I don’t doubt that Rebrikov (pictured in ResearchGate image) might want to do this nor that he might try it, but rather I’m writing this post to point out how his statements including about why it’d supposedly be a good idea don’t withstand much scrutiny.
What has Rebrikov said about his plan and why am I so skeptical?
Strangely, as much as He Jiankui‘s earlier misguided effort to heritably CRISPR the CCR5 gene in humans led to scathing criticism both at a bioethics level and scientifically, Rebrikov apparently also is going down that CCR5 path too according to David Cyranoski’s Nature item:
“The experiment will target the same gene, called CCR5, that He did, but Rebrikov claims his technique will offer greater benefits, pose fewer risks and be more ethically justifiable and acceptable to the public. Rebrikov plans to disable the gene, which encodes a protein that allows HIV to enter cells, in embryos that will be implanted into HIV-positive mothers, reducing the risk of them passing on the virus to the baby in utero. By contrast, He modified the gene in embryos created from fathers with HIV, which many geneticists said provided little clinical benefit because the risk of a father passing on HIV to his children is minimal.”
Really, CCR5, again? Targeting CCR5 via CRISPR in this way is misguided. I am surprised he didn’t choose some monogenic disease instead.
But Rebrikov claims his planned context is different. Still, just because Rebrikov would introduce CRISPR’d embryos into the wombs of HIV+ pregnant women instead of within the context of couples with HIV+ father’s (as He did) doesn’t make a meaningful difference. I still see it as unethical.
Not surprisingly, Rebrikov is quoted that his plan would be ethical and pushes back on those arguing it would be wrong:
“How it can be unethical if we will make [a] healthy baby instead of diseased?” Rebrikov told NPR during his first broadcast interview. “Why? Why [is it] unethical?”
His thinking about this is upside down.
Knocking out the normal CCR5 gene via CRISPR in otherwise healthy human embryos (even in the context of an HIV+ mom) would probably on the whole increase the resulting children’s risk of various diseases and would only have an iffy chance of lowering HIV infection risk depending on how well the CRISPR process went. So that “instead of diseased” part of his quote is bogus in my view. There are also established ways to try to prevent HIV transmission from mother to child in the womb.
Many of us doubt that He Jiankui’s somewhat random deletions within CCR5 mosaically in some cells of the twin baby girls produced will protect them for HIV infection. I don’t see Rebrikov somehow being able to make much more precise, deliberate changes either. He apparently published a paper on CRISPR’ing embryos, but top CRISPR scientists quoted in the media don’t seem to put much weight on that.
Practically speaking, he’s likely to run into a regulatory wall too. While Rebrikov claims to be upbeat about his chances of getting regulatory approval, others in the know in Russia doubt that he’ll get the green light there, according to Nature:
“Konstantin Severinov, a molecular geneticist who recently helped the government design a funding programme for gene-editing research, says such approvals might be difficult. Russia’s powerful Orthodox church opposes gene editing, says Severinov, who splits his time between Rutgers University in Piscataway, New Jersey, and the Skolkovo Institute of Science and Technology near Moscow.”
Similarly in the subsequent NPR piece:
“But Sergey Kutsev, the chief geneticist and ethicist at the Russian Ministry of Health, told NPR that he doubts the government would authorize Rebrikov’s experiment.
“I am confident that Denis Rebrikov doesn’t have any chances to get approval from the Ministry of Health as of today,” Kutsev told NPR. He says the safety and usefulness of the technology needs to be proved first.”
Sounds like a probable no-go to me from the regulators so it seems likely that if Rebrikov is going to go forward on the CRISPR baby stuff, he’ll probably have to go rogue like He. We’ll see, but that doesn’t seem likely.
And the cherry on top, is that Rebrikov also supposedly is a fan of the idea of human enhancement as well, as per a quote in the NPR piece:
“I think it’s the next step. In the future, people would like to make those babies more smart, for example. For my child, I’d like smarter, maybe stronger and faster,” he says.”
As many of you know, in my view a temporary moratorium on CRISPR babies is a wise way to go. It’s not perfect, as I’ve written before, and enforcement would be complex, but it’d send an unambiguous message that might make government’s such as Russia more inclined to reject reckless proposals.
Unfortunately, we’re likely to see more such wild ideas.