Can we cure genetic diseases by rewriting DNA? | David R. Liu

Can we cure genetic diseases by rewriting DNA? | David R. Liu

The most important gift
your mother and father ever gave you was the two sets
of three billion letters of DNA that make up your genome. But like anything
with three billion components, that gift is fragile. Sunlight, smoking, unhealthy eating, even spontaneous mistakes
made by your cells, all cause changes to your genome. The most common kind of change in DNA is the simple swap of one letter,
or base, such as C, with a different letter,
such as T, G or A. In any day, the cells in your body
will collectively accumulate billions of these single-letter swaps,
which are also called “point mutations.” Now, most of these
point mutations are harmless. But every now and then, a point mutation disrupts
an important capability in a cell or causes a cell to misbehave
in harmful ways. If that mutation were inherited
from your parents or occurred early enough
in your development, then the result would be
that many or all of your cells contain this harmful mutation. And then you would be one
of hundreds of millions of people with a genetic disease, such as sickle cell anemia or progeria or muscular dystrophy
or Tay-Sachs disease. Grievous genetic diseases
caused by point mutations are especially frustrating, because we often know
the exact single-letter change that causes the disease
and, in theory, could cure the disease. Millions suffer from sickle cell anemia because they have
a single A to T point mutations in both copies of their hemoglobin gene. And children with progeria
are born with a T at a single position in their genome where you have a C, with the devastating consequence
that these wonderful, bright kids age very rapidly and pass away
by about age 14. Throughout the history of medicine, we have not had a way
to efficiently correct point mutations in living systems, to change that disease-causing
T back into a C. Perhaps until now. Because my laboratory recently succeeded
in developing such a capability, which we call “base editing.” The story of how we developed base editing actually begins three billion years ago. We think of bacteria
as sources of infection, but bacteria themselves are also
prone to being infected, in particular, by viruses. So about three billion years ago, bacteria evolved a defense mechanism
to fight viral infection. That defense mechanism
is now better known as CRISPR. And the warhead in CRISPR
is this purple protein that acts like molecular
scissors to cut DNA, breaking the double helix into two pieces. If CRISPR couldn’t distinguish
between bacterial and viral DNA, it wouldn’t be a very useful
defense system. But the most amazing feature of CRISPR is that the scissors can be
programmed to search for, bind to and cut only a specific DNA sequence. So when a bacterium encounters
a virus for the first time, it can store a small snippet
of that virus’s DNA for use as a program
to direct the CRISPR scissors to cut that viral DNA sequence
during a future infection. Cutting a virus’s DNA messes up
the function of the cut viral gene, and therefore disrupts
the virus’s life cycle. Remarkable researchers including
Emmanuelle Charpentier, George Church, Jennifer Doudna and Feng Zhang showed six years ago how CRISPR scissors
could be programmed to cut DNA sequences of our choosing, including sequences in your genome, instead of the viral DNA sequences
chosen by bacteria. But the outcomes are actually similar. Cutting a DNA sequence in your genome also disrupts the function
of the cut gene, typically, by causing the insertion and deletion
of random mixtures of DNA letters at the cut site. Now, disrupting genes can be very
useful for some applications. But for most point mutations
that cause genetic diseases, simply cutting the already-mutated gene
won’t benefit patients, because the function of the mutated gene
needs to be restored, not further disrupted. So cutting this
already-mutated hemoglobin gene that causes sickle cell anemia won’t restore the ability of patients
to make healthy red blood cells. And while we can sometimes introduce
new DNA sequences into cells to replace the DNA sequences
surrounding a cut site, that process, unfortunately, doesn’t work
in most types of cells, and the disrupted gene outcomes
still predominate. Like many scientists,
I’ve dreamed of a future in which we might be able to treat
or maybe even cure human genetic diseases. But I saw the lack of a way
to fix point mutations, which cause most human genetic diseases, as a major problem standing in the way. Being a chemist, I began
working with my students to develop ways on performing chemistry
directly on an individual DNA base, to truly fix, rather than disrupt,
the mutations that cause genetic diseases. The results of our efforts
are molecular machines called “base editors.” Base editors use the programmable
searching mechanism of CRISPR scissors, but instead of cutting the DNA, they directly convert
one base to another base without disrupting the rest of the gene. So if you think of naturally occurring
CRISPR proteins as molecular scissors, you can think of base editors as pencils, capable of directly rewriting
one DNA letter into another by actually rearranging
the atoms of one DNA base to instead become a different base. Now, base editors don’t exist in nature. In fact, we engineered
the first base editor, shown here, from three separate proteins that don’t even come
from the same organism. We started by taking CRISPR scissors
and disabling the ability to cut DNA while retaining its ability to search for
and bind a target DNA sequence in a programmed manner. To those disabled CRISPR
scissors, shown in blue, we attached a second protein in red, which performs a chemical reaction
on the DNA base C, converting it into a base
that behaves like T. Third, we had to attach
to the first two proteins the protein shown in purple, which protects the edited base
from being removed by the cell. The net result is an engineered
three-part protein that for the first time
allows us to convert Cs into Ts at specified locations in the genome. But even at this point,
our work was only half done. Because in order to be stable in cells, the two strands of a DNA double helix
have to form base pairs. And because C only pairs with G, and T only pairs with A, simply changing a C to a T
on one DNA strand creates a mismatch, a disagreement between the two DNA strands that the cell has to resolve
by deciding which strand to replace. We realized that we could further engineer
this three-part protein to flag the nonedited strand
as the one to be replaced by nicking that strand. This little nick tricks the cell into replacing the nonedited G with an A as it remakes the nicked strand, thereby completing the conversion
of what used to be a C-G base pair into a stable T-A base pair. After several years of hard work led by a former post doc
in the lab, Alexis Komor, we succeeded in developing
this first class of base editor, which converts Cs into Ts and Gs into As at targeted positions of our choosing. Among the more than 35,000 known
disease-associated point mutations, the two kinds of mutations
that this first base editor can reverse collectively account for about 14 percent
or 5,000 or so pathogenic point mutations. But correcting the largest fraction
of disease-causing point mutations would require developing
a second class of base editor, one that could convert
As into Gs or Ts into Cs. Led by Nicole Gaudelli,
a former post doc in the lab, we set out to develop
this second class of base editor, which, in theory, could correct up to
almost half of pathogenic point mutations, including that mutation that causes
the rapid-aging disease progeria. We realized that we could
borrow, once again, the targeting mechanism of CRISPR scissors to bring the new base editor
to the right site in a genome. But we quickly encountered
an incredible problem; namely, there is no protein that’s known to convert
A into G or T into C in DNA. Faced with such a serious stumbling block, most students would probably
look for another project, if not another research advisor. (Laughter) But Nicole agreed to proceed with a plan that seemed wildly ambitious at the time. Given the absence
of a naturally occurring protein that performs the necessary chemistry, we decided we would evolve
our own protein in the laboratory to convert A into a base
that behaves like G, starting from a protein
that performs related chemistry on RNA. We set up a Darwinian
survival-of-the-fittest selection system that explored tens of millions
of protein variants and only allowed those rare variants that could perform the necessary
chemistry to survive. We ended up with a protein shown here, the first that can convert A in DNA into a base that resembles G. And when we attached that protein to the disabled CRISPR
scissors, shown in blue, we produced the second base editor, which converts As into Gs, and then uses the same
strand-nicking strategy that we used in the first base editor to trick the cell into replacing
the nonedited T with a C as it remakes that nicked strand, thereby completing the conversion
of an A-T base pair to a G-C base pair. (Applause) Thank you. (Applause) As an academic scientist in the US, I’m not used to being
interrupted by applause. (Laughter) We developed these
first two classes of base editors only three years ago
and one and a half years ago. But even in that short time, base editing has become widely used
by the biomedical research community. Base editors have been sent
more than 6,000 times at the request of more than
1,000 researchers around the globe. A hundred scientific research papers
have been published already, using base editors in organisms
ranging from bacteria to plants to mice to primates. While base editors are too new to have already entered
human clinical trials, scientists have succeeded in achieving
a critical milestone towards that goal by using base editors in animals to correct point mutations
that cause human genetic diseases. For example, a collaborative team of scientists
led by Luke Koblan and Jon Levy, two additional students in my lab, recently used a virus to deliver
that second base editor into a mouse with progeria, changing that disease-causing
T back into a C and reversing its consequences
at the DNA, RNA and protein levels. Base editors have also
been used in animals to reverse the consequence of tyrosinemia, beta thalassemia, muscular dystrophy, phenylketonuria, a congenital deafness and a type of cardiovascular disease — in each case, by directly
correcting a point mutation that causes or contributes to the disease. In plants, base editors have been used to introduce individual
single DNA letter changes that could lead to better crops. And biologists have used base editors
to probe the role of individual letters in genes associated
with diseases such as cancer. Two companies I cofounded,
Beam Therapeutics and Pairwise Plants, are using base editing
to treat human genetic diseases and to improve agriculture. All of these applications of base editing have taken place in less
than the past three years: on the historical timescale of science, the blink of an eye. Additional work lies ahead before base editing can realize
its full potential to improve the lives of patients
with genetic diseases. While many of these diseases
are thought to be treatable by correcting the underlying mutation in even a modest fraction
of cells in an organ, delivering molecular machines
like base editors into cells in a human being can be challenging. Co-opting nature’s viruses
to deliver base editors instead of the molecules
that give you a cold is one of several promising
delivery strategies that’s been successfully used. Continuing to develop
new molecular machines that can make all of the remaining ways to convert one base pair
to another base pair and that minimize unwanted editing
at off-target locations in cells is very important. And engaging with other scientists,
doctors, ethicists and governments to maximize the likelihood
that base editing is applied thoughtfully, safely and ethically, remains a critical obligation. These challenges notwithstanding, if you had told me
even just five years ago that researchers around the globe would be using laboratory-evolved
molecular machines to directly convert
an individual base pair to another base pair at a specified location
in the human genome efficiently and with a minimum
of other outcomes, I would have asked you, “What science-fiction novel
are you reading?” Thanks to a relentlessly dedicated
group of students who were creative enough to engineer
what we could design ourselves and brave enough
to evolve what we couldn’t, base editing has begun to transform
that science-fiction-like aspiration into an exciting new reality, one in which the most important gift
we give our children may not only be
three billion letters of DNA, but also the means to protect
and repair them. Thank you. (Applause) Thank you.

31 thoughts on “Can we cure genetic diseases by rewriting DNA? | David R. Liu

  1. I am sure genetic is like playing a cooking game of "Let's throw everything in and then see what comes out"
    We can't say it will be good until…..

  2. We can`t play with the keys of God! and we may not. Humanity is still on the low lever of knowledge, we`re very young children of the Universe. Do not play with DNA.
    -or shall we treat this subject as a philosophical problem..?

  3. 2:05 – Kid on the left, had presented a lecture here on TED with an important message, check this out if you have a brief moment –

  4. This guy and his team (of STUDENTS!) should win the Nobel Prize for their efforts if they do, indeed, prove fruitful. If they don't, that would be a tragedy, indeed. Having said that, my hat is off to those brave individuals who continued to work through this obstacle despite mountainous odds.

  5. I hate humanity, because we are dumb and let us fool by governments and industries. We could easily manipulate our dna with CRISPR and modify upcoming generations in a positive way, we can make them immune to cancer, aids and other deadly illnesses, we could make them way more intelligent, which would upgrade the human race, we could step up in so many ways and become advanced in a way you couldnt even imagine. But instead we get fucked by retarded politicans which IQ isnt over 100…. sad life, sad world end is going to be soon.

  6. This removes suffering and hardship from the world, whether it’s improving food or healing humans with genetic diseases. Even modifying is so that we live longer, are more intelligent, stronger etc. Ethically speaking, if everyone has access to this treatment, and I think they will due to the massive savings on the health industry, this is a win win. Better humans means less suffering, more happiness, and success for our species. I’m ready

  7. This guy is a charlatan. Just more bad advertising to get your money. He doesn't understand his own body, gravity or the Unified Field Theory. He split the body up into pieces instead of a whole.

    The problem is multi-generational malnutrition. GMO grains inhibit the body's ability to produce glutathion. An amino acid that gets rid of heavy metals. Throw a handful of aluminum filings in your fuse box and see what happens. Aluminum phospheen is put into grain silos to kill vermin and they don't wash the grain before you eat it. Consequences. Educate yourself and stop listening and praising snake oil salesmen.

  8. Thank God for people like David R. Liu and people around him, we often forget to thank these scientists for their research ❤👌

  9. Well I was thinking the same thing to find the cure of genetic diseases.. i.e. rewriting dna, sending proteins which change the mutant sequence of proteins..

  10. This is amazing and seems like a much more efficient method compared to the current Crispr method of cutting and pasting DNA. I hope this means that gene-editing will become much safer for human use in the near future.

  11. How do we know that a mutation which currently causes disease wouldn't over time become beneficial to the species?

  12. Если хотите посмотреть это видео на русском:

  13. I plan to study molecular biology, and I hope to contribute to this great field, which can potentially save many lives.

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