working. ”

“What the researcher He Jiankui did is an atrocity,” said Federico Pereyra Bonnet, who leads a group of the Conicet that studies the genetic edition as a way to treat patients with diabetes in the University Institute of the Italian Hospital of Buenos Aires. “We were progressing with the genetic edition step by step, the scientific community understood that the technique has the potential to have a positive impact on human health, but we still need to understand how it works, whether it is safe and effective. He did, experiments were conducted directly on humans and the controls were skipped. Nobody knows the consequences of experimentation, since its effects have never been tested in animal models, they could trigger an autoimmune reaction today or within a few years. ”

Attempts to modify genes or cells in embryos have already aroused controversy in the past. In the nineties, they had begun to develop genetic therapies, through different techniques, and there was a consensus that should not be applied in the germ line to avoid unexpected consequences not only in the individuals who received them but in the human species. “Germline cell gene editing produces changes in DNA that can be inherited by later generations, which is why the therapeutic use of the germline modification has not been approved in any country,” he told Infobae. Fabiana Arzuaga, coordinator of the Inter-ministerial Commission of Advanced Therapies, of the Government Secretariat of Science, Technology and Productive Innovation and member of the Association for Responsible Research and Innovation in Genetic Editing.

Dr. He revived the debate about what the world should do from now on. For Jaydee Janson of the International Center for Technology Assessment in Washington, DC, the United States, who was attending the summit in Hong Kong, we should not let the scientific community decide on its own and the international ban is imposed .

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Asked by Infobae , Janson recalled: “In 2015, from the coalition that we formed with other organizations, we strongly believed the scientists’ promise that self-regulation would prevent the use of genetic engineering in embryos and germline cells. This week’s conference made it clear that the purpose was to lay the foundation for embryo genetic engineering. The failure of the Summit leadership to categorically denounce He’s work is tragic. Only the Chinese government has said that this should not happen ” .

Janson emphasized: “We are calling for a mandatory and international moratorium, since we believe that if it is not done in this way, there will be countries that will allow babies to be born by genetic editing.” If a global agreement is not made, an edited baby tourism will be generated. genetically, as it happened with embryonic stem cell laboratories that were a bait for people, Dr. He does not understand that he has a lifelong obligation to make the babies he produced stay healthy, we do not want a proliferation of those charlatan doctors. The leaders of the summit in Hong Kong called for an independent review of Dr. He’s work, but it is not said who and how it should be done, and these questions must be answered through an international treaty.

In contrast, Dr. Charo opined differently. He fears that the announcement of twins produced by genetic editing will affect the rigorous work of many scientists. ” It is important that the unfortunate work of the scientist He does not become an obstacle to the ongoing development responsible for genetic editing , which is already in clinical trials with somatic cells.” The genetic edition of heritable germline is far from ready For human trials, a translational pathway would include standards for prediction, identification, and evaluation of unwanted effects as well as desired effects. After all, this is done, the use of genetic editing should be limited to situations in which Reasonable alternatives were not available. ”

Regarding the claim to ban the genetic edition, Charo said: ” I am afraid that the facts in China will lead to many calls for complete prohibitions, but they are neither necessary nor wise. Governance is an ecosystem, and there is a role for funders (who should insist on compliance with the local norm, on the submission to the protocol by peer review and on the transparency of the data), of the insurers (who should condition the coverage of institutions to a commitment to education and supervision of their teaching staff), for professional accreditation bodies (which should move quickly to discipline those who violate legal or ethical requirements). If that were coupled with strict regulatory controls at the governmental level, the development and possible uses of the germline edition can be managed. ”

Charo explained why he does not want the total restriction. “Prohibitions simply deprive government authorities and the public of the opportunity to direct the development and ethical use of technology.” No system can absolutely guarantee that there will never again be a rogue scientist who attempts genetic germline editing without a job. clinically appropriate and supervised, but that is more likely to happen with the prohibition than with regulations. “

How to prevent high blood pressure in pregnancy, the third cause of maternal death in the country

Experts warn that the incidence of this condition in Argentina is on the rise, and already reaches 16% of pregnancies. Is hypertension during pregnancy an indicator of later cardiovascular disease?

Pregnancy is a physiological situation in which the body puts certain mechanisms into operation. Every pregnant woman has cardiovascular changes regardless of their age and their underlying diseases. Thus, there is an increase in cardiac output, that is, the work performed by the heart to expel a volume of blood appropriate to the needs of the body by increasing the heart rate throughout the pregnancy and the volume of blood expelled in each beat. Another important change is that which occurs with blood pressure, which according to this cardiovascular adaptation to pregnancy, will fall in the first 20 weeks of gestation and then try to rise to values similar to those that had this mother before pregnancy.

The 20th week of gestation, then, is an important point for cardiologists since this is where the pressures begin to rise and problems may begin to manifest themselves. For this reason, specialists recommend carrying out a cardiological check-up from the beginning of pregnancy, not only to control the pressure but also to warn of the presence of any heart disease ignored until then. In turn, they emphasize the importance of cardiological monitoring throughout the life of those women who had hypertensive disorders.

The blood pressure drops during the first 20 weeks of gestation and then try to rise to values similar to those that had this mother before pregnancy

This is one of the topics addressed during the 44th edition of the Argentine Congress of Cardiology, organized by the Argentine Society of Cardiology (SAC), which took place in Buenos Aires from October 18 to 20 and which is considered the scientific meeting most important Spanish-speaking in the cardiovascular area and fourth in relevance internationally.

Hypertensive disorders of pregnancy are the third cause of maternal death in the country (Getty)

” As of week 20 the cardiac output doubles, the heart rate rises, and the pressure begins to rise, so this may be the moment where heart disease begins to become evident,” said the plant doctor at the Hospital de Clínicas José of San Martín Analía Aquieri.

As explained by the specialist of the Cardiology Division, on the one hand, there is the group of women who have heart disease prior to pregnancy; This is the case of those who were born with heart disease but who, thanks to scientific advances and surgical techniques, reach adulthood in good condition and can become pregnant. “On the other hand, more and more often chronic hypertensive patients who get pregnant, this happens because you can reach motherhood at older ages, between 40 and 45 years.”

As these women are larger, they have a higher risk of developing diabetes, obesity or having high cholesterol. In addition, usually do not do physical activity and do not follow a healthy diet or smoke more, all this makes them more likely to develop hypertension in pregnancy.

“Hypertensive disorders of pregnancy are the third cause of maternal death in the country, it is known that increases both mortality and morbidity both maternal and fetal. As of 2009 local data showed that the incidence of these disorders in pregnancies was 13% and in recent years they have exceeded approximately 16% The increase is due to the mother’s advanced age, which generally goes hand in hand with higher levels of obesity, diabetes, high cholesterol, lack of physical activity and healthy dietsAquieri said. Today at age 45 with a fertility treatment a woman can get pregnant, but the cardiovascular risk is much higher than at 23 years. There are more cardiovascular risk factors at that age and this makes it possible for the mother to have more complications during her pregnancy. ”

During pregnancy, a woman can trigger a disease called preeclampsia, which affects all maternal organs (Getty)

Official data until 2010 show that hypertensive disorders complicate around 10% of pregnancies
During pregnancy, a woman can trigger a disease called preeclampsia, which affects all maternal organs. It can manifest with high pressure, as well as seizures, edema, proteinuria (loss of protein in the urine), depending on its severity. This entity has in common with cardiovascular disease the presence of damage to the wall of blood vessels; This alteration is responsible for the increase in cardiovascular risk throughout his life.

Official data up to 2010 show that hypertensive disorders complicate around 10% of pregnancies. Its severe forms, preeclampsia, and eclampsia, account for about 4.4% of all births.

“Those women who suffer from hypertension, eclampsia or preeclampsia during pregnancy increase the risk of cardiovascular problems in older adults several times, which is why they should have a more careful follow-up from the cardiological point of view, in order to avoid that over the years appear events such as unstable angina, myocardial infarction or cerebrovascular accident. Something similar is observed with gestational diabetes (diabetes that appears during pregnancy) since they are also more likely to develop cardiovascular problems in the future, “said cardiologist Lucia Kazelian, member of the Heart and Women Group of the Argentine Society of Cardiology (SAC).

During the cardiological consultation, data should be collected about how it was during pregnancy because this data shows the possibility of developing cardiovascular risk factors. “You always have to ask if you had children and how were the pregnancies, because if you had any of the complications mentioned (hypertension, preeclampsia, diabetes) you have to follow more frequently in search of the emergence of risk factors for treatment, different of the woman who had normal pregnancies, “remarked Kazelian.

According to data from the National Health Secretariat, in 2016 diseases of the circulatory system were responsible for one in three deaths of women in the country. Within this group, the most frequent causes were heart failure (28.5%), stroke (21.2%) and ischemia (19%). Hypertensive diseases accounted for 9.9% of cases.

They look for ways to control maize diseases through genetics

Within the Center for Bioinvestigations of UNNOBA (CeBio) (Argentina), Dr. Inés Catalano directs the project funded by the Commission of Scientific Investigations of the Province of Buenos Aires (CIC), in which two species are studied of “leafhoppers”: Delphacodes kuscheli, vector of the agent that causes the “Evil of Río Cuarto”; and Dalbulus maidis, which causes corn stunting. “While the evil of Río Cuarto affects the core zone, what is known as ‘achaparramiento’ occurs more towards the north of the country. With a different scope, the entire maize area was affected in one or another campaign by these diseases, “said Catalano. The model they use takes some axes of the advances achieved by research developed at the University for the study of the kissing bugs.

The research team is focused on studying different aspects of the vector that transmits the causal pathogen of these diseases. What they seek is to determine which genes affect the development or survival of these insects to try to find a control method that preserves the crop and does not affect its performance. “We have the transcriptome sequenced in all stages and we have an infected colony that we are maintaining to be able to work in the search for immunity genes,” he said. With both species try the same thing: discover genes that can be used to devise ways in which the plant itself can exercise some control over the plague. The Deputy Director of CeBio remarked that the relevance of the research is given by the impact that these insects and the diseases they transmit have on the cultivation of corn.

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In fact, the “leafhoppers” have a buccal system similar to that of the kissing bugs. “The leafhoppers and the kissers are of the same order of insects, have the same buccal apparatus and have a similar behavior. The only difference is that the kissers feed on human blood and the leafhoppers of ‘the blood of the plant. According to Catalano, all the knowledge generated in this field will be novel because “there are no studies on leafhoppers that are so specific. The transcriptome and the genome are not studied, so any gene we discover will be an advance. ”

Currently, the management of these diseases is carried out through the use of insecticides. The purpose of this research is to have the knowledge to develop a plant that contains genes that may have the ability to inhibit others of the insect to make your life does not persist. “Our highest aspiration would be to achieve an insecticide method, provide knowledge for the development of a plant that carries with it certain characteristics that affect the development and survival of these pests,” concluded the project director.

The development of this project involves the participation of professionals from different disciplines. With anchoring in genetics, each of them deploys a task within the framework of this research.

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Victorio Palacio, from the Bioinformatics, is devoted to the analysis of the transcriptome of the species studied.
Lucia Dalaison, who is doing her final thesis of the Degree in Genetics, managed to develop the entire life cycle of the leafhoppers artificially. It is also devoted to the study of the normal embryonic development of insects.

Hugo González is an agronomist, has a doctoral fellowship from CONICET and is responsible for the maintenance of infected insects in colonies. You will also have the task of comparing the transcriptome of healthy and infected.
Lucila Pérez has a CIN scholarship and is doing the final work of the degree in Genetics. It was inserted in the project to study neuropeptides in “chinches”, an insect that affects the soybean crop.
Elías Gazza has a degree in Genetics, a doctoral fellowship from CONICET and is putting genome editing techniques to the test.

WHO publishes new guidelines on childbirth with focus on individuality

The UN agency has presented a list of 56 recommendations based on scientific evidence and gathered in the new guidelines on childbirth.

The right to decide how to control pain during childbirth and to reject unnecessary medical interventions are two of the recommendations that are part of the new guidelines developed by the World Health Organization (WHO) on how to manage care for pregnant women.

The United Nations agency on Thursday unveiled a list of 56 recommendations based on scientific evidence and brought together in the new guidelines on childbirth. The goal is to highlight the importance of a mother being at the center of decisions and to discard unnecessary medical interventions.

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“The guidelines propose a holistic approach to childbirth where the mother has a pre-eminence,” said Olufemi Oladapo, a specialist in maternal health research at the WHO Department of Reproductive Health.

It is estimated that annually 140 million births worldwide occur, the vast majority without complications. However, over the past two decades the use of medical interventions that were previously only made when there was a risk or some complication, such as the administration of oxytocin to help in dilation or a cesarean section, has been greatly increased.

According to WHO, on many occasions, these interventions are not only unnecessary but also cause the mother to have a negative experience in childbirth. It is estimated that a large number of healthy women, with a normal process, received some type of intervention, although the report does not give concrete data.

Because of this, the agency drew up rules that emphasize the importance of an unmedicalized delivery, which includes the possibility for the mother to decide how to manage her own pain, which involves deciding whether or not to use epidural anesthesia and, if want, at what time.

In addition, the new guidelines recognize that each delivery is a delivery and that rules implemented over the past 70 years should not be maintained. An example of this is the dilation of the neck of the uterus. Until now, it was believed to be “normal” for him to expand by one centimeter per hour. The new guidelines state that these limits are ” unrealistic ” and ” inadequate ” to determine if a child is progressing poorly or is simply slower than average.

“These rules were established in the 1950s and we have enormous scientific evidence that shows that in many cases this does not happen because each delivery is unique. In fact, the speed with which the uterus dilates does not have any importance in the chances of survival of the baby, as long as there is progress, “said Oladapo.

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He stated that no other category of speed has been established for dilatation because they do not want to “restrict” delivery again to a rule since what should change in the mentality of doctors and midwives is that each case is different.

Another generalized intervention is the episiotomy, the surgical incision in the vulva made in certain deliveries to facilitate the exit of the fetus.

“It is almost barbaric and almost routine, although its advantages are a complete myth,” exclaimed Oladapo, explaining that the method should only be used in extreme cases, due to the multiple negative consequences for the mother in the future.

Another intervention used excessively is a cesarean section. According to the organization, the method is applied in many countries of average investment routinely, for the convenience of doctors, and because in many cases, the experts charge much more for a surgical delivery than for a natural one.

“The guidelines are intended for doctors and remind them of the risks in the short and medium term of cesareans, but also mothers, so that they know they are entitled to a birth as natural as possible and with their control.”