Baby is healed with first personalized gene-editing treatment

Are the edited genes inherited, or the original ones? Does the previous question have an answer that depends on the babies sex?

From an evolutionary perspective it‘s interesting how the further medicine gets, the more we inherit genes unfit for life without medical support.

I'm sure we'll be editing these diseases out of the germ line at the same time in the not too distant future.

No, it's only in the liver, from what I can tell from the science, not the gametes.

No, it would not depend on the sex of the baby, as the chromosomes that you're editing aren't X or Y.

Evolutionarily, the inheritance of genes is a far slower process than the medical advancements we make, so what I think we're seeing here is a chasing down of the low probability events. In that, most of the evolutionary pressure is coming from things like dirty water and bad food, but as we're solving those low hanging fruit, we have to go to lower probability events to make progress that feels equally important.

Also, if I am wrong here on the answers to the questions, please correct me!

Is the global gene pool actually degrading though? I only ever hear that in thinly veiled attempts at advocating for eugenicism. And it never comes substantiated by any research.

Anyway, this baby proves we can fix hereditary diseases now.

couldn't be unless they reached reproductive cells.

If they could get complete delivery to the liver stem cells, then the change could be permanent, although this is making many simplifications.

Organs in your body usually keep some very old cells (formed in the embryo) around which act as parents for all the new cells in an organ. Any cell can only divide a limited number of times, so they typically maintain a "tree structure" where the old cells create children and grandchildren (etc) that then differentiate into the organ-specific cells that do the actual organ work.

If you modify only the differentiated cells, eventually they die, and are replaced by descendents of stem cells; if those stem cells didn't get modified, their descendents will not have the fix, and the treatment efficacy reduces over time.

Speaking as a person whose friend died at 21 from complications related to cystic fibrosis I would like to see these diseases edited out of the germ line.

That‘s what I was asking: Baby females already have all the eggs they will ever have once they are born, right? Matryoshka doll style. While sperm is always (relatively) fresh.

> eugenicism

That comes in many forms:

Black/dark one, nazi style, where you outright sterilise or even kill those with unhealthy/bad genes.

And white/peaceful one, where you‘d appeal to those with unhealthy/bad genes not to procreate and encourage those with healthy/good ones to do.

You can‘t seriously tell me it‘s not extremely unethical for people with huntington‘s disease or cystic fibrosis to have children.

Both eggs and sperm producing cells are created during formation of embrio. We could even define that these cells as "clones of you" that were created not much after your first cells were created, because your DNA, that undergoes changes in your organism is never given to your offsprings - it is DNA of your "clone" cells. Eggs are as you have defined - "very old cells". Most probably cells that are producing sperm also can be defined as "very old cells" as most probably sperm production does not function the same way as other cells, that are staying in organism and accumulate mutations.

Stem cells from other organs has absolutelly nothing to do with this. Unless you are refering to procedures of planting stem cells from one organ to another to help failing organ, as stem cells are universal cells, that are able to produce cells for any organ.

The issue here is that with this approach we have to ask who has to be limited next. Especially if you get older...

>>>You can‘t seriously tell me it‘s not extremely unethical for people with huntington‘s disease or cystic fibrosis to have children. Don't flatter yourself - your genes are basic and ridddled with bad genes. You do not know what time bomb you are carying in your DNA.

The solution that you are offering is quite simple - procreate early as possible and die not in old age and voila - there are no issues in more than 99.99% cases. But something tells me that you are already older than healthy monkey and do not plan to live in a tree - your bones are too old for that and thanks to evolution are not meant for that.

Evolution of humans in future includes even longer lifespan which naturally comes with children produced at much later age than we do now and that comes with diseases to be dealt with, as that is part of evolution. We do not know much about mutations in DNA - they are never good or bad - they are combinations of something. For example - diabetes type 2 seems to be from genes, that allowed humans to survive hunger for long period of time - are those genes bad, because people are obese nowadays? As for mentioned diseases - we value other humans not by DNA, but what they are to us. You would sing a different song, when their offspring would have any of such disease and you are in luck and not planning to have any.

Most genetic diseases only occur when two parents happen to have it, but they won't necessarily be aware of it; would it be unethical for people who are unaware of their genetic defects to have children?

Second, according to a quick search, 10% of cases of Huntington's Disease are due to new mutations; I suspect (but I'm a HN commenter, no geneticist) this is the case for many other genetic conditions.

So the other ethics question to ask: should people be able to get DNA tests for genetic conditions (voluntary)? I'd say yes. Should people be mandated to get DNA tests and be forbidden to procreate if there's something in there? No, that's eugenics. Should people who know they have a genetic condition and there's a chance their child has it too have children? That'd be their choice. I don't think it's fair for people to intentionally place a burden on health care systems like that, but thing is, there's very, very few people that have children with that as the intent.