PGD and germline therapy

Germline therapy to prevent the transmission of serious hereditary diseases is the subject of controversy, since, for example, damage may only occur later in individuals whose DNA has been genetically modified. Therefore, some call for its use only in cases where there are no alternative treatment options. Preimplantation genetic diagnosis (PGD) represents a possible alternative for avoiding the transmission of serious diseases. A detailed description of the methods, regulations, and ethical aspects of PGD is provided in the “In Focus” on Preimplantation Genetic Diagnosis.

The extent to which PGD represents an equal alternative to the possibilities of treatment with the aid of genome editing is controversial. PGD entails, for example, the discarding of embryos that could be identified as carriers of a serious hereditary disease. This is because PGD can only select and, unlike genome editing, cannot intervene curatively. However, according to current research, a possible germline intervention would also require the subsequent performance of PGD to test whether the genes were edited successfully.

Further information:

Albrecht, S. / König, H. / Sauter, A. (2021): Genome Editing am Menschen. Endbericht zum Monitoring. TAB-Arbeitsbericht Nr. 191. Berlin: Büro für Technikfolgen-Abschätzung beim Deutschen Bundestag (TAB): 8, 16, 64. Online Version(German)

Aslan, S. E. / Beck, B. / Deuring, S. / von Fallois, M. / Leidenfrost, R. / Primc, N. / Rubeis, G. / Rüther, M. / Hähnel, M. / Schnieder, K. / Haltaufderheide, J. (2018): Genom-Editierung in der Humanmedizin: Ethische und rechtliche Aspekte von Keimbahneingriffen beim Menschen. In: CfB-Drucksache 4: 11.

Deutscher Ethikrat (2019): Eingriffe in die menschliche Keimbahn. Stellungnahme: 96f. Online Version(German)

German Ethics Council (2019): Intervening in the human germline. Opinion. Executive summary & reccomendations. Online Version

Ranisch, R. (2020): Germline genome editing versus preimplantation genetic diagnosis: Is there a case in favour of germline interventions? In: Bioethics. 34 (1): 60–69. Online Version 

Schöne-Seifert, B. (2017): Genscheren-Forschung an der menschlichen Keimbahn: Plädoyer für eine neue Debatte auch in Deutschland. In: Ethik in der Medizin 29 (2), 93–96. Online Version (German)

Wells, D. / Vermeesch, J. R. / Simpson, J. L. (2019): Current controversies in prenatal diagnosis 3: Gene editing should replace embryo selection following PGD. In: Prenatal Diagnosis (39), 344–350. Online Version 

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