• Russian biologist plans more CRISPR-edited babies

    Je n’ai pas réussi à extraire une simple partie de ce texte, tant l’ensemble me semble complètement hors-jeu. Je partage l’avis de l’auteur de l’article : la folie et l’hubris scientifiques se serrent la main dans le dos de l’humanité. Choisir de surcroit des femmes en difficulté (HIV positive) est bien dans la lignée machiste d’une science qui impose plus qu’elle ne propose.

    La guerre internationale à la réputation, la course à « être le premier » (ici le masculin s’impose), la science sans conscience ne peuvent que provoquer ce genre de dérives. Il faudra réfléchir à une « slow science » et à un réel partage des découvertes, qui permettrait de prendre le temps du recul, et qui pourrait associer la société civile (ici au sens de celle qui n’est pas engagée dans la guerre des sciences).

    The proposal follows a Chinese scientist who claimed to have created twins from edited embryos last year.
    David Cyranoski

    Denis Rebrikov

    Molecular biologist Denis Rebrikov is planning controversial gene-editing experiments in HIV-positive women.

    A Russian scientist says he is planning to produce gene-edited babies, an act that would make him only the second person known to have done this. It would also fly in the face of the scientific consensus that such experiments should be banned until an international ethical framework has agreed on the circumstances and safety measures that would justify them.

    Molecular biologist Denis Rebrikov has told Nature he is considering implanting gene-edited embryos into women, possibly before the end of the year if he can get approval by then. Chinese scientist He Jiankui prompted an international outcry when he announced last November that he had made the world’s first gene-edited babies — twin girls.

    The experiment will target the same gene, called CCR5, that He did, but Rebrikov claims his technique will offer greater benefits, pose fewer risks and be more ethically justifiable and acceptable to the public. Rebrikov plans to disable the gene, which encodes a protein that allows HIV to enter cells, in embryos that will be implanted into HIV-positive mothers, reducing the risk of them passing on the virus to the baby in utero. By contrast, He modified the gene in embryos created from fathers with HIV, which many geneticists said provided little clinical benefit because the risk of a father passing on HIV to his children is minimal.

    Rebrikov heads a genome-editing laboratory at Russia’s largest fertility clinic, the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology in Moscow and is a researcher at the Pirogov Russian National Research Medical University, also in Moscow.

    According to Rebrikov he already has an agreement with an HIV centre in the city to recruit women infected with HIV who want to take part in the experiment.

    But scientists and bioethicists contacted by Nature are troubled by Rebrikov’s plans.

    “The technology is not ready,” says Jennifer Doudna, a University of California Berkeley molecular biologist who pioneered the CRISPR-Cas9 genome-editing system that Rebrikov plans to use. “It is not surprising, but it is very disappointing and unsettling.”

    Alta Charo, a researcher in bioethics and law at the University of Wisconsin-Madison says Rebrikov’s plans are not an ethical use of the technology. “It is irresponsible to proceed with this protocol at this time,” adds Charo, who sits on a World Health Organization committee that is formulating ethical governance policies for human genome editing.
    Rules and regulations

    Implanting gene-edited embryos is banned in many countries. Russia has a law that prohibits genetic engineering in most circumstances, but it is unclear whether or how the rules would be enforced in relation to gene editing in an embryo. And Russia’s regulations on assisted reproduction do not explicitly refer to gene editing, according to a 2017 analysis of such regulations in a range of countries. (The law in China is also ambiguous: in 2003, the health ministry banned genetically modifying human embryos for reproduction but the ban carried no penalties and He’s legal status was and still is not clear).

    Rebrikov expects the health ministry to clarify the rules on the clinical use of gene-editing of embryos in the next nine months. Rebrikov says he feels a sense of urgency to help women with HIV, and is tempted to proceed with his experiments even before Russia hashes out regulations.

    To reduce the chance he would be punished for the experiments, Rebrikov plans to first seek approval from three government agencies, including the health ministry. That could take anywhere from one month to two years, he says.

    Konstantin Severinov, a molecular geneticist who recently helped the government design a funding program for gene-editing research, says such approvals might be difficult. Russia’s powerful Orthodox church opposes gene editing, says Severinov, who splits his time between Rutgers University in Piscataway, New Jersey, and the Skolkovo Institute of Science and Technology near Moscow.

    Before any scientist attempts to implant gene-edited embryos into women there needs to be a transparent, open debate about the scientific feasibility and ethical permissibility, says geneticist George Daley at Harvard Medical School in Boston, Massachusetts, who also heard about Rebrikov’s plans from Nature.

    One reason that gene-edited embryos have created a huge global debate is that, if allowed to grow into babies, the edits can be passed on to future generations — a far-reaching intervention known as altering the germ line. Researchers agree that the technology might, one day, help to eliminate genetic diseases such as sickle-cell anaemia and cystic fibrosis, but much more testing is needed before it is used in the alteration of human beings.

    In the wake of He’s announcement, many scientists renewed calls for an international moratorium on germline editing. Although that has yet to happen, the World Health Organization, the US National Academy of Sciences, the UK’s Royal Society and other prominent organizations have all discussed how to stop unethical and dangerous uses — often defined as ones that pose unnecessary or excessive risk — of genome editing in humans.
    HIV-positive mothers

    Although He was widely criticized for conducting his experiments using sperm from HIV-positive fathers, his argument was that he just wanted to protect people against ever getting the infection. But scientists and ethicists countered that there are other ways to decrease the risk of infection, such as contraceptives. There are also reasonable alternatives, such as drugs, for preventing maternal transmission of HIV, says Charo.

    Rebrikov agrees, and so plans to implant embryos only into a subset of HIV-positive mothers who do not respond to standard anti-HIV drugs. Their risk of transmitting the infection to the child is higher. If editing successfully disables the CCR5 gene, that risk would be greatly reduced, Rebrikov says. “This is a clinical situation which calls for this type of therapy,” he says.

    Most scientists say there is no justification for editing the CCR5 gene in embryos, even so, because the risks don’t outweigh the benefits. Even if the therapy goes as planned, and both copies of the CCR5 gene in cells are disabled, there is still a chance that such babies could become infected with HIV. The cell-surface protein encoded by CCR5 is thought to be the gateway for some 90% of HIV infections, but getting rid of it won’t affect other routes of HIV infection. There are still many unknowns about the safety of gene editing in embryos, says Gaetan Burgio at the Australian National University in Canberra. And what are the benefits of editing this gene, he asks. “I don’t see them.”
    Hitting the target

    There are also concerns about the safety of gene editing in embryos more generally. Rebrikov claims that his experiment — which, like He’s, will use the CRISPR-Cas9 genome-editing tool — will be safe.

    One big concern with He’s experiment — and with gene-editing in embryos more generally — is that CRISPR-Cas9 can cause unintended ‘off-target’ mutations away from the target gene, and that these could be dangerous if they, for instance, switched off a tumour-suppressor gene. But Rebrikov says that he is developing a technique that can ensure that there are no ‘off-target’ mutations; he plans to post preliminary findings online within a month, possibly on bioRxiv or in a peer-reviewed journal.

    Scientists contacted by Nature were sceptical that such assurances could be made about off-target mutations, or about another known challenge of using CRISPR-Cas 9 — so-called ‘on-target mutations’, in which the correct gene is edited, but not in the way intended.

    Rebrikov writes, in a paper published last year in the Bulletin of the RSMU, of which he is the editor in chief, that his technique disables both copies of the CCR5 gene (by deleting a section of 32 bases) more than 50% of the time. He says publishing in this journal was not a conflict of interest because reviewers and editors are blinded to a paper’s authors.

    But Doudna is sceptical of those results. “The data I have seen say it’s not that easy to control the way the DNA repair works.” Burgio, too, thinks that the edits probably led to other deletions or insertions that are difficult to detect, as is often the case with gene editing.

    Misplaced edits could mean that the gene isn’t properly disabled, and so the cell is still accessible to HIV, or that the mutated gene could function in a completely different and unpredictable way. “It can be a real mess,” says Burgio.

    What’s more, the unmutated CCR5 has many functions that are not yet well understood, but which offer some benefits, say scientists critical of Rebrikov’s plans. For instance, it seems to offer some protection against major complications following infection by the West Nile virus or influenza. “We know a lot about its [CCR5’s] role in HIV entry [to cells], but we don’t know much about its other effects,” says Burgio. A study published last week also suggested that people without a working copy of CCR5 might have a shortened lifespan.

    Rebrikov understands that if he proceeds with his experiment before Russia’s updated regulations are in place, he might be considered a second He Jiankui. But he says he would only do so if he’s sure of the safety of the procedure. “I think I’m crazy enough to do it,” he says.

    Nature 570, 145-146 (2019)
    doi: 10.1038/d41586-019-01770-x

  • Viral hepatitis: A silent epidemic killing more people than HIV, ma...

    Viral hepatitis: A silent epidemic killing more people than HIV, malaria or TB

    Viral hepatitis is on the rise. Tackling hepatitis B in Africa is key to fighting back. Article word count: 2534

    HN Discussion: Posted by pseudolus (karma: 2692) Post stats: Points: 153 - Comments: 63 - 2018-12-07T14:03:41Z

    #HackerNews #epidemic #hepatitis #hiv #killing #malaria #more #people #silent #than #viral

    Article content:

    Nuru was prepared for the worst when she went to get screened for HIV eight years ago. After caring for her mother in Uganda, who died as a result of the virus, Nuru moved to the United Kingdom to study, and decided to take her health into her own hands. “I was ready to be told I had HIV,” she says. “I felt, ‘That’s okay. I’ve (...)

  • The controversial case of a rogue scientist responsible for the world’s the first gene-edited babies | Alternet

    Public perception

    This backlash may have caught He by surprise. According to one report, He commissioned a large-scale public opinion survey in China a few months prior to the announcement. The survey found that over 70 percent of the Chinese public was supportive of using gene editing for HIV prevention. This is roughly in line with a recent Pew poll in the United States that found 60 percent of Americans support using gene editing on babies to reduce lifetime risk of contracting certain diseases.
    Report Advertisement

    But polling tells only part of the story. The same Chinese poll also found very low levels of public understanding of gene editing and did not mention the details of He’s study. Abstract polling questions ignore the risks and state of the science, which were crucial to most objections to He’s experiment. It also obscures the involvement of embryos in gene editing. In the American Pew poll, despite overall support for gene editing, 65 percent opposed embryonic testing – a necessary step in the process of gene editing to address disease.

    Moreover, polling is a crude and simplistic way to engage in public debate and deliberation over the controversial issue of gene editing. Various bodies, such as the National Academies of Sciences, Medicine and Engineering in the U.S. and the Nuffield Council on Bioethics in the U.K., have emphasized that, for gene editing to proceed to human trials, a robust public discussion is first needed to establish its legitimacy.

    But looking a little closer reveals other, more problematic motivations.

    For such couples, it is possible to safely conceive an HIV-negative child using robust IVF procedures. Such therapy is expensive, prohibitively so for many couples. But He’s study offered a particularly enticing carrot – free IVF treatment and supportive care, along with a daily allowance and insurance coverage during the treatment and pregnancy. According to the consent form, the total value of treatments and payments was approximately US$40,000 – over four times the average annual wage in urban China.

    This raises a serious concern of undue inducement: paying research participants such a large sum that it distorts their assessment of the risks and benefits. In this gene editing context, where the risks are incredibly uncertain and there is substantially limited general understanding of genetics and gene editing, society should be especially concerned about the distorting effect of such a large reward on the participants’ provision of free and informed consent.

    #Gene_editing #Designer_babies #Ethique

  • Chinese scientists are creating #CRISPR babies - MIT Technology Review

    According to Chinese medical documents posted online this month (here and here), a team at the Southern University of Science and Technology, in Shenzhen, has been recruiting couples in an effort to create the first gene-edited babies. They planned to eliminate a gene called CCR5 in hopes of rendering the offspring resistant to #HIV, smallpox, and cholera.

    #recherche #génétique #gattaca

  • Offline: Why has global health forgotten cancer? - The Lancet

    Nothing illustrates the embedded irrationality of global health more than our attitudes to cancer. In 2016, according to the Global Burden of Disease, 8·9 million people died from cancer (23% of total worldwide deaths from NCDs, and 16% of deaths from all causes). The leading causes of cancer death are tumours of the trachea, bronchus, and lung (1·7 million deaths); gynaecological cancers (breast, cervix, ovary, and uterus: 1 million deaths); gastric cancer (834 000 deaths); colorectal cancer (829 600 deaths); and liver cancer (828 000 deaths). So why the indifference?

    The NCD community has become trapped in an ideology that privileges prevention over treatment. A similar mistake disfigured the early response to AIDS. I can recall senior WHO leaders two decades ago agreeing that a generation of people living with HIV would have to die before the pandemic could be controlled by prevention. Only anger and activism overturned the complacency of traditional public health practice. But the NCD community has no time for anger or activism

    #cancer #OMS #prévention #traitement (again)

  • The Importance of Diversity in Cartography | Trajectory Magazine

    Exploring the meaningful influence of female and minority mapmakers

    (...) In nations with less social parity, the information delivered by these humanitarian mapping projects has life-changing implications. Women in Africa, South America, and other parts of the world are often forced to either travel long distances for services such as HIV testing and counseling, cancer screenings, and OB-GYN services, or to forgo those services altogether. Many times, these services are available locally, but are not advertised or marked in existing maps. Accurate, up-to-date maps containing information pertinent to women’s health can prevent deaths or injuries as a result of HIV/AIDS and maternal complications—the top two causes of death globally for women ages 15-44.

    #femmes #cartographie #humanitaire

  • How both sides in Ukraine’s war are losing the #HIV battle

    Displacement, aid delivery issues, and different strategies are all feeding a raging epidemic.
    Every month or so, health project manager Yulia sets off on an arduous 24-hour, 100-kilometre journey across eastern Ukraine’s “contact line” from Severodonetsk to the rebel-held city of Luhansk. It is the front line not only of a conflict that has claimed more than 10,000 lives since early 2014 but also of one of Europe’s worst HIV epidemics.
    #sida #AIDS #Ukraine #santé

  • Aetna May Have Exposed The HIV Status Of Thousands Of Clients | HuffPost

    Insurance company Aetna Inc. inadvertently revealed the HIV status of potentially thousands of its customers when it sent information about HIV medication using an envelope with a mailing window large enough to read the letter’s contents, according to reports. Aetna sent the letter to about 12,000 people, Time reported.

    In addition to breaking privacy laws that give people the right to have their medical information protected, the breach also put people’s safety at risk, as HIV stigma is still strong in the U.S.

    Several of the affected clients said that family members and neighbors had learned that they were using HIV medication from these mailers, the letter from the nonprofit advocacy groups said.

    People have been denied medical and dental care on the basis of their HIV status. People have been fired or had job offers rescinded on the basis of their HIV status. Indeed, shame and fear about the infection prevents many from getting tested in the first place. The U.S. Centers for Disease Control and Prevention estimates that 15 percent of Americans with HIV don’t know that they have it.

    #Données_santé #Sécurité_informatique

  • Aetna May Have Exposed The #HIV Status Of Thousands Of Clients | HuffPost

    Insurance company Aetna Inc. inadvertently revealed the HIV status of potentially thousands of its customers when it sent information about HIV medication using an envelope with a mailing window large enough to read the letter’s contents, according to reports. Aetna sent the letter to about 12,000 people, Time reported.

    In addition to breaking privacy laws that give people the right to have their medical information protected, the breach also put people’s safety at risk, as HIV stigma is still strong in the U.S.

    #privacy (au minimum…) #secret_médical

  • WHO | WHO validates elimination of mother-to-child transmission of HIV and syphilis in #Cuba

    30 JUNE 2015 ¦ GENEVA ¦ WASHINGTON - Cuba today became the first country in the world to receive validation from WHO that it has eliminated mother-to-child transmission of HIV and syphilis.

    “Eliminating transmission of a virus is one of the greatest public health achievements possible,” said Dr Margaret Chan, WHO Director-General. “This is a major victory in our long fight against HIV and sexually transmitted infections, and an important step towards having an AIDS-free generation” she added.

    Michel Sidibé, Executive Director of UNAIDS: “This is a celebration for Cuba and a celebration for children and families everywhere. It shows that ending the AIDS epidemic is possible and we expect Cuba to be the first of many countries coming forward to seek validation that they have ended their epidemics among children.”

    #VIH #SIDA #enfant #santé #bonne_nouvelle

    Viva Cuba !

  • New report says completing a course of antibiotics even after symptoms abate is overrated

    Vers une remise en cause de la stratégie d’utilisation des antibiotiques ?

    Scientists have explained the mechanism of development of antibiotic resistance.

    • Target selected resistance - When a microbe multiplies within the host it leads to infection. These microbes may undergo genetic mutations that may make them deadlier and resistant to antibiotics. These genetic mutations are seen to be accelerated in case of inadequate dosing of the antibiotics or when a single drug is used to kill the microbe. Tuberculosis, HIV, typhoid, malaria and gonorrhoea are notable infections that develop resistance in this manner.

    • Collateral selection – There are several bacteria types that live harmlessly within the gut or other mucus membranes. During antibiotic treatment for other infections, these harmless bacteria genetically mutate to become resistant and cause infections. Their mutations are passed on to other strains of the bacteria leading to antibiotic resistance. Organisms that show this type of resistance include Methicillin Resistant Staph aureus (MRSA).

    Researchers have seen that most of the antibiotic resistance now does not come from the first type of resistance selection or target selection. This means the second type is more common. This also means that longer the duration of the antibiotic use, longer the time the harmless bacteria in the gut gets to develop resistance and pass it on to the other strains and species of bacteria. These harmless bacteria are called “opportunistic pathogens” which means they become dangerous only at certain times i.e. antibiotic use, immunosuppression etc.

    In this new work, researchers have suggested optimum usage of antibiotics as the key to prevent resistance.

    • L’article original (accessible)

      The antibiotic course has had its day | The BMJ

      Key messages
      • Patients are put at unnecessary risk from antibiotic resistance when treatment is given for longer than necessary, not when it is stopped early
      • For common bacterial infections no evidence exists that stopping antibiotic treatment early increases a patient’s risk of resistant infection
      • Antibiotics are a precious and finite natural resource which should be conserved by tailoring treatment duration for individual patients
      • Clinical trials are required to determine the most effective strategies for optimising duration of antibiotic treatment

    • Why you really should take your full course of antibiotics

      Feeling better doesn’t mean you’re past the worst.
      Jonathan Cox, Author provided

      An article in the BMJ argues that contrary to long-given advice, it is unnecessary to make sure you finish all the antibiotics you’re prescribed. The article sparked debate among experts and more worryingly widespread confusion among the general public, who are still getting to grips with what they need to do to stem antibiotic resistance. Even my colleagues at the university this morning were asking me whether or not to finish their course of antibiotics.

      As an active campaigner for action to halt the progression of antibiotic resistance and a firm promoter of the “finish the course” message, the article and that the scale of coverage concerns me greatly.
      Only time will tell as to what the impact of suggesting people stop taking antibiotics when they feel better will be. I believe this has undone a lot of the hard work scientists like myself have invested in improving antibiotic awareness and personal responsibility surrounding antibiotic administration. Nevertheless, we all need to follow the advice of our clinicians who will no doubt hold out for some more conclusive scientific evidence before changing their advice surrounding antibiotics.

  • Prudence Mabele was a radical who led the struggle for openness about HIV, by Zackie Achmat | GroundUp

    Prudence was radical because she was a black woman: the first to come out in national newspapers as living with HIV, and unafraid of people knowing that she loved women. She was followed by Mercy Makhalemele, the first black heterosexual woman and mother to live openly with HIV. Prudence was radical in her own right and brought a vivaciousness to radicalism in the Treatment Action Campaign (TAC).

  • In 2016, drug overdoses likely killed more Americans than the entire wars in Vietnam and Iraq

    “Every year for the past few years, we’ve gotten even more horrible statistics showing the harrowing impact of the opioid epidemic on America. In 2015, overall drug overdose deaths, largely as a result of the opioid crisis, reached a new historic record — topping deaths from guns or cars that year, and even the toll from HIV/AIDS at the height of that epidemic’s peak in 1995.

    In 2016, we got another awful statistic: Drug overdose deaths reached another record — and, based on the highest estimate by a New York Times analysis of state data, topped total US casualties from the entire wars in Vietnam and Iraq.

    The Times’s analysis calculated that 59,000 to 65,000 people died of overdoses in 2016, with a harder, but likely imprecise, number of 62,497. (We’ll get the official numbers later in 2017.) In comparison, more than 58,200 US troops died in the Vietnam War between 1955 and 1975, and more than 4,500 have died so far in the Iraq War since 2003 — which adds up to more than 62,700.

    Although it’s hard to say for certain, the Times suggested “the [opioid] problem has continued to worsen in 2017.” In short, the opioid epidemic was already the deadliest drug crisis in American history in 2015. It got much deadlier in 2016, and is likely even worse so far in 2017.

    It can be hard to conceptualize the numbers we’re talking about here. So Bella Lucy from Vox’s graphics team put together the following chart. It requires a bit of scrolling.” @fil

  • Boom in human gene editing as 20 CRISPR trials gear up | New Scientist

    The CRISPR genome editing revolution continues to advance at an astounding pace. As many as 20 human trials will be under way soon, mostly in China, New Scientist has learned.

    One of these trials will involve the first-ever attempt to edit cells while they are inside the body. The aim is to prevent cervical cancers by using CRISPR to target and destroy the genes of the human papillomavirus (HPV) that cause tumour growth. This study is due to begin in July at the First Affiliated Hospital of Sun Yat-Sen University in China.

    Gene therapy, which involves adding extra genes to cells, was first used to cure people in 1990, but it is mainly useful for treating rare genetic disorders. In contrast, gene-editing, which involves altering existing genes inside cells, promises to treat or cure a much wider range of conditions, from HIV infection to high blood cholesterol.

    The HPV trial, meanwhile, will break new ground. Instead of editing cells outside the body, a gel containing DNA coding for the CRISPR machinery will be applied to the cervix. The CRISPR machinery should leave the DNA of normal cells untouched, but in cells infected by HPV, it should destroy the viral genes, preventing them from turning cancerous.

    “Targeting HPVs seems a sensible approach if they can deliver the genome-editing components to sufficient numbers of cells,” says Robin Lovell-Badge of the Crick Institute in the UK.

    #génomique #médecine
    “It is tricky to do these experiments in animals as they are not infectable by HPV,” says Bryan Cullen of Duke University Medical Center in North Carolina, whose group also hopes to use gene editing to get rid of HPV. But there is a risk of off-target mutations leading to cancer, he warns.

  • #CRISPR Eliminates #HIV in Live Animals | GEN

    Due to their innate nature to hide away and remain latent for extended periods of time, HIV infections have proven notoriously difficult to eliminate. Yet now, new data released from a research team led by investigators at the Lewis Katz School of Medicine at Temple University (LKSOM) and the University of Pittsburgh shows that HIV DNA can be excised from the genomes of living animals to eliminate further infection. Additionally, the researchers are the first to perform this feat in three different animal models, including a “humanized” model in which mice were transplanted with human immune cells and infected with the virus. Findings from the new study were published recently in Molecular Therapy in an article entitled “In Vivo Excision of HIV-1 Provirus by saCas9 and Multiplex Single-Guide RNAs in Animal Models.”

  • ’We can’t accept the new HIV, TB plan’ - Treatment Action Campaign-Bhekisisa

    It is a disgrace that over the last 10 years, we have made almost no progress on the employment of community healthcare workers — an area in which this new national plan also fails.

    #TAC #Afrique_du_Sud #santé

  • Devastating HIV epidemic hits Russia - World Socialist Web Site

    Devastating HIV epidemic hits Russia
    By Clara Weiss
    10 January 2017

    A quarter century after the dissolution of the USSR in December 1991, an HIV epidemic, closely bound up with massive heroin consumption, is raging in Russia. It is a devastating indictment of the social catastrophe that was brought about by the restoration of capitalism.

    According to Vadim Pokrovski, head of the Federal AIDS Centre in Moscow, around 850,000 Russians were diagnosed with HIV at the beginning of 2016. Another 220,000 have died of AIDS since the late 1980s. He estimates that another half-million Russians are infected, but not diagnosed, with HIV. An estimated 100,000 were newly infected in 2016.

    #russie #santé #Sida #hiv