为什么不能在胚胎中编辑基因？三个原因，且都不是“我们不知道怎么做”
Why can’t we edit genes in an embryo? Three reasons, and none of them are because “we don’t know how.” 1 Heritability. Casgevy edits blood cells, so the change dies with the patient. An embryo edit lands in every cell, including sperm and eggs. It’s permanent across generations, and nobody downstream consented. 2 Mosaicism. CRISPR doesn’t edit a single cell embryo cleanly before it divides. He Jiankui’s 2018 twins came out as a patchwork. Some cells edited, some not. And most of the embryo’s cells were never checked for off target cuts. 3 Pleiotropy. Genes multitask. The CCR5 gene is the one people target to block HIV, but it also helps fight West Nile virus. People born without it get severely ill. And the diseases we actually fear, like heart disease and type 2 diabetes, involve thousands of variants. There’s no single typo to fix.
胚胎基因编辑无法推行的三个原因并非技术不会，而是遗传性、嵌合体与基因多效性。Casgevy 编辑血细胞会随患者死亡而终止，胚胎编辑则进入包括精子卵细胞在内的每个细胞并永久传给后代；贺建奎 2018 年的双胞胎即呈部分细胞被编辑的嵌合状态；CCR5 缺失虽可阻断 HIV，却也会削弱对西尼罗病毒的抵抗，而心脏病、2 型糖尿病涉及数千个变异，没有单一“错字”可改。
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数字来自平台，为最近一次抓取时的数据。
以下是视频口播的自动转写，可能有错字。
Here's a question for you. Why can't we just edit a disease out of a baby before it is born? I mean, think about it. We can already edit genes.
Cas9 got approved in 2023, which is the first crispr therapy. Doctors take a patient's blood cells out. Fix them in a dish and put them back.
That edit though stops with that patient. An embryo edit doesn't stop. It essentially ends up in every cell of the person who gets born, including the cells that make their kids.
The change joins the family tree, and nobody downstream of it got asked for permission. One science went ahead anyway. In 2018, he announced twin girls born from embryos he's edited to resist hiv.
Then went to prison for 3 years. But when researchers went through his own data, the embryos were a patchwork. So essentially, some cells were edited, some were not, with cuts in places he never aimed at.
So here's the part though that i find really fascinating. Genes essentially will multitask. The one he deleted helps you fight off west nile virus, and people born without it get severely ill from it, and the disease is.
We actually worry about don't have just one typo in the genes. For example, heart disease type 2 diabetes, there's thousands of variants of each and there's nothing to go in and fix it.
The one legal exception is in the uk. Eight babies were reportedly born healthy that way in 2025. Whoever inherits this edit is the one who finds out what else that gene was doing.
So that is the really big question here and one that maybe over the years we will solve share this with someone who loves biotech.
来源：TikTok · Tiff in Tech · tiktok.com