We are the expert contributors to a free online course on the science, ethics, and societal impacts of CRISPR Gene Editing - ask us anything!

How long before CRISPR is available and affordable for the average person? For medical and/or designer baby purposes?

I think this is more of a regulatory and ethics issue than anything. We already have the capabilities to edit humans both as adults and embryos and cost is mostly driven by the market-ish. So I really think it depends on governments or the risk you are willing to tolerate. I am sure there are some people who will inject you some gene editing solution in a country without much regulation but will it actually do anything? Will you have proper standard of care?

I think governments ar going to sit on human embryo editing for a long time. It's kind of like a weapons race and no one wants to start it? Maybe?

I also dont know that this is as simple as governments regulating/slowing this down. There are mixed data on how interested the public is in gene editing (particularly for things for which other options already exist). Many in the scientific community are quite optimistic/hopeful about the possibilities of gene editing, but some concerns still certainly remain. The scientific community still is generally opposed to germline gene editing, though conversations are beginning about how it might be able to proceed in a safe, thoughtful, and ethical fashion. I'm not sure, but I still think we're a ways away from germline gene editing - From Jonathan Marron MD MPH

Where is the bottleneck for targeting things like, autism, down syndrome, or other severe physiological defects in unborn children?

Detection? Expense? Possibility? Ethics? Something else?

In addition to the science, it is also important to think about the ethics (but I wouldn't describe this as a bottleneck).

There is an important difference between "Making People Better" and "Making Better People".

There is wide agreement on the ethics of helping patients (persons who exist and are suffering) by offering therapeutic somatic genome editing. There is emerging debate about the ethics of in utero somatic genome editing on developing fetuses. There is considerable and sustained debate about the ethics of choosing the traits of persons who do not yet exist. Heritable genome editing involves the genetic manipulation of gametes, precursors to the gametes, early (one-day) embryos. It is about bringing into being, a being that do not yet exist. This is very different from trying to develop treatments for people who exist and have a debilitating condition.

Another consideration to build on Professor Baylis's point - are we discussing CRISPR to treat a disease/disorder? Or for enhancement? For some of the things you mentioned, the answer is not so clear. Further, there is a argument to be made that trying to "edit out" certain traits/disorders implies a perceived lack of value for the person who has that trait/disorder - many in the disability rights community have made such an argument. -From Jonathan Marron MD MPH

What is the biggest hurdle for biohackers in bringing out an Open-source revolution like we have witnessed in the coding side? Lack of infrastructure (free/cheap equipments/reagents)? regulatory issues?

I believe that this is actually further along than many realize. Groups have begun to discuss "DIY CRISPR." And some academic groups (including individuals from the George Church lab and others) have argued for a similar "open revolution" in CRISPR and related technologies. Whether such a revolution is "good" for science and good for society, however, is a very different question.... -From Jonathan Marron MD MPH

Is biotech the next big Silicon Valley thing or you think biotech it’s too complicated to follow the standard SF startup “hustle” culture?

I hate to be the "wet blanket," but I think the Theranos experience has demonstrated that biotech (and other health-related markets) is a very different beast than most of those that SF startup "hustle" culture has previously approached. This is one of the reasons that Google Health and similar efforts have not found as much success as might be anticipated. I dont doubt that the startup world could get into this space (and could potentially be very successful), but I think it's quite difficult

And the regulatory processes in these areas, while often seen as obstructive, serve an important purpose - in trying to help protect people and their health. When we are discussing patients and healthcare, it's no longer just a consumer and a product...-From Jonathan Marron MD MPH

My lifegoal is to modify a single gene, a monogenic defect so. How's realistic to do it with CRISPR? I mean my only true fear is the Immune system going nuts, is that an issue? (It's a single organ I'm talking about, not a gene involving too much functions, just an enzyme reduced by 70% of its power)

This has already been achieved in recent human trials. https://www.nature.com/articles/d41586-021-01776-4

News stories like this will start to be more common, as a number of human trials are underway. In general CRISPR systems shouldn't be a concern for immune systems or microbiota.

Thank you, my only concern was that as the organ in question is the Liver. It should be easy to edit, 3 mins in the bloodstream and I would be set. Shit...I feel so pathetic as it's not a life treathening disorder but I must win Nature. Before I die I must settle this.

One of the questions/concerns with gene editing is that of off-target effects, including unanticipated ones (ie, the "unknown unknowns"). Can we be sure that a single gene change will only affect the intended target? - Jonathan Marron, MD MPH

I work in AgTech -- robotics. I see globalization ending for a few decades which will probably result in mass starvation in Asia and Africa among others before (my guess) America reasserts globalism in a few decades hence. The only hope I see of food security in many of these places is genetic adaptation of core food groups.

What is happening in CRISPR with agricultural plants?

Ben answered some about this question here.

Is the course gonna be available after July 4?

Yes, but it'll move from Coursera to our Michigan Online website with all of our Teach-Outs: https://online.umich.edu/teach-outs/

You'll be able to access all the content, just without live discussion forums.

How do we make this technology more affordable and accessible?

With time, nearly all technologies become more affordable and accessible with time. Take, for example, genome sequencing -- it cost several billion dollars to sequence the first human genome. We now do genome sequencing for only a few thousand dollars (and maybe even less!), about 30 years later: https://www.genome.gov/about-genomics/fact-sheets/Sequencing-Human-Genome-cost -From Jonathan Marron MD MPH

Other than Dr. Marron, what makes any of you experts?

Well, I'm not even sure that I would consider myself an expert in something like this -- "expertise" is a challenging thing to define (or quantify). But I always encourage people to thoughtfully consider where they are getting their information. These days, information comes from all types of sources and people, and it's harder than ever to verify the quality of that information.

Always consider who the individual is, potential biases and blindspots, etc. Personally, I worry about anyone who doesnt admit that they have biases (and blindspots) - we all have them. We just need to be aware of what they are and try to be honest about them and minimize them when we can... -From Jonathan Marron MD MPH

How exactly does CRISPR target the right string of genes? I dont understand how it knows exactly where to cut and modify the DNA strands.

The Cas9 enzyme binds a piece of RNA that is complementary/matches to the piece of DNA that it cuts.

Anywhere I can read a eli5 explanation of this?

Consider joining the free Teach-Out that we're running - the third lesson is an accessible explanation of how CRISPR functions.

In a few weeks, we'll archive that content on online.umich.edu, if you prefer not to sign up for Coursera. We also like this video from the Mayo Clinic.

Wish you posted this in early June. Would've loved to take the course! What aspects of CRISPR do you find most societally promising? What about most likely advents / usecases?

You can still take the course on Coursera for the next week, after which we will archive it on online.umich.edu, along with our other archived Teach-Outs. Hope you're able to join for part of it! We'll let the experts answer your questions.

From a learner on Coursera: “Hello all! Were you guys always passionate about your field when you were younger (like high school)? Was this something you wanted to pursue from the start or did you find out about it later on in your education?”

Do you have any advice on how to pursue a career in this?

One of the interesting things about the Teach-Out and all the contributors we worked with is the range of disciplines they represented, researchers of CRISPR, medicine, public engagement, bioethics, conservation, ecology, deliberative democracy, and more. One key question is what part of this conversation intrigues you the most? Do you want to work in a lab or on public policy?

Probably public policy! Is there a good way to get into that?

We will pull some resources about science and public policy together, and get back to you later! To start with, joining conversations that are happening around you locally (e.g., libraries, schools) and virtually can help you familiarize yourself with the discussions that are happening. There are also a wealth of online resources.

From a learner on Coursera: "W​hat kinds of governmental controls are there or do we need to check the unwise use of CRISPR?"

How do you personally assess the ethics of using CRISPR to "correct" certain aspects of hereditary conditions such as deafness or blindness where there are communities related to their condition?

I think this is such an interesting question. Do you think using CRISPR for this reason - to either prevent or correct these conditions - may be distinct from corrective measures, like implants?

there are a few different layers to that question:

1) are you performing somatic CRISPR (meaning it would affect the genes of just the person treated) vs germline CRISPR (meaning it would affect the person as well as their future children). The latter is more complex, ethically and otherwise, since those future children no longer would have a choice in the matter

2) And as for the difference/distinction between CRISPR and a corrective measure like a cochlear implant, that's a fantastic question. One of the many reasons that the germline editing of the babies in China (the "CRISPR babies") was considered so unethical was that there was another viable option to prevent HIV transmission beyond gene editing. So why go for CRISPR if another option is possible? Is CRISPR in this particular case better/different than cochlear implants in that way?

All that is not to say that CRISPR might not be still ethically supportable for conditions for which alternative options are available - but we should think hard about these questions before proceeding...

-From Jonathan Marron MD MPH