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2018 was bonkers for science.
From a woman who gave birth using a transplanted uterus, to the infamous CRISPR baby scandal, to forensics adopting consumer-based genealogy test kits to track down criminals, last year was a factory churning out scientific “whoa” stories with consequences for years to come.
With CRISPR still in the headlines, Britain ready to bid Europe au revoir, and multiple scientific endeavors taking off, 2019 is shaping up to be just as tumultuous.
Here are the science and health stories that may blow up in the new year. But first, a note of caveat: predicting the future is tough. Forecasting is the lovechild between statistics and (a good deal of) intuition, and entire disciplines have been dedicated to the endeavor. But January is the perfect time to gaze into the crystal ball for wisps of insight into the year to come. Last year we predicted the widespread approval of gene therapy products—on the most part, we nailed it. This year we’re hedging our bets with multiple predictions.
Gene Drives Used in the Wild
The concept of gene drives scares many, for good reason. Gene drives are a step up in severity (and consequences) from CRISPR and other gene-editing tools. Even with germline editing, in which the sperm, egg, or embryos are altered, gene editing affects just one genetic line—one family—at least at the beginning, before they reproduce with the general population.
Gene drives, on the other hand, have the power to wipe out entire species.
In a nutshell, they’re little bits of DNA code that help a gene transfer from parent to child with almost 100 percent perfect probability. The “half of your DNA comes from dad, the other comes from mom” dogma? Gene drives smash that to bits.
In other words, the only time one would consider using a gene drive is to change the genetic makeup of an entire population. It sounds like the plot of a supervillain movie, but scientists have been toying around with the idea of deploying the technology—first in mosquitoes, then (potentially) in rodents.
By releasing just a handful of mutant mosquitoes that carry gene drives for infertility, for example, scientists could potentially wipe out entire populations that carry infectious scourges like malaria, dengue, or Zika. The technology is so potent—and dangerous—the US Defense Advances Research Projects Agency is shelling out $65 million to suss out how to deploy, control, counter, or even reverse the effects of tampering with ecology.
Last year, the U.N. gave a cautious go-ahead for the technology to be deployed in the wild in limited terms. Now, the first release of a genetically modified mosquito is set for testing in Burkina Faso in Africa—the first-ever field experiment involving gene drives.
The experiment will only release mosquitoes in the Anopheles genus, which are the main culprits transferring disease. As a first step, over 10,000 male mosquitoes are set for release into the wild. These dudes are genetically sterile but do not cause infertility, and will help scientists examine how they survive and disperse as a preparation for deploying gene-drive-carrying mosquitoes.
Hot on the project’s heels, the nonprofit consortium Target Malaria, backed by the Bill and Melinda Gates foundation, is engineering a gene drive called Mosq that will spread infertility across the population or kill out all female insects. Their attempt to hack the rules of inheritance—and save millions in the process—is slated for 2024.
A Universal Flu Vaccine
People often brush off flu as a mere annoyance, but the infection kills hundreds of thousands each year based on the CDC’s statistical estimates.
The flu virus is actually as difficult of a nemesis as HIV—it mutates at an extremely rapid rate, making effective vaccines almost impossible to engineer on time. Scientists currently use data to forecast the strains that will likely explode into an epidemic and urge the public to vaccinate against those predictions. That’s partly why, on average, flu vaccines only have a success rate of roughly 50 percent—not much better than a coin toss.
Tired of relying on educated guesses, scientists have been chipping away at a universal flu vaccine that targets all strains—perhaps even those we haven’t yet identified. Often referred to as the “holy grail” in epidemiology, these vaccines try to alert our immune systems to parts of a flu virus that are least variable from strain to strain.
Last November, a first universal flu vaccine developed by BiondVax entered Phase 3 clinical trials, which means it’s already been proven safe and effective in a small numbers and is now being tested in a broader population. The vaccine doesn’t rely on dead viruses, which is a common technique. Rather, it uses a small chain of amino acids—the chemical components that make up proteins—to stimulate the immune system into high alert.
With the government pouring $160 million into the research and several other universal candidates entering clinical trials, universal flu vaccines may finally experience a breakthrough this year.
In-Body Gene Editing Shows Further Promise
CRISPR and other gene editing tools headed the news last year, including both downers suggesting we already have immunity to the technology and hopeful news of it getting ready for treating inherited muscle-wasting diseases.
But what wasn’t widely broadcasted was the in-body gene editing experiments that have been rolling out with gusto. Last September, Sangamo Therapeutics in Richmond, California revealed that they had injected gene-editing enzymes into a patient in an effort to correct a genetic deficit that prevents him from breaking down complex sugars.
The effort is markedly different than the better-known CAR-T therapy, which extracts cells from the body for genetic engineering before returning them to the hosts. Rather, Sangamo’s treatment directly injects viruses carrying the edited genes into the body. So far, the procedure looks to be safe, though at the time of reporting it was too early to determine effectiveness.
This year the company hopes to finally answer whether it really worked.
If successful, it means that devastating genetic disorders could potentially be treated with just a few injections. With a gamut of new and more precise CRISPR and other gene-editing tools in the works, the list of treatable inherited diseases is likely to grow. And with the CRISPR baby scandal potentially dampening efforts at germline editing via regulations, in-body gene editing will likely receive more attention if Sangamo’s results return positive.
Neuralink and Other Brain-Machine Interfaces
Neuralink is the stuff of sci fi: tiny implanted particles into the brain could link up your biological wetware with silicon hardware and the internet.
But that’s exactly what Elon Musk’s company, founded in 2016, seeks to develop: brain-machine interfaces that could tinker with your neural circuits in an effort to treat diseases or even enhance your abilities.
Last November, Musk broke his silence on the secretive company, suggesting that he may announce something “interesting” in a few months, that’s “better than anyone thinks is possible.”
Musk’s aspiration for achieving symbiosis with artificial intelligence isn’t the driving force for all brain-machine interfaces (BMIs). In the clinics, the main push is to rehabilitate patients—those who suffer from paralysis, memory loss, or other nerve damage.
2019 may be the year that BMIs and neuromodulators cut the cord in the clinics. These devices may finally work autonomously within a malfunctioning brain, applying electrical stimulation only when necessary to reduce side effects without requiring external monitoring. Or they could allow scientists to control brains with light without needing bulky optical fibers.
Cutting the cord is just the first step to fine-tuning neurological treatments—or enhancements—to the tune of your own brain, and 2019 will keep on bringing the music.
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The human mind can be a confusing and overwhelming place. Despite incredible leaps in human progress, many of us still struggle to make our peace with our thoughts. The roots of this are complex and multifaceted. To find explanations for the global mental health epidemic, one can tap into neuroscience, psychology, evolutionary biology, or simply observe the meaningless systems that dominate our modern-day world.
This is not only the context of our reality but also that of the critically-acclaimed Netflix series, Maniac. Psychological dark comedy meets science fiction, Maniac is a retro, futuristic, and hallucinatory trip that is filled with hidden symbols. Directed by Cary Joji Fukunaga, the series tells the story of two strangers who decide to participate in the final stage of a “groundbreaking” pharmaceutical trial—one that combines novel pharmaceuticals with artificial intelligence, and promises to make their emotional pain go away.
Naturally, things don’t go according to plan.
From exams used for testing defense mechanisms to techniques such as cognitive behavioral therapy, the narrative infuses genuine psychological science. As perplexing as the series may be to some viewers, many of the tools depicted actually have a strong grounding in current technological advancements.
Catalysts for Alleviating Suffering
In the therapy of Maniac, participants undergo a three-day trial wherein they ingest three pills and appear to connect their consciousness to a superintelligent AI. Each participant is hurled into the traumatic experiences imprinted in their subconscious and forced to cope with them in a series of hallucinatory and dream-like experiences.
Perhaps the most recognizable parallel that can be drawn is with the latest advancements in psychedelic therapy. Psychedelics are a class of drugs that alter the experience of consciousness, and often cause radical changes in perception and cognitive processes.
Through a process known as transient hypofrontality, the executive “over-thinking” parts of our brains get a rest, and deeper areas become more active. This experience, combined with the breakdown of the ego, is often correlated with feelings of timelessness, peacefulness, presence, unity, and above all, transcendence.
Despite being not addictive and extremely difficult to overdose on, regulators looked down on the use of psychedelics for decades and many continue to dismiss them as “party drugs.” But in the last few years, all of this began to change.
Earlier this summer, the FDA granted breakthrough therapy designation to MDMA for the treatment of PTSD, after several phases of successful trails. Similar research has discovered that Psilocybin (also known as magic mushrooms) combined with therapy is far more effective than traditional forms of treatment to treat depression and anxiety. Today, there is a growing and overwhelming body of research that proves that not only are psychedelics such as LSD, MDMA, or Psylicybin effective catalysts to alleviate suffering and enhance the human condition, but they are potentially the most effective tools out there.
It’s important to realize that these substances are not solutions on their own, but rather catalysts for more effective therapy. They can be groundbreaking, but only in the right context and setting.
In Maniac, the medication-assisted therapy is guided by what appears to be a super-intelligent form of artificial intelligence called the GRTA, nicknamed Gertie. Gertie, who is a “guide” in machine form, accesses the minds of the participants through what appears to be a futuristic brain-scanning technology and curates customized hallucinatory experiences with the goal of accelerating the healing process.
Such a powerful form of brain-scanning technology is not unheard of. Current levels of scanning technology are already allowing us to decipher dreams and connect three human brains, and are only growing exponentially. Though they are nowhere as advanced as Gertie (we have a long way to go before we get to this kind of general AI), we are also seeing early signs of AI therapy bots, chatbots that listen, think, and communicate with users like a therapist would.
The parallels between current advancements in mental health therapy and the methods in Maniac can be startling, and are a testament to how science fiction and the arts can be used to explore the existential implications of technology.
Not Necessarily a Dystopia
While there are many ingenious similarities between the technology in Maniac and the state of mental health therapy, it’s important to recognize the stark differences. Like many other blockbuster science fiction productions, Maniac tells a fundamentally dystopian tale.
The series tells the story of the 73rd iteration of a controversial drug trial, one that has experienced many failures and even led to various participants being braindead. The scientists appear to be evil, secretive, and driven by their own superficial agendas and deep unresolved emotional issues.
In contrast, clinicians and researchers are not only required to file an “investigational new drug application” with the FDA (and get approval) but also update the agency with safety and progress reports throughout the trial.
Furthermore, many of today’s researchers are driven by a strong desire to contribute to the well-being and progress of our species. Even more, the results of decades of research by organizations like MAPS have been exceptionally promising and aligned with positive values. While Maniac is entertaining and thought-provoking, viewers must not forget the positive potential of such advancements in mental health therapy.
Science, technology, and psychology aside, Maniac is a deep commentary on the human condition and the often disorienting states that pain us all. Within any human lifetime, suffering is inevitable. It is the disproportionate, debilitating, and unjust levels of suffering that we ought to tackle as a society. Ultimately, Maniac explores whether advancements in science and technology can help us live not a life devoid of suffering, but one where it is balanced with fulfillment.
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