The creation of humans immune to common diseases through gene editing technology is a complex and challenging scientific issue, involving ethical, technical, and safety considerations. The following is a step-by-step overview, while emphasizing the ethical framework and the principle of scientific caution that must be followed： --- ### **1. Selection and gene localization of target diseases** -**Identify key diseases**: Give priority to single-gene genetic diseases (such as cystic fibrosis, sickle anemia) or diseases that are clearly caused by specific gene mutations (such as BRCA1/2 and breast cancer). -**Multi-factor disease challenge**: For complex diseases such as hypertension and diabetes, multiple susceptibility genes (such as TCF7L2 and type 2 diabetes) or genes that regulate immunity (such as HLA region and autoimmune diseases) need to be identified. -**Tools such as CRISPR-Cas9**: Use Base Editing or Prime Editing to reduce the risk of off-target, and target modification of pathogenic mutations (such as repairing F508del mutations to treat cystic fibrosis). --- ### **2. Gene editing strategy** -**Functional enhancement**: Insert protective gene variants (such as CCR5Δ32 mutations, which can resist HIV infection). -**Functional repair**: Correct pathogenic mutations (such as repairing β-globin gene therapy for β-thalassemia). -**Gene regulation**: Upregulate cancer-suppressing genes (such as p53) or downregulate inflammatory factors (such as IL-6) to reduce the risk of chronic diseases. --- ### **3. Delivery technology and Security** -**In vivo editing**: Use AAV virus to deliver CRISPR components to specific tissues (such as the liver to deliver PCSK9 editing tools to lower cholesterol). -**In vitro editing**: Editing hematopoietic stem cells (such as treating SCID) or embryos (subject to strict ethical review, currently limited to research). -**Off-target control**: Safety is verified through sgRNA optimization, HiFi-Cas9 variants, and whole genome sequencing. --- ### **4. Ethics and Regulation** -**International consensus**: Follow the "Declaration of Helsinki" and national laws (such as China's "Regulations on the Management of Clinical Applications of New Biomedical Technologies"). -**Restrictions on germ line editing**: Currently, clinical application to human embryos (except for some studies) is generally prohibited worldwide because it involves heritable changes. -**Fairness**: Ensure the availability of technology and avoid exacerbating social inequality. --- ### **5. Potential path to extend life** -**Aging-related genes**: Editing telomerase (TERT), mTOR, or SIRT6 genes may delay aging, but caution is required (such as cancer risk). -**Senolysis**: Remove senescent cells (such as p16INK4a-positive cells) by editing. -**Multi-gene synergy**: Systematic biology methods are needed to analyze gene interaction to avoid unpredictable side effects. --- ### **6. Long-term monitoring and iteration** - **Animal model**: First verified in non-human primates (such as the monkey TERT editing experiment reported in Science in 2021). -**Organoid verification**: Use organoids from patient sources to test the editing effect. -**Lifelong follow-up**: The offspring of edited individuals need to track potential cross-generational effects. --- ###**Realistic challenges and alternatives** -**Technical limitations**: The editing efficiency of polygenic diseases is low, and the delivery vector may trigger an immune response. - **Ethical substitution**: Prioritize the development of somatic cell editing (such as CAR-T for cancer treatment) or vaccine prevention (such as HPV vaccine). -**Comprehensive health management**: Gene editing cannot replace a healthy lifestyle and public health measures. --- ###**Conclusion** Although gene editing may theoretically enhance disease resistance, the technology is not yet mature, and germ line editing is widely prohibited. Future breakthroughs need to rely on： 1. More precise editing tools (such as epigenetic editing)； 2. Strict ethical supervision； 3. The establishment of social consensus. While pursuing human health and longevity, the scientific community must balance innovation and risk to ensure that technology benefits all mankind and not a few groups. At this stage, it is recommended to focus on somatic cell editing therapies that have entered clinical trials (such as the VERTEX-CTX001 trial for sickle anemia), rather than directly modifying the human reproductive system.