Charles J. Link, M. D.

What is Biotech? | What is Gene Therapy? | Arguments for Biotech | More Comments | What is Genetics? | What do the tools of biotech allow . . .? | What are the different types of gene therapy? |

Transcript for Clip 1 -- What is Biotech?

Biotechnology is a tool. There are certain types of experiments and certain types of knowledge you can only do if you have certain types of tools. Biotechnology is basically a toolbox that you can use to study genetics. Much the way if you are an auto mechanic, you need tools to be able to work on an engine, biotechnology has certain techniques, methods, and pieces of equipment that can be used to study genetics. [Biotechnology is] being used to study evolution. It's being used to study plants and animals. It's being used to study humans. It's being used to predict, in humans, disease states. It's being used to treat diseases in humans. It's an incredible range of things. Basically, biotechnology can affect and have impact on anything that is living and that's quite a remarkable thing.

Transcript for Clip 2 -- Gene Therapy:

When you think about gene therapy, there's often a misconception that people have that somehow we're changing evolution or we're changing people in some weird way, or some science fiction way--the way you read about in science fiction books or see on Star Trek. But in actuality what's happening is you're only going in and changing [the genetic makeup] in one person or in one tissue in that person. You're not changing the whole person and you're not changing anything about the children that person would have. In gene therapy, ethicists and people in the field have basically discussed three basic types of gene therapy. One is what we call somatic cell gene therapy. The example of that is trying to treat a patient with cancer. You try to go into a single patient and you try to get the genes into a cancer to just destroy the cancer tissue. So in that situation you're going into the human body in a single person and you're trying to change the genes in some tissue like a cancer. Or maybe there's an enzyme missing in the liver and you're trying to put in a new enzyme. That's somatic cell gene therapy. And currently in the United States, those are the only types of experiments that are allowed to be done in humans because they're therapeutic experiments and gene marking experiments. They're done in a very controlled fashion.

Transcript for Clip 3 -- Arguments for biotech:

If you take kids with a lethal genetic disease that might die an agonizing death over ten or fifteen years from repeated infections and die, and compare that to kids whose stem cells have been taken out, genetically modified and put back into them and seem to be living a normal life, that's a very powerful argument. If you look at cancer patients who've failed radiation and chemotherapy and have received gene therapy and their tumor has regressed and you see that patient up walking around alive who otherwise would have been dead, that's a very powerful argument for biotechnology. So it's fairly difficult to see when you're saving lives and saving children that there's not a very powerful argument for biotechnology. I think we're just on the very early cusp of this. It is very much is akin to the computer revolution that's taken place over the last thirty or forty years, very much akin to the development of the combustion engine, very much to the development of the light bulb, except biotechnology has much more profound potential impact on humanity. There are very complicated issues coming up however, things like; effects on human life span, effects on human intelligence, issues like when if ever would humans consider doing a germ line gene therapy experiment. These are very difficult things that I don't think we have a lot of answers for right now.

More comments from Charles J. Link...

Q: What is genetics?

A: genetics is the study of inheritance, we all know there are certain characteristics you can inherit from your mom and your dad, and genetics is basically the study of inheritance. The word genetics comes from a root word that's gene and gene is actually a unit of inheritance. So if both your parents have blue eyes and you happen to have blue eyes that's usually inherited from your parents, or if both of your parents have brown eyes and you inherit brown eyes then that's where you got your eyes from. Many different things about us actually happen through inheritance, not everything but probably at least 50% of what makes us us comes from inheritance. The other 50% probably comes from our environment. So genetics is the study of inheritance and therefore it's the study of genes that cause inheritance.

Q: what do the tools of biotechnology allow you to do, what are some of the big possibilities that biotechnology provides for the realm of medicine?

A: In the realm of biotechnology you'll hear the term recombinant DNA technology, or recombinant technology. Recombinant DNA means the ability to put new DNA molecules together. Now we talked about inheritance and genes, genes are made out of a chemical DNA, basically people call it the molecule of life. Those chemicals when they're put together define a specific gene that will define whether someone has brown eyes or blue eyes, or whether they're smart or not so smart, whether they're tall or short. It will define a lot of those things. In recombinant DNA you can think of it, when you have a poster that you put together and you cut and paste little pictures onto the poster, if you just saw the pictures in the magazines that you took them from they might not tell the story, but if you put them together on a poster in a certain way it tells you a story, just like actually you do on the internet when you have a story to tell, you don't just show a continuous interview you cut and paste the pieces of an interview together or a story together to communicate something. Recombinant DNA is taking pieces of DNA and cutting and pasting it together with molecular enzymes, very tiny enzymes that come from bacteria and fungi and different types of organisms that allow DNA molecules to actually be cut apart and then pasted back together in a particular sequence. That recombination ability leads to an incredible amount of new experiments which can lead to knowledge and insight about what the genes do and how they function.

Q: What are the different types of gene therapy ?

A: In gene therapy, ethicists and people in the field basically discuss 3 types of gene therapy. One is what we call somatic cell gene therapy, the example of that is trying to treat a patient with cancer. You try to go into a single patient and you try to get the genes into the cancer to just destroy the cancer tissue. So in that situation you're going into the human body in a single person and you're trying to change the genes of some tissue like a cancer, or maybe there's an enzyme missing in the liver and you're trying to put in a new enzyme. That's somatic cell gene therapy, and currently in the United States those are the only types of experiments that are allowed to be done in humans.

Because they're therapeutic experiments and gene marking experiments and they're done in a very controlled fashion. A big part of those experiments is making sure that you don't get an accidental type of gene therapy, and that brings us to a second type of gene therapy, called germ line gene therapy. Germ line gene therapy has been done in plants and animals to modify plants and animals so that you modify the genes so that they're inherited from parent to offspring. Transgenic mice is the most common example of that, there's been more than a thousand mice engineered, had new genes put in them usually to study some disease model. Germ line gene therapy has not been permitted in human beings and I agree with that, and that would entail taking an embryo or fertilized egg, modifying the gene in the embryo so that if you did that in a person, if that person had children, that the children subsequently would be genetically modified. This is not permitted in the United States, Western Europe or Japan, all the countries that have looked at this with expert review bodies have agreed that it's not a wise thing at this point for human beings to modify the inheritance patterns of humans. There's agreement that we don't know enough about human beings and inheritance and evolution to consider changing a person so that we change humanity downstream. Germ line gene therapy is not permitted.

There's another class of gene therapy that's discussed that actually could be either germ line or somatic cell and that's what we call enhancement gene therapy and that's also not permitted. Things that would be possible to enhance in humans in theory is maybe you could develop a gene therapy that could make muscles stronger, you could make people that could lift weights more or run faster than Donovan Bailey. Those sorts of experiments are not permitted. It brings up some dilemmas, you can think of situations where you're trying to treat a disease but that therapy that's developed might actually be able to treat a syndrome. My kids laugh at me when I use the joke of trying to develop a gene therapy for hair loss. There might be a lot of money in developing a gene therapy for hair loss but that would be considered an enhancement so people aren't currently permitted to do such an experiment. But you can think of disfiguring scarring that could happen where somebody's in a car accident and gets scarring that destroys half of their scalp and you could have a woman that's very disfigured and maybe being able to do gene therapy and grow hair on a damaged or scarred scalp, it might be something that treats a disfiguring injury. You could think of a lot of experiments or projects that people are very interested in is trying to treat mental retardation. For a lot of mental retardation the deficit in intelligence in some of those people is marginal, and so if you can improve the intelligence by 10 or 15% the level of functioning and the ability of those people to function in society is greatly enhanced. So there's a goal to do that. A lot of early intervention in mental retardation with that as a goal. If you think about some gene therapy experiments there might be things you can do in the brain to enhance the ability of memory to work or intelligence by doing gene therapy in the brain. If you could do that it would be wonderful we could help cure mental retardation using that sort of an approach. However it might be that u that same technology could be used to make people who are already smart, even smarter. And the question is is that fair, or what kind of challenge does that bring to society if you can improve intelligence using some sort of genetic or biologic approach. So those kind of enhancement experiments are also not permitted in United States Western Europe and Japan where they have committees for this.


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Posted March 6, 2001