"Fooling Mother Nature through Epigenetics"
This article gives an overview of epigenetics and further explanation of methylation of DNA and histones. By focusing in on how epigenetics functions on the genome, medicine can be directly used to mimic mother nature and silence the genes of your mother or father. In this case, epigenetics was used to be therapeutic targets for psychiatric disorders. What are your thoughts on using drugs to mimic mother nature? Should certain genes that cause disorders be silenced? What are the implications or further developments that could come from such actions?
This is really amazing. Setting the possibility of misuse and overuse aside, this type of gene therapy can bring so much hope, happiness, and relief for those currently suffering from psychiatric disorders. For someone who suffers from schizophrenia, bipolar disorder, and/or major depressive disorder, the thought of having kids who will also develop these disorders often prevent them from having children at all. This application of epigenetics can open so many doors that were once locked and this seems pretty congruous with the overarching goal of health care.
ReplyDeleteThe implications could be less optimistic. Questions like where the line should be drawn, and who can access these procedures are critical. But at least at face value, I'm quite excited to see biotechnology get this far.
I agree with you Suzann this is quite an amazing thing. Can you imaging if this was applied beyond psychiatric disorders?! The possibilities are quite endless. This technology needs to be developed further before we can see it implemented at a wide scale. One thing I would like to point out is if we silence one gene we must know how it will effect other genes because many genes work together. Do you think this is an area of further research?
DeleteI also agree with Suzann and Tamika. This finding is amazing and could definitely be helpful, especially since there is no absolute cure for many of the psychiatric disorders. There are ways to quiet the symptoms such as pills, but these pills are often a burden to take or people stop taking them when symptoms subside. This technology would definitely be helpful. Although we need to ask the question of how far can we take this, where should the line be drawn? Further developments do need to done, we do not know the consequence of doing this will be and what effect the change in one gene will have on the others.
DeleteGreat point Tamika. If we silence particular genes, there will likely be other genes that are affected. Perhaps other genes will be expressed more or less when related gene(s) are silenced. Perhaps other genes could also be unintentionally silenced as well. Genes often do work together, so I definitely think the interplay between genes with respect to silencing genes should be an area of further research. The implications for this technology could be immense, but there is certainly a need to better understand exactly what we are doing and what unintentional side effects could exist.
DeleteTamika, those are valid questions that are probably being addressed by researchers as we speak. There's such a frenzy to isolate genes that could be responsible for cancers and chronic diseases (like the BRCA1 and BRCA2 genes) but it's important to remember that genes behave relative to one another. We think of each gene as its own unit but its relation to other genes are just as important as the gene itself. Good point! This also makes definitive results difficult because how does one measure the level of interaction between affected genes, or genes of interest?
DeleteIn any situation regarding identifying genes and/or in this case, silencing particular genes thereafter, there will always be the worry of where do we draw the line? This inevitably follows the post-HGP (Human Genome Project) as we read about in a previous blog entry titled “So we can read our genomes. Now what?” Rather than raising high concerns on how this technology may be misused as abused, as Suzann mentioned, it is interesting to note how one discovery and/or research opens endless opportunities for further developments. Specifically, as noted in the article, it is assumed that epigenetic silencing in an unaffected twin prevented the schizophrenia that is occurring in their co-twin. This theory gave rise to the idea that therapeutic mechanisms would work to in schizophrenics or those at risk of it who may not have a twin.
DeleteFurther, these concepts can relate to another previous blog entry “Nature vs. Nurture” in that in an overview of schizophrenia, ‘nature’ plays a role considering to be inherited or genetic vulnerability to schizophrenia, and 'nurture' is proposed to exert its effects through epigenetic mechanisms. This article (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779706/?tool=pubmed) talks more in detail about epigenetic mechanisms in schizophrenia and it intrigued me how all the blog articles and further research and outside sources all correlate in one way or another.
I agree with Suzann that the possibilities of this technology to help those with psychiatric disorders are great. I think that most people would agree that such disorders cause significantly more harm than good for the people who suffer from them, and if there were an option to cure them then it should be offered. Of course there will be those people who disagree with genetic modifications of this kind because " it is not nice to fool mother nature" as the article said, but no one would be forced to go through a procedure if they did not agree with it.
ReplyDeleteOn the other hand, using this technology is taking a big risk. While the short term effect of helping a person would be great, there is not enough information to know what the long term consequences of genetic medicine will be. Changing one gene could have unknown effects on other genes, for example, or there could be implications on the genetic variation of humanity as a whole.
I definitely agree with you Laura that this kind of technology has many possibilities for psychiatric disorders. However, I do not think that it is as simple as deleting a gene, especially when there is sufficient evidence that many environmental factors come into play. Many people living with mental disorders do not have family members who are afflicted with the same issue.
DeleteIt is also difficult for scientists to pinpoint a specific gene and perform tests that proves that gene causes schizophrenia, for example. As of now, if a person was to be tested for the presence of various genes, there is no evidence that would suggest that one gene in particular causes schizophrenia, or for that matter, that people with schizophrenia have a specific gene in common.
Overall, I think that with today's research, this kind of testing for psychiatric disorders is not yet possible. It does, however, have potential for future developments with further research in the relation between mental disorders and genetics.
I agree with the previous comments that this technology brings great possibilities. Psychiatric disorders and other behavioral disorders can be some of the most difficult disorders to live with because they are not easily seen and often hard to comprehend. Therefore, having technology that would rid people of such afflictions seems too good to be true.
ReplyDeleteHowever, the first thing that came to mind when reading the article was the issue of designer babies, which means that a baby's genes are artificially selected by genetic engineering to pressure the presence or absence of particular genes. Although, this too can rid the baby of certain genetic disorders, the ethical controversies surrounding it are endless. The issue is that at this stage we don't know enough. Scientists and Geneticists don't know whether silencing one gene will negatively impact another. Then again, this is how it is with all new technology. I think that if geneticists were able to directly identify which genes affect these disorders and how to effectively silence them without further damage this would be a great innovation that would positively affect people's lives.
I agree with Kristen around the issue of designer babies. Although this new technology has the potential to change the lives of many individuals suffering from psychiatric disorders, it can also be misused or overly abused by those who wish to create the "perfect" child. In an attempt to prevent their children from having to live with life threatning disorders, parents may get out of hand and try to determine every single gene they would want either expressed or not expressed. Using technology to help correct some negative outcomes due to nature can surely increase the quality of life for some but these advances should not be used to completely take on the role of mother nature.
DeleteYou bring up a good point about designer babies Kristen. Liz sadly what you said is a reality in some areas of the country where parents can create a "perfect" baby with blue eyes and blond hair. The limits of this was challenged when a deaf couple wanted to select genes for their baby to make sure it was born deaf.
DeleteThis issue about designer babies is really a provocative point for discussion. If we have the ability to manipulate genes to prevent devastating psychiatric disorders it certainly feels like it is the right thing to do so and alleviate the potential suffering that can come from psychiatric illness/disability. But where do we draw the line? Are there genes that we shouldn't be able to manipulate? Are there only certain kinds of genes that we should be able to select for our babies? Should we be able to manipulate genes that affect simple aesthetic characteristics like hair or eye color? Or should we simply leave everything to mother nature? These are challenging questions, and it really seems like we have created technology that has exceeded our ability as a society to establish social and moral norms in this area of genetic technology.
DeleteI don't think there are any labs in the US that would support the kind of eugenics-driven "designer babies" that Tamika is describing. Such a venture would be highly unethical in every aspect of the project and would never get approval for funding - there is no legitimate scientific coalition that supports genetic manipulation for purely cosmetic reasons at this point in time.
DeleteCurrent ethics debates about genetic manipulation primarily involve issues of discrimination when families predisposed to a genetic disease are considering whether to eliminate the chance of having a child with that disability by using embryonic selection methods. Advocates for people with disabilities are concerned that families will always choose healthy embryos - a scenario that will certainly benefit the individual child and family, but will increase the stigmatization against people with that disorder as a group.
The Deaf community is one example of a group that feels strongly about parents deliberately choosing embryos that are hearing. The Deaf have a large support network and often choose to live in cities with other large populations of Deaf, have a number of coping mechanisms (like setting the lights to flicker when the doorbell rings), and send their children to special Deaf schools. They view their disability not as a detriment to their enjoyment of life (as many hearing people see it) but as something that makes them unique. By making genetic deafness a "disease" that genetic manipulation can "cure," they worry that Deaf culture will cease to exist.
Great post Sarah. I understand the debate about discrimination you are discussing, but frankly, it stuns me a bit that there is so much controversy about parents selecting healthy embryos if they had the choice to do so due to fears of stigmatization on a societal level. I don't really see how we could justify having the technology to prevent costly, debilitating diseases and choosing not to do it. Like we discussed on this thread there are issues about drawing lines, but as Sarah pointed out, perhaps the eugenics-driven designer babies issue is a little further off the map than the discrimination issue. Obviously this issue about discrimination plays into the idea that illness is socially constructed and that if we do not see a particular mutation or condition - like deafness - to be an illness state, then we will not treat it as such. But I wonder, for diseases that are far more costly and debilitating than deafness, how could we not seek to prevent such diseases given our technological capabilities? It seems like it would be an overwhelmingly beneficial thing for individuals and for society if we were able to eliminate some of the suffering and costs that come from severe illness and eventually phase some of these diseases out of the human population .
DeleteTherapeutic epigenetics is an interesting concept that I have yet to read about in the news or any articles related to gene expression. I think this could have remarkable impacts on our society, especially when it comes to the expression of psychiatric disorders such as schizophrenia, which we have only a poor cure for today. Silencing genes in order for persons not express them during their lifetime could mean lower healthcare costs, less psychiatric hospital usage and prevention of crimes related to mental illness. I think it is important to note that many different psychiatric disorders, like schizophrenia, are not based on previous events that have occured in the person's life or trauma from the environment. Rather, they have abnormal synaptic connections in the brain, imbalances in certain hormones, or missing parts of the brain that are crucial for normal functioning. The concept of methylation in order to silence genes is one that sounds complicated and invasive. Would this have to be performed on each
ReplyDeleteI thought it was intriguing what Tamika said about other disorders/illnesses/abnormalities that are not psychiatric. If we could silence genes related to cancer or Alzheimer's disease or autoimmunity, what could this mean for our society? Would environment still play a role if these genes were forever silenced? To this day, we believe that certain environmental factors can express a gene that may have had a propencity to be expressed. Would this still be true if therapeutic epigenetics was in the mix?
Also, another thought. Is this natural? Are we playing god in the situation? If we could prevent everyone from expressing a gene or genes that may or may not be expressed in their lifetime, should we do it? That is the ethical argument.
Finally, financially, how much is this going to cost? Do we have the resources for it (the doctors, the money, the interest of individuals, the medical tools to perform it). All of these questions need to be answered before this can be implemented.
Dana made some really great points. Despite the fact that so much more research needs to be done in order to fashion a potential cure or at least an effective medicine to treat psychological disorders such as schizophrenia and bipolar disorder, we need to begin thinking about the consequences that would accompany these techniques. In their previous posts, people have brought up financial troubles, designer babies, short and long term consequences, etc. But just imagine if this could work. In my Health and Disability course I took a year ago, we learned that Schizophrenia is one of the most difficult psychological disorders to deal with. I've always been one to encourage constructive, counseling/therapeutic, and cognitive behavioral type treatment before utilizing medication to combat psychological disorders, but with schizophrenia and bipolar disorder, these are not always effective (especially because the causes - although unknown - are largely attributed to genetics and brain development, not environmental factors, as Dana pointed out). So medication is the way to turn at the moment.
DeleteI did a little research to see how current antipsychotic medications work and found this site: http://www.netplaces.com/schizophrenia/treating-schizophrenia-with-drugs/how-do-antipsychotic-medications-work.htm
Even the site itself says that HOW the medication works is largely unknown! This is a great area for research now and I think that biotechnology that can induce epigenetic modification is the future.
I definitely agree that this approach to using epigenetic mechanisms to help those with psychiatric disorders sounds hopeful and promising, especially because it doesn't deal with trying to modify the actual human genes. There is still so much risk since it's not yet proven which genes (out of the 20,000+)cause mental disorders and we don't yet know how to target the right genes selectively without also going off target and silencing or activating the wrong genes. But to me, this article really emphasized how much we have advanced since the Human Genome Project but that there is still so much more to learn about our genes and about the many new mutations that affect our genome and cause these psychiatric disorders. I do agree that going forth with this research is necessary in order to help the population of people who suffer with disorders such as Schizophrenia, but ethically it will bring up many challenges too. With the mention of designer babies, I think in this case of trying to prevent suffering and disorder it is ethical in the sense that it's treatment more than it is enhancement. We are trying to cure and prevent psychiatric disorders, not merely to improve ourselves. I do think though that the ethics of who in society will get to have access to this process is something to think about. Assuming that it will be very expensive, who will be able to use it? It will lead to a bigger division between the rich and the poor and possibly discrimination towards those who have these psychiatric disorders and aren't able to have them cured for financial reasons. But that is all definitely thinking in the long run because it's going to be a long while until therapeutic epigenetics becomes an actual practice.
ReplyDeleteI agree with Priscilla that this is an exciting field of research that could greatly help people with a variety of severe conditions, like schizophrenia. I also agree with Tamika that while this is a promising field, it is very complex. Most genes do not act by themselves, and this is (as far as I have learned), very true about many complex mental health conditions like schizophrenia, which means that drugs targeting specific genes may disrupt (or not properly disrupt) an entire pathway that fails to solve the problem. As mentioned in the article, epigenetic treatments are also somewhat risky at this stage because most forms of epigenetic regulation (methylation, acetylation, or RNAi)can be somewhat broad regulatory mechanisms. If a drug that uses epigenetics regulates the wrong part of DNA, the consequences could be severe. As mentioned in class with the babies who suffered from cancers after receiving gene therapy, epigenetic regulation is (at this point) a difficult tool to use for therapeutic purposes.
ReplyDeleteHowever, I do not think that this research is futile. Quite to the contrary, if epigenetic drugs are carefully and appropriately used in the right pathway for the right sequence of DNA, the possibilities could be endless. As mentioned in the article, the concept of prenatal treatment to reduce the risk of schizophrenia is one that could be expanded to help treat a variety of severe conditions. While a potential implication of such developed epigenetic treatments may be "designer babies," I agree with Priscilla that such treatments would be ethical if solving a disorder rather than "enhancing" the child.
Currently, such treatments or drugs must be further refined, but the idea of silencing genes is not bad. Considering that mental health disorders cost a significant amount of money and also cause significant pain and suffering for both the person with the mental disorder and their family, developing epigenetic treatments that are safe, effective, and appropriate have the potential to both reduce health care costs and suffering.
I agree with Sami that as exciting as this field of research is, a lot still needs to be determined before this type of gene therapy is proven safe for the individuals receiving it. As Sami and Tamika mentioned, this is a very complex process and we want to be sure that by targeting one gene, we don't disrupt another as a result and develop new mutations that could be passed along. When refined, if this procedure will be affordable to the people who need it the most it will be particularly useful and this gene therapy could reduce costs and suffering significantly. If the treatment does not become affordable, it's concerning that this could further the health disparities among different socioeconomic groups.
DeleteI agree with Laura and Rachel that although this is a great advancement and there are endless possibilities…these possibilities can be both negative and positive. What are the risks? What are the short and long-term consequences? We need more information to see what side effects can/will ensue. If we change one gene it could alter another gene and this could lead to several genetic repercussions…some good but some bad. In addition as Kristen and Elizabeth both mentioned, with all this technology things could get out of hand. Yes ridding people of psychiatric disorders is a great achievement but what if people misuse it or abuse this technique. Although this might help our community in the short term at least it is no reason to completely take over the role of Mother Nature. We need to reevaluate how important Mother Nature really is to our society.
ReplyDeleteAlso the idea of being able to silence other genes is incredible. What could this lead to? What could it mean for human kind, biologically, financially environmentally, genetically, and ethically? How much will this cost and who will be able to afford it and have access to it?
In the article, epigenetics was used to be therapeutic targets for psychiatric disorders and I think it’s okay to use drugs to mimic Mother Nature. Haven’t we been doing this for a while now? We take painkillers, we have prosthetics, we perform plastic surgeries…etc. There are so many things in this world that we do that is “unnatural” but sometimes it profits our society. If we can make people healthier and prevent deaths and unnecessary pain then we should be able to silence certain genes. But again although this is for the benefit of human kind we must seriously take into consideration the short and long term goals of further developments. Further developments regardless of how harmful they might be, will shed some light on some processes; and knowledge is always valuable.
Well said Kristely. I love the questions you posed. They are all very valid points that individuals need to consider. Let me ask you this: Should our scientific community focus our attention on other more important things? I am interested in hearing what you think.
DeleteI also have to agree with Kristely and Tamika- well said. My worry is that we are fighting the "natural selection" process and Darwin's "survival of the fittest" theory is being put to the test because the idea of doing this means that those with the financial capacity to perform such a process will be able to do it and those without the money will not be able to do it.
DeleteAlso, if you get the chance, please glance at the abstract of this article:
http://www.who.int/bulletin/volumes/81/8/Patel0803.pdf
It attributes a lot of psychiatric illnesses to poor education and SES. Why is it that we want to take the easy route by allowing the most intelligent scientists to test these methods on people who are never given the opportunity to educate themselves. I find it really upsetting that the we just want to fix things all the time - an overnight solution seems practically better than helping those people with risk factors get preventative care.
Side Note: I'd like to know if the Star Wars mention worries anyone else - I think I would prefer not having a video game occurring inside my body like that; also, the mentioning of "fooling mother nature" doesn't settle well with me
Kristely, I love the questions you bring up. I think gene silencing has the potential to do amazing things for society. Eliminating the burden of certain illnesses, in this example psychiatric, will certainly have biological and financial advantages. Will certain members of society, such as psychiatrists, be for or against this type of gene silencing? I believe these advancements will benefit society overall, but I'm sure there will be some opposition, mostly from the drug companies that manufacture the current psychiatric drugs.
DeleteI'm curious to know about the environmental benefits you foresee. Are you thinking that people might be less likely to be negatively affected by their environment? This would be awesome. Ethically, I do think we will run into issues, especially when this area becomes more advanced. I think this field will freak a lot of people out at first, but I think this will eventually become mainstream science.
I agree with previous post in this blog about how wonderful therapeutic epigenetic's can be for those people who have psychiatric disorders. But as Rachel brings up there are several environmental factors that come into play also that have to be considered and is this being considered in the current research that is being conducted? This research is very far from being done as many of the genes that trigger these disorders have not been identified. One question to ask is can they all be identified? Many genes work in collaborations and although Tamika brings up the point of silencing one gene and affecting others as a consequence the question is how will this affect all the invisible connections. Could it ever be possible that one gene is targeted and silenced but the disorder still continues because we are missing part of the connection? Is so what is being done in the field of research to solve this?
ReplyDeleteAlthough this method has many possibilities, I myself see this as only a temporary solution. If simple things as the Influenza have adapted and transformed to be resistant to vaccines, what is to say the same will not happen with therapeutic epigenetic's? That if we are able to cure these disorders they will not come back in the future. I believe they will only because their existence happened because of nature. There are many things we can do to try to solve or help the situation but if we eliminate one problem it will only come back or another will pop up.
Then we have the questions of when is this conducted? and who can have it conducted? Many parents may think ahead and have such a procedure conducted before they even conceive a child. But what is the protocol to a situation such as when parents find out they will have a child and then think of the possibilities and what diseases that child may inherit and then want to have the procedure conducted? What if such procedure does not transcend through generations and parents never tell the child he had this done.
The last point I would like to bring up is the cost of this. As we have already learned with human genome sequencing it can be quite expensive, and so must be the case for therapeutic epigenetic's which places its existence and effectiveness even farther. I believe this is great breakthrough that is being made in the field of epigenetic's but it may not be as feasible as imagined, there is much research to be done, and maybe by then we will discover that maybe this technology has better uses in other areas such as altering genes to facilitate the recuperation time of patients and how their body heals.
Yoal brings up a good point about the cost of this procedure, and will insurance cover this? Will only the wealthy be able to afford this treatment. But like anything medicine what are the unforeseen problems that could be caused?.Other students have mentioned that this is not a simple fix one gene type of problem. Though this is a huge step forward for psychiatric problems and could be then adapted to other genetic disorders what are truly the problems the human body could have. There could be adverse reaction and complete mutation of genes that could cause farther problems for the person. Does being able to over come/ treat fully a mental disorder out weigh the possible irreversible damage that the drugs could do?
ReplyDeleteWho makes us who we are? If science begins to tamper with the very core of our being will we end up becoming another person?
I agree with Suzann as well. I think this new idea of silencing potentially harmful genes is incredible. I've known many people with diagnosed depression and bipolar disorder and their lives will forever be a challenge as they have to battle every single day to try to live normally. I've even spoken to a few of them about the posibility of their children having the same disorders and they are nothing short of terrified about it. The posiblity of silencing the genes that lead to these disorders is amazing. The technical ways in which this could be done (RNA interference, mylenation, etc) seem very complex and I'm not sure how we could ethically test these ideas in a clinical setting. Would parents be willing to subject their fetus to certain chemicals or medications in hopes that their child would be born free of a specfic disorder? Some might and some might not. The side effects are unknown and that can be very daunting.
ReplyDeleteOne of the "bad" things I can see happening is that if any or all of these scientific approaches work to silence certain genes and stop psychiatric disorders from occuring is that the people who currently have the disorders may feel discriminated against. I know the researchers say that it may be possible to even get rid of the disorders in people who already have them but that seems VERY unlikely to me. Don't get me wrong, I think getting rid of all and any psychiatric disorders would be absolutely phenomenal and is the ideal, but if this is not possible and doesn't happen, then those people left with the disorders could feel very out of place. And maybe the treatments only work 50% of the time in stopping disorders from being passed on to future generations. The people it doesn't work for would be very upset and I can see potential law suits being filed for discrimination.
Overall though, this idea is brilliant. I am fascinated by the potential behind this and I sincerely hope that sometime in the hopefully near future these incredibly hard disorders could be silenced and gotten rid of forever.
Allison Manfreda
ReplyDeleteThe article on using epigenetic mechanisms as a therapeutic intervention in psychiatry was very interesting and introduced many important questions and aspects of epigenetic mechanisms. Although the basic idea of using epigenetic mechanisms in this way may sound “simple” in theory, I think the application of it will be very difficult and will take many years at the very least. The article brought up several important ideas to note, such as the fact that many genes may be working together, and that altering just one of the genes may disrupt the entire process. I also think many of my peers brought up very important points, such as what are the long-term implications and effects of such an intervention? Can we really fool mother nature or will this potentially spur new mutations and methylation processes which may disrupt the new epigenetic mechanisms being used?
I think the idea itself is noble because many people are suffering from psychiatric disorders, and many people who want to have children may choose not to out of fear of passing their illness to their offspring. Although there are many services available to people who are suffering mental illnesses, I think that this effort may have tremendous positive implications if it can be successfully implemented in the future.
In regards to my thoughts on manipulating mother nature, I am not entirely convinced that it is possible to. As I stated above, these epigenetic mechanisms may produce changes, which may then spur mutations and disrupt the changes made by epigenetic mechanisms. We just do not know whether intervening will improve or worsen the situation, or whether it will improve and later cause more mutations which will introduce an entire new set of problems and issues.
I think that choosing to have genes that produce disease silenced should be an individual decision. I do think that the option should be available to the general population because lowering the prevalence of certain diseases may decrease healthcare costs and the burden of costs of society, however I do not believe that this should be mandatory. This option still protects the autonomy of each individual while trying to lower the burden of healthcare costs on society and improve the health and lives of the general population. The problem with this however, is that privacy and legal issues may arise and issues with insurance companies may arise. Insurance companies could potentially cover the services to have the genes silenced, but if a person chooses not to have their child’s “bad” genes silenced, the insurance company could use this information to deny coverage to medication the child may need. Although this is a stretch, it is possible that there may be implications dealing with laws, privacy, and insurance companies.
This type of medical advancement is incredible. The possibilities with performing such a procedure seem endless. Although there are other components to diseases other than genetic makeup, like the environment, being able to control when certain genes are turned on and off is crucial to the development of the disease. Medically it seems like a tremendous technological advancement that will be extremely beneficial. However, there are certain ethical and moral issues with this. It must first be addressed whether insurance companies would pay for this type of treatment. If they do agree to pay for this it would create an exponential growth in the medical expenses that are not feasible for the economical situation we currently face. In addition, many people in the US do not have health insurance so they would not be able to seek such a treatment. If they do not pay for this then it again leads to a great disparity in the social economic standing. Those who are able to pay for this type of treatment will then be able to have a tremendous amount of control over their health while those who can't will be at a big disadvantage yet again.
ReplyDeleteTreating psychiatric disorders is already a very controversial topic because of the difficulty in diagnosing certain diseases and the delicacy of how it affects individuals. Yet, if certain genes predispose people to being affected then it is unbelievable that there are advancements made to help people with these problems. Dealing with psychiatric disorders is extremely challenging and the treatments currently available are not always very effective. Therefore, while a lot of research and information has to be addressed the result of this could be life changing for many. In sum, the direction this is headed looks very promising and could be a very positive change for many.
I agree that this type of gene therapy for patients with psychiatric disorders is amazing. However, as with all medical advancements, I proceed somewhat over-cautiously. In another class I took, we learned about the process of societal acceptance of technological advancements; all breakthrough technologies are initially adopted by tech-faithfuls who consciously (or unconsciously) serve as the guinea pigs for the testing of the product/medication/therapy/etc. If the new technology's success rate increases and more wary onlookers (like myself) accept the technology as a legitimate option, then larger institutions like the government, health insurance companies, hospitals, and maybe in this case rehab/treatment facilities take notice and try to grapple with the ethical and financial aspects of incorporating the new medical technology into routine care.
DeleteIt's a long process, and the more complex an illness is, the longer it takes for people to develop trust in new curative claims. We're learning about this new type of epigenetic psychopharmacological (is that a word?)treatment at it's beginning stages when the risks are relatively unknown. And most of us probably aren't invested enough in figuring out a cure for psychiatric disorders to lend our bodies over for cutting-edge knowledge building, which is why we're already counting the medical bills and thinking about the effects of this gene therapy on our unborn babies. BUT there are people who are highly invested in this and through their efforts we'll see how effective this new technology really is in helping us fight psychiatric disorders. I'm curious to find out....as a spectator.
Overall this seems to be a huge leap in science. The possibilities are endless when it comes to turning on and off specific genes in the human genome. Doing this would greatly advance how we would treat or prevent psychiatric disorders. Being able to turn off undesirable and turn on desirable genes would lead to ideally a decrease in disorders. Ideally this is the goal of current psychiatric disorder drugs and medication and if epigenetic mechanisms can succeed it would be great to be able to prevent disorders from even happening. Being a new treatment though, there are many questions about ethics, costs, and integration. Who decides to receive this treatment? Is it nature versus nurture be able to control the outcomes of child and newborns? This reminds of me the same ethical issues surrounding eugenics. By allowing this to everyone and the population, there is risk or misuse and abuse of epigenetic mechanisms. There should be policy to make sure that epigenetic mechanism would be used to prevent instead enhance the personal human genome as there would be personal greed to enhance themselves or future offspring.
ReplyDeleteAlso there is the issue of cost. With any new treatment it is extremely expensive create integrate this into a clinical setting. Would patients who need it most be able to afford it? Or would it be too out of their price range to even consider?
As stated in this article, using prescription drugs to mimic mother nature is a very risky treatment option in that it may not always be successful and even result in adverse effects. This is because if the drug is designed to target a specific gene that codes for a psychiatric disorder, not all patients ultimately have the same genes or genetic profiles that cause the disease because disease tends to be a product of not only genes but genes and environment. Therefore, as we see this issue just with the usage of prescription drugs, the idea of manipulating specific genes in our genetic sequence to silence disorders creates an even greater undertaking and thus an even greater risk for the patient. With the over 20,000 genes that we have yet to understand how they all work individually, collectively and how they influence mental disorders, attempting to silence a single gene could have profound consequences. I do agree though that the idea and the technology itself, if successful, would be an amazing leap in science and the treatment of devastating mental disorders. Therefore research should be continued in the field of therapeutic epigenetics for it could one day eliminate the occurrence of these disorders.
ReplyDeleteGreat point Bianca. This idea about using prescription drugs to mimic mother nature is really risky, and I think this calls for a serious look at the cost-benefit ratio of using this new technology to alleviate the potential suffering/disability caused by a psychiatric illness. The side-effects of the drugs, as well as other potential adverse effects are largely unknown. As Bianca points out, using prescription drugs in this way could have profound consequences for patients far beyond what we could ever imagine given the complex interplay between genes that we have yet to fully understand. I don't think that this means that we should halt research or not pursue this technology - conversely, I think it means we should pursue it intently in hopes that we can learn more and hopefully someday be able to use this new technology appropriately and without fear because we know its role, its purpose, its capabilities and its limitations.
DeleteBoth of you, Michelle and Bianca, make great points about this article. Drugs that alter our epigenetics and mother nature are very interesting and open doors for a vast array of opportunities. Along with your questions about the risks of certain drugs and the cost-benefit ratios of these prescription drugs, I also wonder about the future implications of this medication option for affected people. In the future, does this mean that people could potentially silence unfavorable genes, even if those genes were not responsible for life-threatening diseases? I know various students have mentioned the issue of "drawing a line" somewhere to avoid this problem, but I reiterate that I think it is a serious problem that the field must consider before suggesting such an impressive advancement in medicine and epigenetics. Furthermore, Bianca's thought about side-effects made me think of psychological disorders specifically. With psychological disorders being so complex, how can we guarantee that a drug would solve a problem, rather than create more problems for the patient. I immediately thought of the protagonist in A Beautiful Mind, Dr. Nash, who despised his drugs because of the "unnatural" effects they had on him. Are we prepared to handle the patients feelings and reactions towards such a life-altering drug opportunity?
DeleteScientific breakthroughs such as the one mentioned in the article are changing the face of medicine. Diseases that before had no cure, merely treatment, could be entirely deleted from your genome. And while this sounds like a dream come true for some people, I think it is important to view possible future consequences.
ReplyDeleteOne of the main things I’ve learned during my studies in public health is that today’s medicine is too much focused on curation, rather than prevention. Doctors are constantly looking for the next great invention: the cure for cancer, a vaccine for HIV, etc., when really changes in behavior could make just as a great a difference (and at a much lower cost). Silencing a gene can seem like a “quick fix” for an issue that stems from a number of different factors.
In the case of schizophrenia, prevention is not so easy. You cannot prevent yourself from developing schizophrenia by not smoking, changing your diet, or exercising, for example. Yet, is silencing a mutation the right thing to do?
I think patients with schizophrenia would probably say yes. They are afflicted with a mental illness that will affect them for the rest of their lives. They are dependent on expensive medicines, with various unpleasant side effects. Silencing the unwanted schizophrenic gene would solve a myriad of emotional, social, and financial problems. While I would completely agree with this sentiment, I do think it is dangerous to offer everyone this opportunity. Who decides what is an “unwanted” gene? For some parents, a deaf child is considered to have a serious disability. However, from my experience taking sign language and talking with deaf parents, this is a blessing! Within the deaf community, it is not uncommon for a parent to prefer having a deaf child. So where does one draw the line?
The possibilities of these findings are fortuitous for many patients, but as with all medical interventions, it is important to continue with caution and to not only focus on the positive outcomes, but also to address possible negative consequences.
Kat, I agree with you on several of the points in which you raise. Science and technology are changing the way we think about medicine, health, and now genes. To be honest, all of the developments in science and technology scare me. They have such potential to do great things but at the same not every invention or discovery is beneficial. In terms of genes, people have been having children “by chance” for over 200,000 years and I think the idea of chance, or mother nature, determining which genes are suppressed and which are not has been working just fine.
DeleteYou, and several others, have mentioned the deaf community and the idea that being deaf is not a detriment but something that is unique or special. Who decides which conditions or characteristics are unique and which are destructive? Is the world headed for a place with genetically engineered humans- ones without psychiatric disorders, Trisomy 21, left-handedness, or bad eyesight? Sarah mentioned above that it would be impossible to receive funding for research for these “designer babies” but I am not so sure that it is. I believe that wealthy people will be willing to pay for their child to have certain genes, whether that may be intellectual, athletic, musical, or others. And if this happens, socioeconomic status will become even a larger determinant for health.
I agree with your final point Kat, that while these discoveries might be beneficial for some, we must look at technology with a “public health” perspective and look at the future effects for not only individuals, but the public as well.
I have to agree with everyone else in saying that these advancements, like any medical advancements, will undoubtedly have a profound effect on the nature of our broad definition of health, and could make a huge difference in many people's lives. Creating something that causes a process, one that is being inappropriately hindered, to occur nominally, or stopping something that should not be occurring chemically, seem like the natural ways to combat mutations that cause these issues. In many cases, this may be completely appropriate, especially when it comes to combating schizophrenia and other disorders that cause significant anguish in some sufferers. However, it is important to realize that every drug or treatment needs to go through a testing phase, and it seems dangerous to me to examine such manipulation in a study group, only to realize that four generations down the line it cause much more terrible genetically-initiated diseases. I do not mean to make the argument that the devil you know is better than the devil you do not, but it seems to me that potential long-term effects of genetic manipulation needs to be examined, and the genome more fully understood, before we start playing with processes that have made us the dominant species and given us the complex systems that run our bodies.
ReplyDeleteThis previous point also speaks to silencing genes... who knows what silencing a particular gene could mean down the line, for our generations to follow? Certainly psychological disorders are bad, but they are often treatable, and it seems like a typically human behavior to mess with our natural basis (namely, DNA) on the basis of seeing what happens. This transgenerational effect is of particular importance to me, mostly because we will not be around to speak for our mistakes, if such advancements turn out to be such.
Finally, in a previous post I talked about cookie-cutter babies and the fact that I did not trust society to allow genetic engineering (which seems the natural evolution [no pun intended] of what is discussed in the article) while we have an idea of perfection given to us by social media that, if we could, we would constantly replicate in our children. I am all for advancements that allow us to reduce the incidence of Huntingtons, the effects of BRCA1, etc., but I imaging that the buck will not be able to stop there, and perhaps even these advancements could lead to outcomes that we cannot fathom.
As many people have previously mentioned, there are endless amounts of ethical dilemmas that will come from this technology. Similar to genetic selection, people can argue that this is an unnatural way to reproduce. Others may argue that it is their moral duty to provide their child with the best possible life, and therefore this is ethical. I feel that this technology must be further improved/researched because at this time it will meet far too much resistance. As with most new innovations, this will always meet resistance, however, I believe that by further developing the technology, it has a greater chance of success.
ReplyDeleteTo agree with Tamika, I am concerned with how this process could affect other genes. Not only in the patient but what that will do in future generations of that person's family.
Finally, what type of financial implications will be involved with this technology. Similar to genetic selection, I'm guessing that it would be quite expensive. Furthermore, how would insurance companies react to such a procedure? This could also relate to the ethical debate that this procedure would only be available to those in high socioeconomic statuses. If this ends up being a great scientific advancement that could eventually better society, is it possible that it would be cheap enough to actually have a large enough impact? Many people with disabilities in the United States live below the poverty line due to restrictions (transportation, job security, etc.) caused by their conditions. If a person with a disability cannot afford this procedure to prevent his or her child from potentially developing the same disability, the technology is irrelevant.
The way science is developing is undoubtedly astounding. Theoretically silencing a specific gene can do wonders and help save lives, but it's not an exact science. We do not know for sure the effects of silencing one gene, what happens as a result of the silencing? Yes it might prevent one disorder, but could it cause another? Each genome is specific to the individual in question, and there is no way of knowing there will not be other harmful effects. Another thing comes to mind when reading the article, are we trying to "program" humans to be more robotic, perfect in every way? The human body is being seen more and more as something that can be fixed and altered when need be. So many aspects of our lives are medicalized, even natural processes. The question I have is, where does it all stop? What line are we not willing to cross?
ReplyDeleteUsing drugs to mimic mother nature would be beneficial to society but can we as human beings really mimic mother nature. There are so many confounding factors to take into account when dealing with silencing or activating genes. Having certain genes that cause disorders silenced sounds so much simpler than in reality. It is always difficult to determine what the effects of silencing a gene can have on an individual. In the instance of ligands and specific protein binding sites, you can never be too sure what stopping that interaction will do. Also there is a possibility that another ligand is capable of binding to that protein site, so silencing a ligand may not be the best thing to do. Messing with genes no matter how beneficial they may be always comes with effects. Are we ready to be responsible for those effects. We, as humans need to learn to leave certain things alone. Epigenetic use as a therapeutic agent for psychiatric disorders seems like it would be a noble cause but I personally would not want to be apart of it. Mother nature should not be messed with!
ReplyDeleteFor people who are affected by psychiatric disorders (such as schizophrenia) that have a genetic component, I think that using therapeutic epigenetics could potentially be very beneficial. If you can mimic epigenetic mechanisms to effectively target and alter the expression of genes that contribute to psychiatric disorders, and in turn give people with such disorders a better life, then there is value in using drugs that mimic Mother Nature.
ReplyDeleteHowever, psychiatric and other disorders are complex and not very well understood. As the article states, many genes act together to cause psychiatric disorders and we do not yet know which genes are involved. How do we know which genes or combinations of genes to target with drugs? And how do we selectively target only the genes we are interested in without affecting other genes? When targeting a gene through epigenetic mechanisms (methylation, deacetylation, RNA interference), we need to consider the ramifications of doing so because drugs can have unintended, and negative, consequences. For example, what effect does silencing one gene through drugs have on the expression of other genes? Or what are the long-term effects of solving one problem by, say, silencing a gene, which may beget other problems (and we may not know what these problems are until the drugs are tested in humans).
One question that I have about using epigenetic therapies to prevent or treat psychiatric disorders is how young of people can we treat with these therapies? It seems that many psychiatric disorders can begin in the teenage years, so do you begin treatment in childhood (for at-risk children) to treat adolescents? What effect would this have on their development?
In addition, I think it is important to recognize that factors outside of genetics also play a role in the development of psychiatric disorders. (Although, it seems that these factors are just as elusive as the genetic factors.) Thus, prevention and treatment for psychiatric disorders can’t rely solely on epigenetic therapeutics. Focusing on prevention of disease expression, in particular, supporting optimal brain and overall development during the prenatal period and in childhood and beyond through nutrition, good parenting, psychosocial support (especially during and after stressful life events) is critical.
In sum, epigenetic therapeutics sounds promising for preventing and treating psychiatric disorders, but these diseases are enormously complex. Much research still needs to be done to understand these disorders, especially their causes, before adequately understanding their treatments. We need to be cautious in interfering with Mother Nature; she has developed in humans something far more complex than I think we can ever truly understand.
I found this article very interesting to say the least since I have yet to hear of this kind of gene therapy. It’s exciting to think that people who have been suffering with life long psychiatric disorders will be able to silence genes causing their symptoms and live their lives to the fullest potential. This new technology has the possibility to change the lives of many people. I also think that there may be an ugly side to the use of this technology that must be considered. With the option of manipulating genes, one can easily misuse this. While the pros seem too good to deny the use of this technology, the possibility of misuse must be realized.
ReplyDeleteI also agree with Tamika who said we should first consider how silencing one gene will affect another gene. We should determine all potential risks before putting this kind of therapy to use. Its possible that silencing one gene can also silence another gene or overly express another one.
Thank you to tell us so much useful information. So nice sharing. I’m glad to read it.
ReplyDeleteI do not think the drugs that mimic mother nature should be looked at differently from other drugs. All drugs are meant to alter normal bodily functions in order to help the person ingesting them in some way. It should not matter how the drug goes about helping the person as long as it does not harm them or others in the process.
ReplyDeleteIf there is a disorder that could be prevented by silencing a gene, I think it should be done. Silencing a gene could be compared to a process like getting rid of a cancerous mole. If you remove it, or silence it, the negative outcome can be prevented.
Of course there is always the worry of abuse of such a procedure, such as use for social reasons such as altering physical appearance. However, abuse can be avoided with certain laws and regulations.