Transfiguring Medicine With CRISPR

Can diseases be cured by engineering DNA? Radiologists may need to be part of the team to find the answer.



July 2015

Do you know what CRISPRs are? If you don’t and you don’t plan on retiring within the next few years, you should find out. They may soon be changing the way disease is diagnosed and treated.

What’s a CRISPR?

If you think it sounds like a plot in an X-Men comic book or an episode of Star Trek, you aren’t far off. Essentially, these clustered regularly interspaced short palindromic repeats (CRISPRs) are chunks of a virus’s DNA code that are stored by bacteria within their own DNA code. The CRISPRs’ purpose is to protect the bacteria from attacks by an enemy virus. They do this by seeking out the virus’s DNA and destroying it.

How Is This Changing Medicine?

In 2012, bioengineers and other scientists figured out how that same defense process could be used to edit and engineer the genomes of a variety of organisms, including humans.

Genome engineering is not a new technology, but what is new is that it’s cheap and incredibly effective using CRISPRs. While still largely in the testing stage, the potential applications for using CRISPR technology to engineer genomes extends through medicine and beyond. For example, the technology could be used to identify cancer cells and destroy them at the molecular level without harming nearby healthy tissue. It could also be used to render Alzheimer-causing genes inactive or even cut and destroy HIV DNA.

Why Does This Matter to Radiologists?

Well, during the Moreton Lecture at ACR 2015, James Thrall, MD, FACR, stated that radiologists will play a key role in helping classify genotypes and “provide surveillance and information on the location, extent, and severity of the disease.” Although Thrall didn’t call out CRISPR technology by name, as the technology lengthens its stride into application and perhaps even clinical trials, radiologists may be essential to monitoring the effectiveness of the technology by viewing its effect on diseased and surrounding tissue over time. They will also need to be experts in communicating the results to referring physicians as well as the patient.

Are We Sure This Is a Good Idea?

While its medical applications are certainly far-reaching, the ethics associated with tinkering with human genomes, or what some call “biohacking,” is understandably messy. Theoretically, human embryo genomes could be engineered to make an individual tall or short, fat or thin, or blonde or red haired. In April of this year, Chinese scientists published a paper in which they attempted to alter the DNA of non-viable human embryos using CRISPR technology.

Regardless of the ethical questions raised, however, it seems that CRISPR technology is here to stay and radiology will likely need to be poised to help test and monitor this new giant leap forward into precision medicine.

Additional Sources

Listen to the NPR program RadioLab for more information about CRISPR 

By Brett Hansen, senior managing editor for ACR Press

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