Chinese researcher He Jiankui has been sentenced to prison for three years for genetic manipulation of babies. The case has set off a fierce debate among scientists and the general public. DW offers some key facts.
Image: picture-alliance/AP Photo/M. Schiefelbein
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What did He Jiankui do?
Just before a symposium in Hong Kong on 28 November 2018, the biophysicist announced that he had created human embryos by artificial insemination and had previously altered their genetic material using the CRISPR-Cas9 genetic scissors. The embryos had been implanted into the biological mothers, who then carried the babies. Two twin sisters had already been born prior to He's announcement. A third baby was born a little later.
What was the transgression?
In contrast to the usual artificial insemination, which doctors worldwide perform on couples who have an unfulfilled desire to have children, He Jiankui had carried out a process called germ-line interference. He manipulated the genetic material even before the sperm and egg were joined, with the aim of creating new, altered genetic material. If the children thus created will have children of their own, they will pass the altered genetic information on to them. This is believed to be first case worldwide of creating designer babies.
Ethicists in medicine and the life sciences reject germ-line intervention in humans almost without exception. They fear that such an approach could tempt doctors to play God and create human life a la carte: Parents might be able to select certain characteristics of their offspring, which can then be built into the genome before fertilization. The idea of repairing existing hereditary diseases before fertilization also meets with little support among ethicists. Parents who wish to have children often have the option of using sperm and eggs donated by healthy people.
How did He Jiankui justify the intervention?
The biophysicist justified the procedure by saying that the biological father of the two twin sisters was HIV positive. The aim was to give the babies a mutation of the CCR5 gene that would make them immune to the HIV virus. It was therefore ethically justified, he says.
Was the intervention necessary to protect the children from HIV?
No, even HIV-positive parents can give birth to healthy children if the parents consistently take their antiretroviral medication. In addition, the children must be treated from the beginning. It is also by no means medically certain that the babies have gained the promised immunity against HIV. Although there is a natural mutation of the CCR5 gene that makes people immune to HIV, the mutation introduced by He Jiankui is not identical to this one.
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What are the risks for the children?
There is a risk that the genetically modified material in the children will show completely unpredictable side effects later in life. Their life expectancy is probably significantly lower than that of children conceived normally, according to a study by doctors at the University of Berkeley.
How did the Chinese authorities react to the scandal?
Rather awkwardly. China is striving for research leadership in the field of genetic engineering also in the field of human medicine, but does not like bad press. With He Jiankui's sentencing, the Chinese government apparently wants to put an end to the scandal that hit it relatively unprepared in 2018. There are indications that many other scientists in his field shared He Jiankui's lack of awareness about the ramifications of such work. When the scandal broke out, documents from the hospital involved were available that showed that the medical ethics committee had even agreed to the procedure. Later, however, Chinese investigators raised doubts over the authenticity of these documents. Only after the scandal broke did close colleagues of the biophysicist distance themselves from him and his methods. Until then, He Jiankui had been promoted as a top researcher.
Now he has been sentenced to three years in prison and must pay a fine of three million yuan, which is the equivalent of about 380,000 euros.
Nobel Prize in Medicine: Achievements to heal and cure
Since 1901, when the year the Nobel Prize in Physiology or Medicine was first awarded, medicine has come a long way. But many discoveries researchers made back then still help patients today.
Image: Colourbox
1902: It's a mosquito's fault
British researcher Ronald Ross found out that mosquitoes transmit the tropical disease malaria. He showed that the Anopheles mosquito carries one-celled parasites that cause malaria. Today, 200 million people a year still catch malaria, and about half a million of them die because of it. But thanks to Ross' findings, researchers were able to develop treatments to fight the disease.
Robert Koch discovered the tuberculosis pathogen, the bacterium mycobacterium tuberculosis. Tuberculosis is still a globally widespread infectious disease. Treatment is possible but protracted, even though there are antibiotics for the illness today. There is also a vaccine which protects children, but not adults.
Image: AP
1912: Switching organs and stitching them up
French surgeon Alexis Carrel succeeded at transplanting blood vessels and entire organs. He developed a suture technique with which he could stitch torn blood vessels back together. He also discovered how to store organs outside the human body. Today, doctors transplant roughly 100,000 organs every year.
Image: picture-alliance/dpa
1924: Watching the heart beat
Dutch doctor Willem Einthoven developed the electro-cardiogram (EKG) to a point where it could be used in hospitals and doctor's offices. An EKG records the heart's electric activity. The data it provides helps doctors recognize an irregular heart rhythm and other heart diseases. It's a wide-spread method in modern medicine.
Image: Fotolia
1930: Four types of blood
Austrian physician Karl Landsteiner discovered that mixing the blood of two different people often - but not always - led to clotting. He soon found the cause for that phenomenon: the different blood types A, B and O (which he called C). Later, his colleagues also discovered the blood type AB. Because of these findings, safe blood transfusions became possible.
Image: picture-alliance/dpa
1939, 1945 and 1952: Drugs to kill bacteria
Three Nobel Prizes went to the discoverers and developers of antibiotics, among them Alexander Fleming (1945), who discovered penicillin. Today, antibiotics are still some of the most commonly used drugs and often save lives. New kinds of antibiotics constantly need to be developed, however, as bacteria become resistant to the medicines.
Image: Fotolia/Nenov Brothers
1948: Attacking mosquitoes
The chemical compound DDT kills insects but hardly affects mammals, as Swiss chemist Paul Hermann Müller found out. Following that discovery, DDT became one of the most used insecticides worldwide. But then it turned out that DDT was damaging to the environment, especially to birds, and its use is now frowned upon. But it is still being used is places where mosquitoes are known to carry malaria.
Image: picture-alliance/dpa
1956: Straight to the heart
German physician Werner Forssmann received the Nobel Prize together with two colleagues for the development of cardiac catheterization. Forssmann conducted the procedure for the first time on himself. It calls for inserting a tube into an artery in the hand, bend of the elbow or the groin, and pushing it up to the heart.
Image: picture-alliance/Andreas Gebert
1979 and 2003: Looking into the human body
When you wanted to see the inside of a human body, there used to be only one way: X-rays. But by now, doctors have superior methods. One of them is computed tomography (CT), which also uses x-rays, but takes detailed pictures of the body's "layers" as if it were cut into slices. The discovery was followed by that of magnetic resonance tomography (MRI), which works with harmless magnetic fields.
Image: picture-alliance/dpa
2008: Cancer caused by a virus
Thanks to Harald zur Hausen from the German Center for Cancer Research, we know that the human papillomavirus can cause cervical cancer. This knowledge helped the development of vaccines against the virus. Girls and women can now be vaccinated against the viral type of cervical cancer.
Image: AP
2010: Test-tube babies
Robert Edwards developed the in-vitro fertilization. The first baby that was created this way was born in England in 1978. Advancements improved the method's success-rate further. Globally, several million in-vitro babies have been born.
Image: picture-alliance/ZB
2018: Unleashing the immune system to fight cancer
We all have natural defenses against tumors in us. We only need to release the natural brakes in the immune system. James P. Allison and Tasuku Honjo have laid the foundation for a cancer treatment in which tumors which have already formed metastases recede. At the end of the therapy, many patients remained cancer-free — a huge breakthrough.
Image: Imago/Science Photo Library/A. Pasieka
2019: Undertanding how cells adapt to oxygen
William Kaelin, Peter Ratcliffe and Gregg Semenza discovered how cells sense and adapt to the availability of oxygen. When oxygen level change, cells undergo shifts in gene expression. Responses include cell metabolism, tissue remodeling and heart rate. It plays a role at high altitudes and has medical implications from exercising to pregnancy, altitude sickness and wound healing.
