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Problems and ethics in Gene therapy
Posted Date: 16 May 2008 Resource Type: Articles/Knowledge Sharing Category: How things work
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Posted By: Karthika M Member Level: Gold
Rating:  Points: 1
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Problems and ethics
For the safety of gene therapy, the Weismann barrier is fundamental in the current thinking. Soma-to-germline feedback should therefore be impossible. However, there are indications that the Weissman barrier can be breached. One way it might possibly be breached is if the treatment were somehow misapplied and spread to the testes and therefore would infect the germline against the intentions of the therapy.
Some of the problems of gene therapy include:
Short-lived nature of gene therapy - Before gene therapy can become a permanent cure for any condition, the therapeutic DNA introduced into target cells must remain functional and the cells containing the therapeutic DNA must be long-lived and stable. Problems with integrating therapeutic DNA into the genome and the rapidly dividing nature of many cells prevent gene therapy from achieving any long-term benefits. Patients will have to undergo multiple rounds of gene therapy.
Immune response - Anytime a foreign object is introduced into human tissues, the immune system has evolved to attack the invader. The risk of stimulating the immune system in a way that reduces gene therapy effectiveness is always a possibility. Furthermore, the immune system's enhanced response to invaders it has seen before makes it difficult for gene therapy to be repeated in patients.
Problems with viral vectors - Viruses, while the carrier of choice in most gene therapy studies, present a variety of potential problems to the patient --toxicity, immune and inflammatory responses, and gene control and targeting issues. In addition, there is always the fear that the viral vector, once inside the patient, may recover its ability to cause disease.
Multigene disorders - Conditions or disorders that arise from mutations in a single gene are the best candidates for gene therapy. Unfortunately, some of the most commonly occurring disorders, such as heart disease, high blood pressure, Alzheimer's disease, arthritis, and diabetes, are caused by the combined effects of variations in many genes. Multigene or multifactorial disorders such as these would be especially difficult to treat effectively using gene therapy.
Chance of inducing a tumor (insertional mutagenesis) - If the DNA is integrated in the wrong place in the genome, for example in a tumor suppressor gene, it could induce a tumor. This has occurred in clinical trials for X-linked severe combined immunodeficiency (X-SCID) patients, in which hematopoietic stem cells were transduced with a corrective transgene using a retrovirus, and this led to the development of T cell leukemia in 3 of 20 patients.[2]
Religious concerns - among people who believe that humans were created in God's image, some may consider the alteration of an individual's genes as tampering or corrupting God's work.
Deaths have occurred due to gene therapy, including that of Jesse Gelsinger.
Various ethics debates involved in gene therapy are controlling fate by altering germline cells and the effect of knowing one’s fate. Many debates are about altering germline cells. When germline cells are altered, they are altered to better the fate of the child. Many people do not believe it is right to take control of fate. Others believe we were given the knowledge and ability to better a child’s fate. Another debate concerns the devastating affects of knowing one’s ill fate. Depending on the person, they may either decide to live life to the fullest, or they may just give up. Is it in the patient’s best interest to tell them their fate? It depends on the person.
While gene therapy shows a great deal of potential, opponents, biomedical reductionism will undoubtedly have several responses. The way a person experiences a disease involves many social and psychological elements (such as emotional impact of the disease, the stigmatism attached to it, the cost and employment implications, etc). These important aspects of disease are neglected by therapeutic approaches aimed strictly at the genetic level.
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| Author: Vidya 23 May 2008 | Member Level: Diamond Points : 2 | useful information
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