'Incredible' editing of life's building

blocks
By James GallagherHealth and science reporter, BBC News website
25 October 2017

From the sectionHealth

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Scientists have demonstrated an "incredibly powerful" ability to manipulate the building blocks of life
in two separate studies.
One altered the order of atoms in DNA to rewrite the human genetic code and the instructions for life.

The other edited RNA, which is a chemical cousin of DNA and unlocks the information in the genetic code.

The studies - which could eventually treat diseases - have been described as clever, important and exciting.

Cystic fibrosis, inherited blindness and other diseases caused by a single typo in the genetic code could
ultimately be prevented or treated with such approaches.

Both studies were performed at the Broad Institute of MIT and Harvard.

Base editing
The first, published in the journal Nature, developed tools called base editors.

DNA is built out of the four bases: adenine (A), cytosine (C), guanine (G) and thymine (T). If a single one of
them is in the wrong place, it can cause disease.

Base editors alter the molecular structure of one base to convert it into another. Researchers can now
manipulate the four bases.

And the team used base editing to correct an inherited disease that leads to dangerously high levels of iron in
the blood.

Prof David Liu of the Broad Institute said: "We are hard at work trying to translate base editing technology
into human therapeutics."

However, he admits there are still issues around safety and implementation:

"Having a machine that can make the change you want to make is only the start. You still need to do all this
other work, but having the machine really helps."

RNA
The second study, published in the journal Science, focused on RNA, another of the molecules essential for
life.

DNA is the master copy of the genetic code, but in order for a cell to use the genetic instructions, it must first
create an RNA copy.

It is like going to a library where you cannot read any of the books, but can only use photocopies.

The researchers used their RNA approach to correct an inherited form of anaemia in human cells.

Feng Zhang - also of the Broad Institute - said: "The ability to correct disease-causing mutations is one of the
primary goals of genome editing.

"This new ability to edit RNA opens up more potential opportunities to... treat many diseases, in almost any
kind of cell."
 All of the experiments were on human cells growing in the laboratory.
DNA surgery on embryos removes disease
Human embryos edited to stop disease
UK scientists edit DNA of human embryos

Dr Helen O'Neill, from UCL, said: "This is an exciting week for genetic research.

"These papers highlight the fast pace of the field and the continuous improvements being made in genome
editing, bringing it closer and closer to the clinic."

Scientific advances in genetic engineering are taking place at an incredible pace.

And the same technologies work on plants, animals and micro-organisms too, posing questions for areas like
agriculture.

Dr Sarah Chan, a bioethicist at the University of Edinburgh, said we can no longer pretend the technology is
too dangerous to contemplate.

She told the BBC: "We can't hide any more.

"The science is moving fast in the sense it is becoming less risky, more certain, more precise and more
effective.

"It is absolutely past time for us to engage more widely with publics on the issue of gene editing."
Follow James on Twitter.
http://www.bbc.com/news/health-41724994

Health tourism charges come into force

in England
By Katie SilverHealth reporter, BBC News
23 October 2017

From the sectionHealth

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Image copyrightISTOCK

Providers of NHS treatment are required from Monday to make sure patients in England are eligible
for free care - and to charge them up front if not.

The measures apply to planned, non-urgent care - A&E, general practice and infectious disease treatment
remain free to all.

The government hopes it will contribute to 22bn of savings needed in the NHS.

But the British Medical Association said the changes may prevent vulnerable people getting treatment they
need.

Under the new measures, patients will be asked where they have lived in the last six months.

If they have lived abroad, they will be asked to show documentation that they are entitled to free NHS care,
such as a non-UK European Health Insurance Card.
 Hospitals and other parts of the NHS are also required to flag when a patient should be charged so that
providers elsewhere within the health service can more easily recoup costs.
Reality Check: How much could NHS recover from foreign patients?

Health Minister Lord O'Shaughnessy said: "We have no problem with overseas visitors using our NHS as long
as they make a fair financial contribution, just as the British taxpayer does.

"The new regulations simply require NHS bodies to make enquiries about, and then charge, those who aren't
entitled to free NHS care."

But Dr Chaand Nagpaul, of the British Medical Association, which represents doctors, said the current
proposals "lack clarity" and "run the risk of causing confusion".

"It is vital that patients do not face bureaucratic or financial obstacles that prevent acutely sick and vulnerable
individuals from seeking necessary treatment," he said.

"This would be morally unacceptable and could end up costing the NHS more money due to lack of timely
treatment."

The government has previously estimated that up to 500m could be recovered from overseas visitors' and
migrants' use of the NHS every year.
The BMA, at the time however, called that figure "exaggerated" and "unreliable".
http://www.bbc.com/news/health-41692815