CAN CRISPR CURE AN EXISTENTIAL RISK?

ALM No.67, August 2024

ESSAYS

SHIV KUMAR VERMA

7/28/20247 min read

As curious beings, we perpetually seek to refine our world through change. As Cheryl James rightly points out, "Change is not an event; it's a process," a process that brings about profound transformations. These transformative changes, as highlighted by Toby Ord in The Precipice, have "accelerated our accumulation of power," leading to advancements in medicine that signify our progress and promise a healthier future. As time has progressed, our understanding of new medical treatments has emerged. In the 19th and 20th centuries, medical treatments were often dangerous and ineffective. For example, before 1840, surgical procedures were "disgusting, filthy, and unsafe," resulting in "great suffering and emotional distress." However, as we have progressed into the modern era, advancements have significantly improved our understanding of various diseases and the effectiveness of those treatments. However, even today, researchers have not found effective treatments for numerous diseases, and a name that comes to mind is cancer. Despite the ongoing battle against cancer, a leading cause of death and sorrow in many people's lives, a shine of hope emerges in the form of CRISPR. Its possibilities could lead to a "level of health and prosperity that our ancestors could only dream of."

CRISPR, an acronym for Clustered Regularly Interspaced Short Palindromic Repeats, is a groundbreaking technology that enables scientists to selectively amplify the DNA of living organisms. In simpler terms, it is like a pair of molecular scissors that can cut and paste DNA. This process, known as CRISPR editing, involves identifying a specific sequence of DNA, cutting it out, and replacing it with a new sequence. It is a leading innovation with significant implications for treating diseases. For example, it can target cancer by editing the TP-53 gene and sickle cell anemia by editing the beta gene HBB. Researchers have also proven that CRISPR editing could eliminate the RPE65 mutated gene in the DNA to replace it with normal vision, effectively curing blindness and allowing the shine of hope to enter a patient's eyes.

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CRISPR technology is not only crucial to medicine, but it also has wide-reaching effects in different fields. CRISPR will advance agriculture, as the gene editing of several crops will enhance crop yield, add nutritional value, and, most importantly, improve resistance to pests and diseases. Despite its benefits and optimistic outlook, CRISPR has limitations and issues that may hinder its full potential. One of the major concerns is the ethical implications of gene editing, as it raises questions about its potential misuse. Additional issues include immune response, off-target effects, regulatory hurdles, and accessibility problems. It is crucial that CRISPR researchers and government officials collaborate in developing solutions that fully harness the potential of CRISPR. Only through such coordination can we realize its potential to improve the world for the greater good.

Distributing a new technology to the public at an affordable price is a significant challenge. For example, the first commercial flight in 1914 cost $400, which is equivalent to $8500 today. Despite over a century of technological advancement in the aerospace industry, flight fares, even in economy class, have increased, making air travel nearly unaffordable for lower-class individuals and causing many in the middle class to think twice before flying. While advancements in the aerospace industry have led to increased flight costs, similar challenges exist for CRISPR, an emerging technology with the potential to revolutionize medicine and improve countless lives. However, as we continue to innovate, it is vital to consider the development of new technologies and their equitable distribution to benefit society. But how?

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The United States has an annual defense budget of over "$841.4 billion," exceeding the combined defense budgets of "China, Russia, India, Saudi Arabia, the UK, Germany, South Korea, Japan, France, and Ukraine." As globalization has increased and several countries are demilitarizing and collaborating, it is worth acknowledging that governments, like those in the US, are finding ways to lower their defense spending. Further, redirecting the saved money to CRISPR research could make the technology more affordable and accessible to the public. Furthermore, scientists, schools, and NGOs are responsible for making the public aware of CRISPR. Educating young people will further enable them to use their knowledge to exercise their constitutional right to vote. By doing so, they can elect officials to ensure that CRISPR is accessible to everyone. A leading ethical concern about CRISPR is that it will only be available to the wealthiest, posing an existential risk to health disparities.

Another significant issue with CRISPR is the potential for off-target effects and long-lasting genetic complications that could lead to other health problems. For example, when editing a specific gene in human cells, researchers have found that CRISPR can sometimes cause mutations in unintended genes, potentially resulting in future diseases. Additionally, while CRISPR enhances crop yield, off-target effects could have severe ecological consequences. Editing a gene to improve pest resistance in crops might inadvertently affect other organisms in the ecosystem, disrupting the natural balance. How can we address these potential calamities and ensure the safe application of CRISPR?

(4) COVID-19 is the first pandemic to have a vaccine ready for emergency use in less than a year. To the world, it is a surprise how Pfizer developed a vaccine so quickly, as it takes 5 to 10 years to create an effective vaccine and distribute it to everyone. However, due to rapid growth and a lack of significant clinical trials in the development process, COVID-19 vaccines had severe side effects, and several studies reported risks of "cardiac arrest." This example underscores the importance of thorough testing and development to avoid such side effects. Fortunately, CRISPR does not face the same urgent demand as the COVID-19 vaccines. This allows CRISPR researchers to take the time needed to develop a robust system that addresses existing issues without introducing new problems. Three key steps can be taken to achieve this.

First, establish a team of renowned medical scientists, including CRISPR pioneers like Jennifer Doudna, Paul Dabrowski, and Kevin Holden. Then, divide this team into smaller groups, each dedicated to tackling specific challenges related to CRISPR. For example, a group of oncologists, pathologists, and CRISPR developers should focus on issues arising from using CRISPR in cancer treatment. Forming specialized groups with professionals directly involved in fields impacted by CRISPR will ensure meticulous attention to detail and minimize errors.

Second, after years of dedicated research, the team should compile their findings into a comprehensive research paper and make it publicly available online. This step is crucial as it will allow other scientists and private pharmaceutical companies like Pfizer, AstraZeneca, or Johnson & Johnson to conduct further research and identify any overlooked issues. This review process will help avoid confirmation biases and prevent overlooked issues, addressing Dr. Swiss Cheese's model of unsafe acts, prediction of unsafe acts, unsafe supervision, and organizational influences. Furthermore, it will enable not only substantial private organizations but also individual college students and professionals to conduct research and share their findings, contributing to a comprehensive, well-researched paper.

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Finally, gather feedback and additional data from third-party researchers. Use this information to create a second, refined report for submission to the FDA for final review. Another crucial step to ensure robust data and the final report is to employ the EEE method: "Evaluate, Evaluate, Evaluate." This method is crucial because changes may occur over time, and it is essential to carefully document these changes or dismiss them if they are irrelevant to the final report. Although this process may take years, it is essential for ensuring robust CRISPR development and minimizing potential negative consequences and side effects.

Black Death "devastated Europe" by wiping "22.5 million people." The only known cure was "social distancing and quarantine," as people in medieval times did not understand bacteria and viruses. The NIH, in its article titled "Is early-onset cancer an emerging global epidemic?" compared cancer to an epidemic. This parallels Toby Ord's description of the Black Death as the "greatest catastrophe humanity has seen,'" highlighting the similarity between the two. With cancer now claiming over 15.3 million lives, the comparison underscores the severity of the situation. However, this generation is experiencing peak advancements in medicine because now we have treatments such as CRISPR, which can cure countless diseases forever.

Nevertheless, we must compile thoroughly researched data to achieve the best results from CRISPR and ensure it is free from side effects. Such meticulous detail is crucial, as CRISPR can potentially prevent several deadly diseases from becoming pandemics and causing widespread devastation—what Toby Ord calls an "existential risk." This commitment to precision symbolizes humanity's potential and represents a transformative era in medicine, achieving a "level of health and prosperity that our ancestors could only dream of." By turning risk into resilience and potential into progress, CRISPR can genuinely change the world.

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ShivKumar Verma about himself: I am currently a senior at Buffalo Grove High School, passionate about majoring in biochemistry, with a specific interest in medical research. My journey in high school has been resembled by a deep commitment to academic excellence and extracurricular involvement. I have consistently participated in the Scholastic Bowl, the Science Olympiad, and the Math Team, where I have demonstrated my critical thinking and problem-solving skills. These experiences, along with my coursework in AP Chemistry, Physics, and Psychology and Medical Pathway courses such as Medical Terminology or Introduction to Human physiology have fueled my desire to contribute to study and deep dive into the wonders of health sciences. In addition to my academic pursuits, I have dedicated significant time to playing tennis, achieving a spot on the varsity team, and competing in several tournaments. Balancing sports and academics has taught me the value of discipline and perseverance. My goal is to attend a college that offers robust research opportunities and a strong pre-med program, where I can further explore my interests in cardiology and CRISPR technology.