Science and Research

Designer Genes: The Future of Preventive Care

January 4, 2022

Despite leaps and bounds in understanding our genetic makeup and exactly how genes impact our health, human genomics is still a frontier left largely untapped– or at least, not actionable. 

Since discovering DNA half a century ago and birthing the field of human genetics, science has made leaps and bounds in furthering our understanding of how these complex series of proteins encode who we are. 

Below is a closer look at the exciting possibilities that could arise from the field of genetics, and how it might change preventive care for the better. 

What Is Genetics?

The field of genetics dates back to the days of Charles Darwin and his famous theory of evolution. 

Almost 200 years ago, Charles Darwin concluded that traits in animals are inherited from their parents, and that animals evolve over time based on natural selection. He recognized that "something" was being passed from one animal to the next, and his theories led to immense growth in the field, where subsequent experiments elucidated exactly how traits are passed from parent to offspring. 

But the underlying "instructions" that are passed from one offspring to the next, known as DNA (deoxyribonucleic acid), weren't discovered until much later. DNA's discovery – most notably its structure, credited to James Watson and Francis Crick – changed the field of genetics, as there was now an identifiable molecular code that could be analyzed to understand how traits are passed from one person to another.

Still, our understanding of this code was limited. Fast forward to October 1st, 1990 and the beginning of an international effort known as the human genome project, through which the entire genetic code of humans was analyzed and mapped. Its completion in 2003 marked a pivotal moment in genetics, but represented only a small piece in a much larger puzzle. 

The sequencing of the human genome might be thought of as getting an entire instruction manual to build a human, but in coded encryption. With the human genome in hand, genetics research now focuses on how this code translates to human traits, diseases, and more, and whether "flipping a switch" can turn traits on or off.

Might cutting out or adding genes to our DNA change human traits? Sure, and it's already starting to happen.

How Genetics May Revolutionize Medicine

Your genetic code provides a detailed set of instructions for how your body is formed and functions. There are slight variations from person to person, and these differences are part of what make each person unique. 

Genetics account for differences in physical appearance, but they can also be the basis for how our bodies function. 

Below is a closer look at some of the positive ways that our improving understanding of genetics is and might change the field of medicine for the better.

Preventive Care

Preventive (or preventative) care proactively treats people to keep them as healthy as possible. A great example of preventative care is eating a healthy diet and getting routine physical exercise to avoid chronic conditions such as cardiovascular disease, obesity, and more. 

Another aspect of preventive care is routine screenings to look for signs of disease or potential illness.

Preventive care boils down to reducing the likelihood of developing a medical condition.

Genetics may become an integral part of preventive care in the future as many diseases have a genetic component; it's just a matter of knowing what to screen for.

For example, a DNA test is already providing early warning signs of cancers. We’re already using genetic screening to determine an individual's predisposition to developing breast cancer. BRCA genetic screening looks for BRCA mutations (BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast CAncer gene 2)), which increase the likelihood of developing an aggressive form of breast cancer. This forewarning can provide lifesaving information, as those with a BRCA mutations are at much greater risk of developing breast cancer and can take steps to have more frequent screenings or even proactively remove tissue to reduce the risk of cancer development.

Personalized Medicine

More than ever, medicine can fit into more people’s lives with improved access and reduced barriers. Personalized treatment plans (like through telemedicine) are an excellent means of treating the individual as an individual, but genetics will be the catalyst for truly personalized medication. 

This is already underway in some cancer settings, where targeted, personalized therapies are being used to address certain genetic mutations in cancers. Just like we're preventively helping women with BRCA genes, we're also now targeting mutations that cause cancer cells to grow faster or divide more frequently. This "personalized" or precision approach to cancer care is highly effective in certain settings, but only when someone's cancer genetics suggest their cancer is driven by a particular mutation.

When the genetic code is completely defined, it may be possible to design each person’s drugs and treatments based on their genetic code. Some day, drugs might be produced that provide more benefit, have fewer side effects, and are optimally tailored for specific populations, genders, and genotypes. 

Genetic Editing In Medicines

One major hope for medicine and genetics is to eliminate or replace faulty genes in humans that cause mostly rare genetic disorders. Diseases where genetic medicine might someday be put to use include sickle cell disease and cystic fibrosis. 

In the United States, a drug for a rare inherited form of blindness called retinal dystrophy has been approved. The drug, called Luxturna, replaces a faulty gene with a correct one in a patient's eye, helping to alleviate this rare form of blindness.

Ethical Considerations

While there are many potential benefits to genetics and medicine, several ethical considerations might give people pause. Below is a closer look at a few of the issues raised in relation to genetics and medicine. 

Designer Babies

One ethical dilemma that's frequently raised is the potential use of genetic alterations for babies. 

Currently, genetic testing can indicate a variety of potential birth defects or complications. But with the speed at which gene editing is moving, theoretically one might soon be able to select the traits they wish their child to have. The first human use of "CRISPR" technology occurred in China in 2018, for example. In that case, a researcher said he altered embryos for seven couples during fertility treatments, with one pregnancy resulting. He said his goal was not to cure or prevent an inherited disease, but to try bestow a trait to resist possible future infection with HIV.

This was widely denounced by the scientific community.

This concept has been coined “designer babies,” and it poses a real ethical and social dilemma. While there is, of course, the potential for individuals to design their offspring's physical attributes, there's also the potential to edit out congenital diseases, such as cystic fibrosis. 

The debate lies in where the line should be drawn and when gene editing goes too far. While we are still a ways from this becoming a reality, it's likely to become more pressing as time goes on. 

Cloning

Another ethical dilemma is the concept of cloning an individual. This topic has been highly debated since it was conceived as a possibility, and human cloning is widely seen as unethical.

The Takeaway

In summary, the field of genetics and gene mapping is an exciting new frontier. From genetic screening to watch for risk factors, to possible editing faulty genes out of someone's DNA, the future of genetics in medicine is bright. 

SOURCES

The Human Genome Project | NIH

Androgenetic alopecia | Medline Plus

Why Human Cloning Must Be Banned Now | CBHD