FINAL VERSION Issues Essay

 

Pros and Cons of Gene Therapy

What is the only method of completely curing a genetic disease? The medicine of gene therapy is genetic DNA. Most of us believe that viruses are bad existences. In gene therapy, viruses are also medicine. Genes are made up of four bases: adenine, thymine, cytosine and guanine. The arrangement of the bases codes for genetic information. Proteins are created when mRNA reads the genetic information. Genes will mutate and cause genetic diseases. Cancer is caused by the same reasons. Genes which have the ability to fix itself, for example, when hurt by ultraviolet rays or to prevent cancer do exist. Gene therapy is simply replacing the problem gene with a normal gene. The official definition would be: placing genes or cells that contain genes into a person’s body for the purpose of treatment. (Takashi Shimada 2001, p.3.)One very successful and widely known example of what is notgene therapy is the prescription of growth hormones to people affected by dwarfism. This cannot be considered as a type of gene therapy in wider terms. 75% of the usage of gene therapy is occupied by cancer. (Hitachi Solutions Business, Ltd. 2013) Of course, most people with cancer don’t place gene therapy on their list as a first choice.

Gene therapy has had a rather long history, spanning from 1975 to the present. The first country to begin research in this new type of treatment was the United States of America. They created a guideline in 1985 and also stated the process for all actions related to it. In the year 1980, genes were inserted into a human body without approval. There was a debate on the ethics of the therapy in 1982. In the 1990s, several operations were carried out. Current uses in society include medicine (e.g. Gendicin- made by a Chinese company) and treatment of patients with late stages of cancer. Experiments carried out by universities and researchers are being continued. An example of treatment using genes is taking out cells from the bone marrow of a patient, integrating normal genes into the nucleus of those cells using a virus, and duplicating those cells, before reinserting them into the patient’s body. This is ex vivo gene therapy. In vivo therapy is when the vector is directly inserted into the body. (Takashi Shimada 2001, p.1.)The proteins that could not be made by the body up until then will be produced and the disease will be cured.

The first successful and popular treatment using gene therapy was two cases of ADA deficiency, carried out by Anderson in 1990 and 1991. (Obunsha Co., Ltd. 2011) Gene therapy was introduced to the whole world and received attention. The children lived without any problems for several years. Gene therapy can cure children and allow them to live normal lives. Many cases afterwards were either unsuccessful or disastrous. There are three different patterns recognized between genes and phenotypes. The first is called monogenic which means that a particular characteristic is only determined by one gene.Huntington’s disease is one example, where one mutated gene and the symptoms are very strongly connected. If the mutated gene is exchanged with a normal gene, then the symptoms would be alleviated. Polygenic means that several genes determine a phenotype. Examples are the shape of faces or intellect. It is hard to cure anything related to this. Pleiotrophic means that one gene affects several characteristics. If this gene is meddled with, cancer may develop and unexpected effects may appear. (Takashi Shimada 2001, p.8.)For some time, we must stick to monogenic cases. Gene therapy is still only good enough for severe and rare genetic disorders. However, there is another gene therapy that only needs to be done once.

Manipulation of gametes, or sex cells (introduction of normal gene into early embryonic cell thereby curing the individual and all future offspring) can allow humans to cleanse from the gene pool any deleterious genes that are widely recognised as dangerous. Diabetes could become non-existent after several decades of therapy on each and every child before they are born. (Britannica Japan Co., Ltd. 2013) Cooperation of the entire human population seems impossible though, and therefore, extermination of bad genes from the gene pool is impossible. Ongoing research will ensure that new choices are provided for parents to consider. Some families may want to be diabetes-free. The efficiency is a major component of the reasons for supporting gene therapyof gametes. Instead of having each member of the family treating themselves for some disease, the cause could be eradicated from the beginning and in the long-term, money would be saved.Each different aspect of gene therapy must be discussed by large organizations on a worldwide scale.

There are many ethical issues that relate to this treatment. As the relation between diseases and gene mutations becomes clearer, more research is being done on the genes to determine various conditions. This is the case for single-gene diseases and cancer. Reasons exist for diagnosing unborn children or patients yet to begin showing symptoms of a disease with a curable condition. Diagnosing patients with no hope of treatment is a problem. Parents may be faced with tough decisions. Patients have the right to know and to not want to know. (Takashi Shimada 2001, p.4.)Our genetic information is said to be private. If the information was to become known to people in society, insurance or employment chances may become harder to find. There still exists the risk that people could become classed into different categories. Relatives of the patient may not want to reveal to the public their disease. Counselling is important and information must be strictly guarded. Up until now, the skills and information available has been used to do whatever is technologically possible. From now on, a clear goal is required, such as research that benefits the human race. The ethical issues must be continuously debated. These include genetic manipulation and selection, research on embryonic tissue, and experimentation on human subjects. (Encyclopædia Britannica, Inc.2011)

Gene therapy may only be an available option for the rich. (State of Victoria 2011) This is only a presumption by the public and may not become reality. It is difficult to foretell the price and extent of gene therapy at present. Once it becomes widespread, other, more daring manipulations may be experimented with. The passage of time will change our course. For the therapy to become cheap, more industries must enter this field. Guidelines must be taken seriously and reflect the whole population’s varied opinions.

Young researchers are not entering this field and lack of facilities is a problem. Companies are not enthusiastic either. Approval is slow in most countries. More research expenses are required. Guidelines must be changed every few years. The key to improving the current state is by having multiple companies grabbing the business chances and speeding up the entire process. Curing inherited diseases have not been the main aim of experiments due to the fact that the technology for replacing a faulty gene with a normal gene does not exist. Cancer treatment should be given less priority than inherited diseases. As always, patients must undertake their own research of treatment options. This is to ensure that they do not listen and follow everything that the doctor says. Counsellors should be used to make the doctor’s job easier. Gene therapy has a bright future. With time and more research, it will truly revolutionise business and medicine.

^References

^{“遺伝子治療” 2013, ブリタニカ国際大百科事典 小項目電子辞書版, Britannica Japan Co., Ltd.}

^{“gene therapy” 2011, Britannica Concise Encyclopedia, Encyclopædia Britannica, Inc.}

^{“遺伝子治療” 2013, 百科事典 マイぺディア 電子辞書版, Hitachi Solutions Business, Ltd.}

^{“遺伝子治療” 2011,旺文社 生物事典 五訂版, Obunsha Co., Ltd.}

^{State of Victoria 2011, Gene therapy https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/gene-therapy, (accessed 23 March 2016).}

^{Takashi Shimada 2001, Ethical Problems in Gene Medicine, J Nippon Med Sch, Clinical Genetics Division}

^{University of Utah 2016, Gene therapy http://learn.genetics.utah.edu/content/genetherapy/gtintro/, (accessed21 March 2016).}

^{U.S. National Library of Medicine 2016, Gene therapy https://ghr.nlm.nih.gov/handbook/therapy/genetherapy, (accessed 22 March 2016).}

^{Wikipedia 17 March 2016, at 09:00,Gene therapy https://en.wikipedia.org/wiki/Gene_therapy, (accessed22 March 2016).}

Noah Nishihara T09