Harnessing the potential of CRISPR-based platforms to advance the field of hospital medicine

ABSTRACT

Introduction

Clustered regularly interspaced short palindromic repeats (CRISPR) are segments of nucleic acid that play a role in prokaryotic defense and form the basis of a genome editing technology that allows permanent alteration of genetic material. This methodology, known as CRISPR-Cas9, is poised to revolutionize molecular biology, but no literature yet exists on how these advances will affect hospitalists.

Areas covered

These specialists in inpatient medicine care for a wide variety of hospitalized patients, including those with infectious disease, cancer, cardiovascular disease, autoimmune disease, hematologic disease, and a variety of other conditions that may soon be impacted by advances in gene-modifying technology provided by CRISPR-Cas9. A Literature search was performed using PubMed [1 December 2019–17 April 2020].

Expert opinion

This paper reviews the remarkable diagnostic and therapeutic potential of the CRISPR-Cas9 platform and concludes with a look at ethical issues and technical hurdles pertaining to the implementation of permanent gene modification in the practice of Hospital Medicine.

KEYWORDS:

• CRISPR-Cas9
• hospitalist
• nucleic acid
• SARS-CoV-2
• resistance

Article highlights

• Clustered regularly interspaced short palindromic repeats (CRISPR) are segments of nucleic acid that play an important role in bacterial defense and form the basis of a genome editing technology known as CRISPR-Cas9.

• CRISPR-Cas9 allows for the permanent modification of genetic material and may be harnessed to treat a variety of diseases in humans.

• Many of the applications of CRISPR-Cas9 may ultimately affect hospitalists—specialists in inpatient medicine—who serve as the primary caregivers for patients with a wide variety of maladies, ranging from heart disease to cancer.

• The CRISPR-Cas9 system has been employed to serve as a diagnostic tool for viral infections.

• CRISPR-based human genome editing comes in two forms: heritable germline editing, and non-heritable somatic modifications.

• Germline edits with CRISPR-Cas9 are passed on to future generations.

• In 2019, the World Health Organization recommended against any clinical research on human germline editing until all technical and ethical considerations have been properly vetted.

Declaration of interest

M McCarthy has served as a paid consultant to Allergan. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.