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让孩子有三个父母的MRT技术

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SINGAPORE—This small city state could become the second country—after the United Kingdom—to explicitly legalize mitochondrial replacement therapy (MRT), a controversial assisted reproduction technique that allows women who are carriers of some rare genetic disorders to give birth to healthy babies.

新加坡——这个小国家将可能成为第二个—继英国之后—明确将线粒体替换疗法(MRT)合法化的国家,这种疗法是一种有争议的辅助生殖技术,可以让那些怀有先天罕见疾病的孩子的孕妇们生出健康的宝宝。

Members of the Singaporean public and religious groups have until 15 June to provide their feedback about MRT to the Bioethics Advisory Committee (BAC). 

新加坡的公共和宗教团体成员们在7月15号之前还可以将他们的关于MRT的意见提交给生物伦理顾问委员会。(BAC)

Based on its findings, a 13-member BAC review committee will make formal recommendations to the government later this year about whether to legalize the technology.

根据其调研,这支13名成员的BAC复核委员会今年下半年将向政府正式提出关于是否将该技术合法化的建议。

“Our position is to keep a close watch on what happens in the U.K., to track the U.K. experience, and to learn from what they have done,” says Oi Lian Kon, who studies human genetics at the National Cancer Centre Singapore and is leading the BAC review group. 

“我们的职责就是密切关注英国,追踪英国的进展,并学习他们的做法,”欧连孔说道,他在新加坡国立肿瘤中心研究人类遗传学,也是BAC复核委员会的会长。

MRT is used to address devastating genetic diseases that arise from abnormalities in the DNA in mitochondria, the cell’s power sources, and that commonly affect energy-intensive organs such as the brain and heart, as well as muscles. 

MRT是用来治疗一种严重的遗传疾病的技术,这种疾病来源于线粒体DNA的异常,而线粒体是细胞的动力来源,这种疾病通常会影响高耗能的器官比如大脑,心脏还有肌肉。

Children inherit mitochondria only from their mothers; replacing faulty mitochondria in an egg or embryo with normal ones from a donor can result in healthy babies. 

孩子只会从他们的母亲那里继承线粒体;用捐赠者的正常线粒体替换卵子或者胚胎中的异常线粒体就可以得到健康的宝宝。

But it also means that offspring will bear DNA from three “parents,” which makes MRT a controversial procedure.

不过这样也意味着这个后代会含有来自三个“父母”的DNA,也使得MRT成为了具有争议的手术。

In 2015, the United Kingdom gave MRT the go-ahead, and the first two babies resulting from the technique are likely to be born there later this year. 

2015年时,英国法律通过了MRT技术,用这种技术产生的头两个宝宝将于今年后半年降生。

MRT has already been used in other countries that don’t explicitly legalize it, but have more relaxed laws on genetic modification. 

MRT也在别国被采用,他们没有明确将其合法化,不过对于基因修饰有更宽松的法律条令。

In 2016, a female carrier of Leigh syndrome, a severe neurological disorder, received treatment in Mexico and gave birth to a healthy boy. 

2016年,一名孩子患有亚急性坏死性脑脊髓病的孕妇,这是一种严重的神经疾病,在墨西哥接受了治疗,剩下了一个健康的男孩。

The following year, a Ukrainian team reported two successful births from MRT as well.

下一年,一支乌克兰团队报道称也有两个利用MRT顺利生育的案例。

No other countries have adopted laws specifically about MRT.

还没有其他的国家有专门针对MRT的立法。

 Many have a blanket ban on changing the human germline that includes the technique.

很多国家还盲目地禁止所有改变人类种系的技术,包括MRT这种技术。

 Thailand is the only country that does not explicitly prohibit altering the human genome, whereas Italy and Israel permit it under certain conditions.

泰国是唯一没有明确禁止改变人类基因组的国家,而意大利和以色列在某些情形下对其许可。

In Singapore, MRT is theoretically possible today, says BAC review panel member Tracey Evans Chan, who studies biomedical law and ethics at the National University of Singapore. 

在新加坡,MRT从理论上来说是可能的,BAC审查小组成员特雷西.伊万斯.陈说,他在新加坡国立大学研究生物医学法律和伦理。

The country does not allow human germline modification in the clinical setting, but it does—unlike the United States and many European countries—permit genetic tinkering for research purposes, so MRT could be done if it were formally part of a scientific study. 

该国不允许临床条件下改变人类种系,不过它—不像美国和很多欧洲国家—允许为了研究目的进行基因修补,因此MRT如果作为科学研究的一个正式部分是可以进行的。

“But in order for the therapy to be mainstreamed,” he says, the law needs to change.

“但要想让这种治疗成为主流,”他说道,就需要改变法律。

Singapore’s BAC has held two public dialogue sessions in the past month; they are also soliciting written feedback.

在过去几个月里,新加坡的BAC已经举办了两次对话会议;他们也在征求书面意见。

 “The most common concern expressed among the lay public whom we have consulted is the issue of self-identity and the fact that children who are born from such a method would, in theory, have part of the genomes of three individuals,” Kon tells us.

“我们就这个问题询问的大众群体所表达出来的最普遍的担忧就是,自我认知的问题还有这种方法生出来的孩子从理论上说会有第三方的一部分基因这个事实,”孔告诉我们。

Two MRTs are now approved for use in the United Kingdom: maternal spindle transfer, in which the nucleus from the mother’s egg is placed inside a donor egg whose nuclear material has been removed, followed by fertilization; and pronuclear transfer, in which an egg is fertilized first, after which the nucleus of the embryo is transferred inside the enucleated donor egg cell.

在英国有两种MRT技术是许可的:孕妇核心移植,来自妈妈的卵子的细胞核被放置在捐赠者的卵细胞内,捐赠者卵细胞的细胞核材料已经被移除,然后再人工授精;还有就是原核移植,先将卵细胞受精,然后再将受精卵的核移植到捐赠者去核的卵细胞中。

Singapore is considering a third, newer method called polar body transfer (PBT), in which a tiny cell from the recipient called a “polar body”—which forms when an egg cell divides—is placed inside a donor egg cell, before or after fertilization. 

新加坡还考虑通过第三种,一种新的叫做极体移植(PBT)的技术,该技术是将接受者的一个叫做“极体”的微小细胞—它是在卵细胞分裂时形成的—放置在捐赠者的卵细胞中,要么在受精前,要么在受精之后。

Polar bodies have very little cytoplasm and contain few, if any, mitochondria, which makes PBT potentially simpler and safer. 

极体的胞质很少,线粒体也几乎没有,这就使得PBT可能会更简单而安全。

That the United Kingdom has not approved PBT is “really a matter of timing,” says Andy Greenfield of the Medical Research Council's Harwell Institute in the United Kingdom, who led the country’s Human Fertilisation and Embryology Authority review of MRT.

英国通过PBT是“迟早的是”,安迪.格林菲尔德说,他来自英国的哈维尔研究所的医学研究委员会,也是英国的人类生殖和胚胎管理局MRT方面的带头人。

 “The possibility of using PBT came rather too late in the process to permit its smooth introduction into law,” he says.

“要将它顺利法律通过,所以利用PBT的可能性来得有点迟”他说道。

· END ·

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