Future Imperfect

By Susan Comrie

His father's eyes, his mother's looks – in the future this won't be left up to the genetic lottery. With the completion of the Human Genome Project in 2003, scientists predict that one day we will be able to choose our baby’s physical characteristics, intelligence and resistance to disease as easily as buying a CD online.

                                

In Loudon, Tennessee some of the world's first genetically engineered workers are already putting this technology to use in a totally unexpected way. At the DuPont factory, deep in the heart of Loudon’s manufacturing district, genetically altered e-Coli bacteria is hard at work creating polyester to be used in carpets, plastic and even clothing. With just 23 little nip-tucks to the bacteria's genetic code, scientists have altered this micro-organism so that when it digests corn it produces a type of polyester called propane diol - 45 million kilograms of it a year to be precise. Of course the idea that this same technology could one day be used on human beings is something that makes most of us recoil in horror. Yet repro-genetics is no longer the domain of science fiction – every day more and more parents are opting to use newly developed technology in the field of genetics to cure infertility, diagnose diseases and give their children the edge over their peers.

Dr. Munro P. Marx, head of Unistel Medical Laboratories in Cape Town, specialises in making those dreams come true. Having worked on the Human Genome Project, Dr Marx's team is at the forefront of genetic diagnostics, being able to diagnose more than 700 genetic disorders in an embryo just days after cell-division begins. "We are a Human Genetics Diagnostic Laboratory and one of the things we do is a prenatal diagnosis for women whose babies have an increased risk of chromosome abnormalities," Dr Marx says. "There may be a hereditary link but any woman over 35 has an increased risk of having a baby, not just with Down's Syndrome, but also many other diseases. IVF also increases the risk of the child being born with genetic abnormalities. You have to remember that with IVF, all this is a very unnatural process, and you're starting off with bad material to begin with. But, if the embryo is healthy, we can implant it within a very short period of time."

Although genetic diagnostics is a more common procedure for women who have struggled to fall pregnant, or women who have had repeat miscarriages, more and more couples who can fall pregnant naturally are opting to interfere in a bid to improve their child's chances of a healthy life. Monthly breakthroughs in the field of genetics are discovering genes that determine everything from cancer risks to obesity to depression, but geneticists disagree on whether it's right for parents to start picking and choosing with embryos because there is a chance that their child could one day develop a disease which could affect their quality of life. While few people would argue against testing for Down's Syndrome, deciding to terminate a healthy pregnancy because the child carries the gene that causes breast cancer is ethically murky water.

"It is possible to test for a gene defect but it's expensive and very complicated to develop a reliable diagnosis," Dr Marx explains. "The question is what are you going to do with the results? Is it ethically correct to terminate a pregnancy because there is a risk of breast cancer when there are many people who carry the gene for breast cancer but it is never expressed? The fact is no one has perfect DNA - we all carry a certain number of mutations and there are so many other factors which could cause those mutations to be expressed. With Down's Syndrome, Prada-Willi Syndrome or Huntington’s Disease, you know what you are in for. But with gene defects, it's greatly unchartered territory there is just no guarantee."

This hasn't stopped medical labs from offering this service for people who are willing to pay to improve their child's odds. And with enough money, a parent could even choose to go beyond diagnostics and enter into genetic manipulation. In 2001 a US fertility clinic announced that several genetically altered babies had been born by swapping out defective mitochondria in the mother's egg cell with healthy mitochondria from a donor. Test on the children years later showed that they carried a small amount of DNA that didn't come from either of their parents, effectively altering their genetic germline - something which is considered highly unethical by many in the field. Although many countries have laws which prevent this kind of genetic intervention, geneticists at Newcastle University in the UK are working to develop this technique and believe it could one day be the answer to eliminating thousands of diseases like muscular dystrophy which are born through defects in the mitochondria.

Money, more than ethics, is the voice of reason in the field of genetics at the moment. And with new technology fast outstripping current laws, money will play an even bigger role in the future. For now the idea of unscrupulous private clinics getting rich by engineering designer babies for wealthy clients remains purely science fiction, but many experts worry that as the technology becomes more available, the cost of these procedures will further widen the gap between rich and poor and the genetic have’s and have not’s.

"Everything gets cheaper, so one day it may become a reality, but for now anyone who thinks that they can make money out of bio- tech is kidding themselves," Dr Marx says. "To map the human genome of one human being cost more than to put a man on the moon. No DNA Biotech Company in the world is running in the black - most only survive with government grants and research grants."

Where money matters most is in research. The Human Genome Project provided a roadmap for human life by telling us the exact sequence of genes in our DNA. What it hasn’t given us though is much information on what functions each individual gene performs and how mutations in a particular gene affect the way that we look or act. Deciphering that code is starting to become big business for medical research companies who are hoping to patent their discoveries and sell on the information at a price. Just how commercially viable genetic engineering is, remains a big question. The technology with the biggest chance of success involved stimulating different genes in the body so as to make healthy genes dominant, keeping defective ones from being expressed. Instead of actually replacing genes with "knock-outs" and "knock-ins", which destabilises the DNA, geneticists are trying to discover how and why some people with the gene for breast cancer for instance never develop the disease. If we can figure out how the body keeps defective genes at bay, we may be able to harness that power and stop our own rogue genes from being expressed.

This technology would be much less invasive than gene therapy, which once looked like a cure-all solution, but which is looking less promising as the mechanics of the technology is developed. Gene therapy involves infecting the body with a genetically altered virus. Instead of attacking the body's cells the virus would insert a piece of good DNA to heal the damaged DNA into each cell in the body, curing gene defects that the person was born with.

"We have only just started to scratch the surface of this technology," Dr Marx says. "Where gene therapy fails is that it is delivered with a virus and all that has to be done while the immune system is completely broken down. If you have a strong immune system it will eventually reject the virus, so the idea of athletes using gene therapy to make themselves faster and stronger just isn't going to happen." Stem cell research also provides a much more promising answer and already thousands of parents in South Africa are making use of companies like Lazaron, Cryoclinic and Netcells which harvest and store stem cells collected from the baby's umbilical cord shortly after birth. Although the procedure is expensive and the technology untested, the promise that these stem cells could one day be used to heal a damaged organ in the child's body or cure diabetes is a strong reason for parents to invest in this technology.

For the moment, creating designer babies remains out of our reach. While current tests can diagnose severe genetic abnormalities and even defective genes, being able to pick and choose a baby's looks and intelligence is still a long way off. Although scientists are making new discoveries every day, human DNA still remains a mystery in many ways. Research has shown that genes have the ability to learn over several generations, passing down skills in things like maths and music from one person to the next. Altering that genetic line may be able to prevent certain diseases, but so far we have very little idea of the detrimental effect that tweaking our DNA could have on the legacy that we leave. Yes, money talks; but for now at least common sense prevails.