From the lab to the people: major challenges in the biological treatment of Down syndrome

Jean A Rondal; Jean A Rondal

doi:10.3934/Neuroscience.2021015

AIMS Neuroscience

2021, Volume 8, Issue 2: 284-294. doi: 10.3934/Neuroscience.2021015

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Review

From the lab to the people: major challenges in the biological treatment of Down syndrome

Running title: Biological treatment of Down syndrome

Jean A Rondal ^,

University of Liège, Belgium

Received: 16 December 2020 Accepted: 07 February 2021 Published: 09 February 2021

Down syndrome (DS) refers to a genetic condition due to the triplication of human chromosome 21. It is the most frequent autosomal trisomy. In recent years, experimental work has been conducted with the aim of removing or silencing the extra chromosome 21 (C21) in cells and normalizing genetic expression. This paper examines the feasibility of the move from laboratory studies to biologically treating “bone and flesh” people with DS. A chromosome or a gene therapy for humans is fraught with practical and ethical difficulties. To prevent DS completely, genome editing would have to be performed early on embryos in the womb. New in vitro findings point toward the possibility of epigenetic silencing the extra C21 in later embryonic or fetal life, or even postnatally for some aspects of neurogenesis. These possibilities are far beyond what is possible or allowed today. Another approach is through epigenetic regulation of the overexpression of particular genes in C21. Research with mouse modeling of DS is yielding promising results. Human applications have barely begun and are questioned on ethical grounds.
- Down syndrome,
- trisomy 21,
- chromosome correction,
- induced pluripotent stem cells,
- neural stem cells,
- gene editing,
- CRISP-Cas9,
- epigenetic regulation,
- epigallocathechin-3-gallate
Citation: Jean A Rondal. From the lab to the people: major challenges in the biological treatment of Down syndrome[J]. AIMS Neuroscience, 2021, 8(2): 284-294. doi: 10.3934/Neuroscience.2021015

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Abstract

Down syndrome (DS) refers to a genetic condition due to the triplication of human chromosome 21. It is the most frequent autosomal trisomy. In recent years, experimental work has been conducted with the aim of removing or silencing the extra chromosome 21 (C21) in cells and normalizing genetic expression. This paper examines the feasibility of the move from laboratory studies to biologically treating “bone and flesh” people with DS. A chromosome or a gene therapy for humans is fraught with practical and ethical difficulties. To prevent DS completely, genome editing would have to be performed early on embryos in the womb. New in vitro findings point toward the possibility of epigenetic silencing the extra C21 in later embryonic or fetal life, or even postnatally for some aspects of neurogenesis. These possibilities are far beyond what is possible or allowed today. Another approach is through epigenetic regulation of the overexpression of particular genes in C21. Research with mouse modeling of DS is yielding promising results. Human applications have barely begun and are questioned on ethical grounds.

Acknowledgments

I am indebted to Dr Jean-Paul Broonen, Free University Brussels, for exchanges regarding the ethical section of this paper, and to Dr Robert Hoffmeister, Boston University, for corrective suggestions and constructive comments on a preceding version of the article.

Conflict of interest

The author declares no conflict of interest.

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