Allen and Frances Adler Laboratory of Blood and Vascular Biology, Rockefeller University, New York, NY 10065, USA; email:
Annu Rev Med. 2019 Jan 27;70:289-305. doi: 10.1146/annurev-med-112717-094629.
Advances in human genome editing, in particular the development of the clustered regularly interspaced palindromic repeats (CRISPR)/Cas9 method, have led to increasing concerns about the ethics of editing the human genome. In response, the US National Academy of Sciences and the National Academy of Medicine constituted a multidisciplinary, international committee to review the current status and make recommendations. I was a member of that committee, and the core of this review reflects the committee's conclusions. The committee's report, issued in February 2017, recommends the application of current ethical and regulatory standards for gene therapy to somatic (nonheritable) human genome editing. It also recommends allowing experimental germline genome editing to proceed if ( a) it is restricted to preventing transmission of a serious disease or condition, ( b) the edit is a modification to a common DNA sequence known not to be associated with disease, and ( c) the research is conducted under a stringent set of ethical and regulatory requirements. Crossing the so-called red line of germline genome editing raises important bioethical issues, most importantly, serious concern about the potential negative impact on individuals with disabilities. This review highlights some of the major ethical considerations in human genome editing in light of the report's recommendations.
人类基因组编辑技术的进步,特别是簇状规律间隔短回文重复序列(CRISPR)/Cas9 方法的发展,引发了人们对编辑人类基因组的伦理问题的日益关注。作为回应,美国国家科学院和国家医学院成立了一个多学科、国际性的委员会来审查现状并提出建议。我是该委员会的成员之一,这份审查报告的核心反映了委员会的结论。该委员会于 2017 年 2 月发布的报告建议将现行的基因治疗伦理和监管标准应用于体细胞(非遗传性)人类基因组编辑。该报告还建议,如果(a)编辑仅限于防止严重疾病或病症的传播,(b)编辑是对已知与疾病无关的常见 DNA 序列的修饰,以及(c)研究是在严格的伦理和监管要求下进行的,那么允许实验性种系基因组编辑继续进行。跨越所谓的种系基因组编辑的红线引发了重要的生物伦理问题,最重要的是,人们严重关切编辑可能对残疾个体产生的潜在负面影响。本综述根据报告的建议,强调了人类基因组编辑中的一些重大伦理问题。