Designer Babies: How A Chinese Scientist Caused An Uproar With The First Genetically Edited Kids

40 years after test tube babies, science is deleting a baby's imperfections. Dr. Jiankui He made designer babies by employing gene editing technology known as CRISPR to further eradicate HIV.

The first designer babies, created by editing out imperfections at the embryonic stage, were born in 2018, around 40 years after the first test tube baby was made in 1978. Dr He Jiankui, a Chinese biophysicist, made the two designer babies, Lulu and Nana, by employing a gene editing technology known as CRISPR, which stands for Clustered Regularly Interspaced Short Palindromic Repeats. CRISPR can be used as scissors to change the genetic code of living cells. Dr He used CRISPR or Cas9, which stands for CRISPR-associated protein 9, to target a gene called CCR5, which codes for a protein used by the human immunodeficiency virus-1 (HIV-1) to enter cells. Cas9 is an endonuclease (an enzyme that breaks down DNA) that causes double-stranded DNA to break, allowing genetic modifications.

The biophysicist introduced a mutation called CCR5-Δ32 into the embryos because this feature is naturally present in certain humans, and is believed to confer innate resistance to HIV-1 infection. On November 25, 2018, Dr He formally announced on YouTube that he had created the world’s first genetically modified babies, or designer babies.  

On Dr He’s promotional Youtube video announcing the scientific experiment, there were mixed reactions. One Youtube user said the biophysicist had opened a Pandora’s box, while others expressed happiness about the experiment. 

 

Why Dr He Made Designer Babies, And Ethical Concerns Linked With Gene Editing

The babies were twins, and their father was HIV-positive. As a result, children born to him would have naturally been at risk of being HIV-positive. Almost all cases of person-to-person and mother-to-child transmission involve HIV strains that have the CCR5 coreceptor found on mucosal surfaces.

The biophysicist administered antiretrovirals to the father to decrease his viral load, and paid and organised for sperm washing to reduce the risk of his offspring being HIV-positive. Dr He performed gene editing as an additional measure to substantially minimise the chances of the children having HIV.

In other words, Dr He combined in-vitro fertilisation (IVF) and gene editing. 

The history of designer babies is closely linked to the history of IVF. The first IVF baby was born in 1978, and since then, IVF has rapidly advanced. There are six key stages in IVF's history: Traditional IVF, Intracytoplasmic Sperm Injection (ICSI), Preimplantation Genetic Screening/Diagnosis (PGS/PGD), Nuclear Transfer (3-Parent Baby Technology), Gene Editing (Designer Babies), and Artificial Gametes (Stem Cells). Each stage represents a major step forward in helping people conceive and improving the success and accessibility of IVF. 

Since 1978, over eight million babies have been born through these advancements.

According to Wang & Yang (2019), Dr He tried to optimise the microinjection procedure using monkey zygotes. Two genetically modified embryos were implanted and successfully carried to term. Dr He claimed that he intended to make the children resistant to possible future HIV infection. In China, CRISPR was used in cases where the male partner was HIV-positive.

According to MIT Technology Review, Zhou & Silva (2016) showed that the deletion of CCR5 not only makes mice smarter but also improves human brain recovery after stroke, and can be linked to greater success in school. 

A description of the study was posted in November 2018, but some trial documents dated back to as early as March 2017. In February 2017, the US National Academy of Sciences cautiously supported gene-edited babies, but only if done safely and with strict oversight.

The scientific community debated the ethical implications of Dr He’s experiment, and discussed how scientifically sound it was. While CRISPR technology holds promise for addressing certain health risks, its use in creating designer babies has raised concerns about the ethical boundaries of gene editing.

In most of Europe and the US, using a genetically engineered embryo to start a pregnancy is illegal. It is also banned in China under a 2003 guideline for IVF clinics. It is unclear if Dr He received special permission or ignored the guideline, which might not be legally binding.

A neurobiologist at University of California, Los Angeles, confirmed that the cognitive abilities of designer babies will be altered but one cannot predict what the impact will be. This is the primary reason why gene editing is risky. 

Also, Dr He’s announcement at a Hong Kong’s Human Gene Editing conference resulted in a conjecture that the CRISPR procedure would be used for the wrong reasons. Although there is no evidence that Dr He set out to create super-intelligent humans, MIT Technology Review stated that there are concerns about it adding to the biotechnology race between the US and China.

The success of the ‘gene surgery’, as Dr He called it, and the health of the babies were not scientifically validated or peer reviewed. 

This is a morally grey area because while it may be done to reduce health risk to children, there are allegations of failure of professional regulation, and concerns about human rights, eugenics and a ‘chilling effect’ on scientific research. Eugenics is the immoral theory of planned breeding and racial improvement by eliminating social evils through gene selection and deletion.