饶毅:基因编辑带来什么危机?
引言涉及人类生命的技术进步是把双刃剑。2012年诞生的简便而强大的基因编辑技术(CRISPR/Cas9)是分子生物学重大技术进步,合理应用可增强人类福祉,不当应用可给公共安全和人类社会带来危机。
基因编辑人类体细胞与基因编辑生殖细胞有着本质的不同,体细胞编辑只影响个人而不带来新的伦理问题;而生殖细胞经过受精、胚胎发育、出生、长大成人结婚后将与其他人产生后代,会遗传给他人,编辑的后果将扩散,进而影响人类社会。体细胞的基因编辑可能治疗人类很多疾病,它与现有框架已接受的基因治疗类似,可按现有法律法规和监管办法,在个体安全性、作用有效性和方法稳定性确定后使用,但针对人类生殖细胞的基因编辑则超出现有伦理框架,它的特征是医学必要性低、技术可控性低、群体危害性高。
绝大多数携带疾病罹患基因的家庭,可用无伦理争议的筛查技术而无需生殖细胞基因编辑。一旦允许人类生殖细胞基因编辑,就难以限定可以编辑什么基因、编辑多少基因、由谁编辑基因等。中国需要立即调查处理已出现违反政策、规定、伦理的人类生殖细胞基因编辑问题,尽快加强监管弥补漏洞,出台有针对性的措施确保基因编辑技术不被滥用,制定人类基因编辑的法律法规:允许体细胞基因编辑,禁止人类生殖细胞的基因编辑。
缺乏监管的人类生殖细胞基因编辑可能带来对人类社会安全危害,相关科技人员和医生必须严格遵守法律、法规和伦理规范。缺乏法律法规和伦理规范可能带来国家之间的基因竞赛,因此需要国际社会协调制定国际公约,并将国际公约转化为各国的法律,以保护全人类共同利益。
深刻认识基因是人类智慧绚丽的结晶、合规操作基因是增进人类福祉可能的途径。但科学技术的进步有时是把双刃剑,特别是涉及人类生活和生命的时候。如何规范基因编辑是今天人类社会面临的严峻考验之一。

撰文 | 饶毅(北京大学教授、《知识分子》主编)
编辑 | 叶水送
基因:科学和技术
自孟德尔发现遗传规律以来的150多年,经过遗传学、生物化学、微生物学和分子生物学的发展带来很多在科学和技术方面的进步。今天以基因为核心的分子生物学渗透了生物学、医学和农业科学等学科,而以基因分析和基因操纵为主的分子生物学技术也早已走出实验室被广泛应用于药学、农业和医学等领域。

百年基础研究,从遗传学到分子生物学

基因编辑技术CRISPR/Cas9技术发现的三位先驱
遗传和扩散:人类基因编辑
长期以来,科学界知道新的科学技术不能用于人类生殖细胞,特别是不能产出婴儿。因为历史和发展的原因,中国科学和技术方面的立法相对滞后,对于基因编辑依法管理是弱项。CRISPR/Cas9基因编辑方法的简易引起了前所未有的问题。
体细胞基因编辑不带来新的伦理问题
在人之外的动植物使用基因编辑技术,不会带来新的伦理问题,科学界和人类已熟悉、并且已有合适的审批和监管措施。

人类胚胎基因编辑的核心问题

人类生殖细胞基因编辑,是此事件的核心问题
人类生殖细胞的基因编辑,缺乏临床必要性
对于遗传疾病来说,绝大多数无需生殖细胞基因编辑,而是通过选择自然产生的受精卵就可以做到。

生殖细胞的基因编辑不如受精卵选择

罕见的父母皆为纯合体可通过婚前自愿披露遗传信息,减少后代患病的可能性
人类生殖细胞基因编辑带来的安全危机
为什么需要格外担心生殖细胞的基因编辑?这不是人文关怀,而是严谨的科学问题。

人类胚胎的基因编辑带来的危害

人类生殖细胞基因编辑的推动者
6) 人类生殖细胞基因编辑的推动者,虽然现在打着为解决父母双方都携带基因变异纯合体(父母的两套染色体都坏了,也就是总共四条染色体坏了)的问题,其实因为这种情况极为罕见,推动者并不能获得商业利益,所以他们的目的是以这种借口说服突破对于生殖细胞基因编辑的禁止,从而进一步推动影响人类其他非疾病性状的基因编辑,他们还会推动对于一个受精卵的多个基因编辑。因为无法达成社会共识可编辑哪些基因,只要允许人类生殖细胞基因编辑,很难避免出现混乱的情况;
国际问题:不能盲目跟风,而是加以甄别
在国际上,人类生殖细胞和胚胎有清晰的红线。其中胚胎的红线不仅是科学而且有宗教原因。但仅仅从科学上,就画出红线,严禁人工改造生殖细胞后植入子宫继续发育成婴儿。
解决方法:亟需立法,建立国家咨询机构

中国的胚胎基因编辑解决方法
1) 对于基因编辑,急需亡羊补牢,由国家建规立法,明确地、严格地规范对基因编辑,允许监管下的体细胞基因编辑,禁止人类生殖细胞基因编辑;
2) 建立健全的制度,审核、批准都有质量过硬、敢于担当的机构。加强执法,对违反规章制度、违反法律法规的个人和单位严惩不怠;
3) 对于日新月异的科学领域,需要建立国家咨询机构,经常、及时交流促进国家保持对科技发展的敏感性,以便今后不出现或少出现因为科技发展而惊世骇俗地突破底线的问题,更要预防危害人类社会安全的问题;
4) 积极建立国际交流合作,协调重大问题,推动建立国际公约,并转化为各国建立全人类利益一致的法律法规。
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