Considering Reprogenomics in the Ethical Future of Fetal Therapy Trials.
Considering Reprogenomics in the Ethical Future of Fetal Therapy Trials.
复制标题
DOI：
10.1080/15265161.2022.2027558
复制
发表时间：
2022-03
影响因子：
13.4
通讯作者：
Michie, Marsha
中科院分区：
文献类型：
--
作者：
Farrell, Ruth M.;Michie, Marsha
自21世纪初以来，母胎医学发生了很大变化，当时建立了先前的胎儿治疗试验伦理框架。我们赞赏Hendriks及其同事在最近的进展背景下承担修改这些框架的重要任务（Hendriks et al. 2022）。我们想要揭示的是，有必要进一步考虑伦理问题。这项工作主要集中在手术和药物干预方面。然而，今天，我们看到多种生殖基因组干预已经在研究中，而且更多的正在研究中，不仅包括胚胎和/或配子的基因组修饰，还包括表观遗传学和母体微生物组的操纵。我们同意，在生殖医学科学和政策变化的背景下，更新的框架是非常必要的，并建议这些框架还必须明确考虑到基因组修饰所涉及的独特的风险-利益并置，这些修饰可能对胎儿、孕妇以及任何未来的后代产生终身影响。作为改善产科结果和辅助生殖技术成功率的一种方式，生殖遗传学和基因组学正在发生重大转变。虽然生殖医学中的基因组学传统上侧重于基因筛选和诊断测试，但越来越多的人关注于开发能够修改人类基因组、表观基因组或微生物组的干预措施。其中一些研究旨在通过CRISPR和相关技术改变未来后代的基因组，可能使用生殖系编辑来预防遗传疾病，甚至“增强”功能。表观基因组学和微生物组在疾病中的作用越来越受到重视
Much has changed in maternal-fetal medicine since the early 2000s, when the previous ethical frameworks for fetal therapy trials were established. We applaud Hendriks and colleagues for taking on the important task of revising these frameworks in the context of recent advances (Hendriks et al. 2022). What we would like to bring to light is that there is need for further ethical consideration. This effort largely focuses on surgical and pharmaceutical interventions. Yet, today, we are seeing multiple reproductive genomic interventions already being researched, and many more on the horizon, including not only genomic modification of embryos and/or gametes, but also manipulation of epigenetics and the maternal microbiome. We agree that updated frameworks are much needed in the context of the scientific and policy changes in reproductive medicine, and suggest that such frameworks must also explicitly consider the unique risk-benefit juxtapositions involved in genomic modifications that may have lifelong effects for the fetus, the pregnant person, and, indeed, any future offspring.A major shift is occurring in reproductive genetics and genomics as a way to improve obstetric outcomes and success rates of assisted reproductive technologies. While genomics in reproductive medicine has traditionally focused on genetic screening and diagnostic testing, there is an increasing focus on developing interventions that will modify the human genome, epigenome, or microbiome. Some of this research is directed toward altering the future offspring’s genome through CRISPR and related technologies, possibly using germline editing to prevent inherited conditions or even “enhance” function. Growing recognition of the role of epigenomics and the microbiome in
登录
查看更多内容
影响因子：
2.2
作者：
Choquette, A. F.;Hirsch, R. M.;Confesor, R. B., Jr.
通讯作者：
Confesor, R. B., Jr.
DOI：
10.1080/15265161.2020.1867932
发表时间：
2022-03
期刊：
The American journal of bioethics : AJOB
影响因子：
--
作者：
Hendriks S;Grady C;Wasserman D;Wendler D;Bianchi DW;Berkman BE
通讯作者：
Berkman BE
影响因子：
9.3
作者：
通讯作者：
--
影响因子：
5.3
作者：
Invernizzi, P;Biondi, ML;Simoni, G
通讯作者：
Simoni, G