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What's Next for Crispr Babies? WHAT’S n the three months since He Jiankui Some are concerned about how the public NEXT FOR announced the birth of twin girls with scrutiny will affect the future of the field, Iedited genomes, the questions facing the whether or not researchers aim to alter the scientific community have grown knottier. germ line. “The negative focus is, of course, not By engineering mutations into human good,” says Fredrik Lanner, a stem-cell scientist CRISPR embryos, which were then used to produce at the Karolinska University Hospital in Stock- babies, He leapt capriciously into an era in holm, who has been editing genes in human which science could rewrite the gene pool of embryos to study how cells regulate themselves. BABIES? future generations by altering the human germ But others predict that the He affair might line. He also flouted established norms for propel human gene editing forwards. Jonathan Following last year’s safety and human protections along the way. Kimmelman, a bioethicist specializing in There is still no definitive evidence that the human trials of gene therapies at McGill Univer- GETTY IMAGES: MIKE MCQUADE; BY ILLUSTRATION bombshell revelation, biophysicist actually succeeded in modify- sity in Montreal, Canada, argues that definitive investigations mount and ing the girls’ genes — or those of a third child action in the wake of the scandal could expe- expected to be born later this year. But the dite global cooperation on the science and its debates swirl about the experiments have attracted so much attention oversight. “That would stimulate, not hinder, future for gene-edited that the incident could alter research for years meaningful advance in this area,” he says. to come. Here, Nature explores four questions still humans. Chinese authorities are still investigating lingering around the births. He, and US universities are asking questions Here are the four most of some of the scientists he consulted. Mean- WHAT WILL HAPPEN TO HE — AND THE CHILDREN? while, calls for an international moratorium on He has been criticized, but not just because he pressing questions. related experiments, which could affect basic pursued germline editing. He also neglected to research, have motivated some scientists to do adequate safety testing and failed to follow BY DAVID CYRANOSKI bolster arguments in favour of genome editing. standard procedures in procuring participants. 440 | NATURE | VOL 566 | 28 FEBRUARY 2019©2019 Spri nger Nature Li mited. All ri ghts reserved. ©2019 Spri nger Nature Li mited. All ri ghts reserved. FEATURE NEWS He was subsequently censured by the health human research, and did not do so for this agrees that it was unclear how any of these ministry in Guangdong, where he worked, and project. They say that he did not attend recruit- individuals could have effectively blown the fired from his university. He did not respond ment or informed-consent meetings, did not whistle. Had the research been conducted in to Nature’s multiple attempts to contact him. authorize the use of his name as an author on the United States, a scientist could have con- At this point, further penalties seem to be any human-gene-editing paper and was not a tacted the Office for Human Research Protec- in the hands of the police. There are a range senior author on the paper. Rice University is tions or the Office of Research Integrity. But of criminal charges that He could face. While investigating Deem’s involvement. China has different values and opaque regula- recruiting participants, He and his team Other scientists have been chastised for tions. “If it is happening elsewhere, a scientist agreed to cover the costs of fertility treatment doing nothing to raise alarms about the work. may be wholly unfamiliar with the norms and and related expenses, up to 280,000 yuan He Jiankui told many US-based academics laws in that foreign country,” says Charo. (US$42,000). He also stipulated that partici- pants would have to repay costs if they dropped THE LEGAL LANDSCAPE out. Liu Ye, a lawyer at the Shanghai Haishang A 2016 survey in Science examined existing laws (legislation) and documented policies (regulation) Law Firm, says that if such payments are found that explicitly govern gene editing or might be applied to such activities. The survey labelled countries , 337–339 (2016). to count as coercive measures, they could as restrictive, permissive or something in between. But specialists disagree over whether rules in 351 constitute a crime. Guangdong province also some nations might be intepreted to permit gene editing (see page 455). found that He used forged ethics-review docu- SCIENCE . ments during recruitment of participants and Canada ET AL ET swapped blood samples to skirt laws against Belgium allowing people with HIV to use assisted United The Netherlands Kingdom China reproductive technologies. Germany France He claims to have disabled a gene called United SOURCE: R. ISASI CCR5, which encodes a protein that allows States Japan HIV to enter cells. He was aiming to mimic a South Korea mutation that exists in about 10% of Europeans, Mexico and helps to protect them from HIV infection. India But He might have inadvertently caused muta- tions in other parts of the genome, which could Restrictive Singapore have unpredictable health consequences. (He Intermediate Brazil claims to have found no such mutations.) Also, Permissive Australia CCR5 is thought to help people fight off the Legislation Regulation effects of various other infections, such as West Springer Nature is neutral about jurisdictional claims in maps. Nile virus. If the gene is disabled, the girls could be vulnerable. If they do suffer in a way that is about what he was doing, including three at She says this could change if the scien- linked to He’s procedure, and He is found to Stanford University in California, and Craig tific community follows through on plans have been practising medicine illegally, he could Mello, a Nobel-prizewinning molecular biolo- mapped out at a gene-editing summit held be sentenced to between three and ten years in gist at the University of Massachusetts Medical in Hong Kong in November — the only sci- prison, says Zhang Peng, a criminal-law scholar School in Worcester, who was an adviser for a entific forum at which He has presented his at Beijing Wuzi University. But identifying those company founded by He. Most of them say that work. The plans propose some kind of trans- health effects could take years. they advised He against proceeding. national advisory body and registry to identify He promised to follow up with the girls until Mello says He ambushed him during a break common norms and differences of opinions they were 18 years old, but it is unlikely that at an advisory board meeting to tell him of his between countries. Other organizations are the health ministry, which ordered He to stop plans and then notified him of the pregnan- also considering measures. Earlier this month, doing science, will allow him to be involved in cies by e-mail. “I immediately expressed my for example, the World Health Organization the evaluations. It is not known what, if any, concern and condemnation,” says Mello. announced the establishment of an inter- special measures are being taken to look out for But Natalie Kofler, a molecular biologist national committee to devise guidelines for the girls’ health or to track the other pregnancy. at Yale University in New Haven, Connecti- human gene editing. It will meet for the first cut, argues that researchers who knew about time in March (see ‘Human gene editing’). WHAT ABOUT THE OTHER SCIENTISTS IMPLICATED? this should have done more. The whole epi- Soon after He revealed his experiment, it sode, she says, is evidence of a growing divide HOW COULD HE’S ACTIONS AFFECT OTHER RESEARCH? became clear that he did not act alone or in between the values scientists proclaim, and Four years ago, a team of scientists from secrecy. The responsibility of other researchers those they actually uphold (see page 427). Guangzhou published a paper1 describing the who were in the know became hotly debated. Kimmelman shares those concerns, and says use of gene-editing techniques in a human The senior researcher with the most intimate that by remaining silent, scientists are in dan- embryo. The researchers used embryos with knowledge of the work seems to be Michael ger of creating a “latency period” in which a mutation that would prevent them from Deem, a biophysicist at Rice University in dangerous practices can emerge and evolve in growing into fetuses. It was, nevertheless, an Houston, Texas. Deem was once He’s adviser, a vacuum. “It often takes a debacle for people earthshaking study, and it triggered immediate and is a member of the scientific advisory board to realize that silence can often be a form of questions about germline editing. of a Shenzhen-based genome-sequencing complicity,” he says. Over the next two years, several groups — company that He founded. Deem was report- Stanford stem-cell biologist Matthew Porteus from China, the United States and the United edly also a senior author on a paper — which says he didn’t speak up for three reasons: he Kingdom — published results2–4 of similar remains unpublished — describing He’s experi- thought he had dissuaded He, he wanted to experiments. The studies went from using ments, and is said to have been present during respect He’s request for confidentiality and he non-viable embryos to using ones that could the recruitment of participants. What role he didn’t know where or how to report what he conceivably be implanted. Some tested new had is not clear. Deem’s lawyers acknowledge had heard.
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