Students\u2019 attitudes towards somatic genome editing versus genome editing of the germline using an example of familial leukemia

Beate Vajen,Smilla Ebeling,Corinna Hößle,Joelle Ronez,Brigitte Schlegelberger,Laura Heinisch,Wiebke Rathje,Ulrich Gebhard

doi:10.1007/s12687-021-00528-1

Abstract

Although the discussion on possibilities and pitfalls of genome editing is ever present, limited qualitative data on the attitudes of students, who will come into contact with this technology within a social and professional context, is available. The attitude of 97 medical students and 103 students of other subjects from Hannover and Oldenburg, Germany, was analyzed in winter 2017/18. For this purpose, two dilemmas on somatic and germline genome editing concerning familial leukemia were developed. After reading the dilemmas, the students filled out a paper-and-pencil test with five open questions. The qualitative evaluation of the answers was carried by a deductive-inductive procedure of content analysis. There was a high approval for the use of somatic genome editing. When it came to germline genome editing, concerns were raised regarding enhancement, interventions in nature, and loss of uniqueness. The students recognized that somatic genome editing and germline genome editing prove different ethical challenges and need to be judged separately. Many students expressed not feeling fully informed. The results of this project show the importance of educating the public about the possibilities, limitations, and risks of somatic and germline genome editing. We recommend that this should already be addressed in schools in order to optimally prepare students and adults for participation in public discourse. Especially for patients affected by genetic diseases, it is of great importance that the treating physicians and geneticists are sufficiently informed about the method of genome editing to ensure good counseling.

Highlights

Scientists have had the tools to modify the genomes of organisms since the 1970s
Specific guide RNAs allow the Cas proteins to bind to their target DNA sequence with high accuracy, genetic changes can be introduced at other unintended locations in the genome as so-called off-target effects
Students who will come into contact with this technology in a professional context such as medical students did not feel informed enough

Summary

Introduction

Scientists have had the tools to modify the genomes of organisms since the 1970s. the emergence of the CRISPR-Cas technology in 2012 marks a decisive breakthrough in genome editing because of its ability to introduce precise, time-saving, and inexpensive genetic changes into the human genome (CRISPR: clustered regularly interspaced short palindromic repeats, Cas: CRISPR-associated) The resulting DNA double-strand is repaired by the error-prone repair mechanism of non-homologous. Specific guide RNAs allow the Cas proteins to bind to their target DNA sequence with high accuracy, genetic changes can be introduced at other unintended locations in the genome as so-called off-target effects. Homology-directed repair (HDR) is an alternative repair mechanism, that allows error-free repair (Zaboikin et al 2017) in which the cell uses an intact copy of the DNA sequence as a template. This mechanism is used in genome editing approaches for an error-free correction of genetic changes (Jinek et al 2012). Numerous clinical studies have been initiated and are still ongoing with the aim of developing a causal treatment of genetically determined diseases by means of somatic genome editing (Hu 2017; Lu 2016; Wu 2017)

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