It's hard to see change occurring all around you. We can always predict the future, but without a larger picture it's tricky to foresee what directions the world is travelling in. The same is true for science; while we're not close to understanding life's intricacies just yet, we've come a long way and we're just getting started.
So what's changed?
There's a definite sense of momentum. We've had the ability to edit DNA for years, but the addition of CRISPR-Cas9 streamlines everything - making it both cheaper and faster to produce and implement. More people are working with it, and the field is expanding fast.
"We're basically able to have a molecular scalpel for genomes. All the technologies in the past were sort of like sledgehammers"
We're still developing the technology so that it's safe to use in humans, and we have some way to go. We need to improve production and routes of getting the editing machinery into cells in the first place. There are a number of ways you can edit and change DNA, but if you want to insert a whole copy of a gene these can be rather large. One of the major hurdles today is fitting larger DNA sequences into a delivery system that's large enough, and will still deliver effectively where you want it to. The most effective way of getting anything into cells is still a virus, but there are still issues with immune response which make multiple treatments tricky.
An inevitable spread?
Rome wasn't built overnight, and gene editing needs more work - but once you obtain knowledge and share it, it's extremely difficult to extinguish. Lots of people once scoffed at mobiles and the internet, but here we are. The possibilities are immense. The future holds a great many challenges, but issues like food security could be tackled by gene editing plants to improve nutrition, growth and hardiness. Research has already shown the potential of gene editing to fight HIV infection, and a huge range of diseases or concerns could be treated with gene editing techniques. The technology can also be used for more practical, or even ethical reasons: the company Recombinetics is working on editing cattle to remove their horns, preventing a painful de-horning procedure.
Editing requires literacy
If you want to rewrite or improve on the manual, you need to know the language it's written in. We now know the basic code, but not how everything fits together. Making accurate and safe tweaks may require more knowledge to work on. After all, when the first gene therapy trials went forward although most patients did well, it also caused leukemia. We now know why that happened, but at the time we didn't. It's likely we'll come across unforeseen problems as we progress.
Looking to the future
Exactly what will happen is still speculation at this point, but given the potential of the technology it's unlikely to go away anytime soon. There are legitimate concerns ahead about misuse and ethics, but governments don't really have an option of sticking their heads in the sand and pretending it'll go away. If we don't acknowledge the technology and start a dialogue, it'll likely happen all the same. Banning narcotics hasn't been very effective, and now that gene editing isn't prohibitively difficult or expensive, it's not beyond the realm of possibility that a lab could be set up at home.
"We live in a much more disrupted world, things aren't top down," Rubenstein says. The person who transforms the way the world sees genetics might be some biohacking enthusiast, not necessarily some well-funded lab. What's going to stop the next Bill Gates from tinkering in his garage?"
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