期刊
ANNUAL REVIEW OF GENOMICS AND HUMAN GENETICS, VOL 22, 2021
卷 22, 期 -, 页码 385-405出版社
ANNUAL REVIEWS
DOI: 10.1146/annurev-genom-111320-091930
关键词
gene editing; CRISPR; genetic disease; governance; regulation; international harmonization
Human gene editing, categorized into somatic therapy, heritable gene editing, genetic enhancement, and research, is subject to varying degrees of governance globally, especially in terms of heritable gene editing and genetic enhancement. The differences in regulatory approaches among different nations highlight the complex nature of human gene editing and call for a polycentric approach in governance.
Human gene editing, particularly using the new CRISPR/Cas9 technology, will greatly increase the capability to make precise changes to human genomes. Human gene editing can be broken into four major categories: somatic therapy, heritable gene editing, genetic enhancement, and basic and applied research. Somatic therapy is generally well governed by national regulatory systems, so the need for global governance is less urgent. All nations are in agreement that heritable gene editing should not proceed at this time, but there is likely to be divergence if and when such procedures are shown to be safe and effective. Gene editing for enhancement purposes is not feasible today but is more controversial with the public, and many nations do not have well-developed regulatory systems for addressing genetic enhancement. Finally, different nations treat research with human embryos very differently based on deeply embedded social, cultural, ethical, and legal traditions. Several international governance mechanisms are currently in operation for human gene editing, and several other governance mechanisms have been proposed. It is unlikely that any single mechanism will alone be effective for governing human gene editing; rather, a polycentric or ecosystem approach that includes several overlapping and interacting components is likely to be necessary.
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