The Future of Science: Humanity Takes a Front Seat
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Over the last few years, we saw breakthroughs and discoveries that scientists had only dreamed of. From the development of the life-saving COVID-19 vaccines to NASA crashing a spacecraft into an asteroid in a successful attempt to alter its orbit, clearly a lot can happen in a short period of time.
With the world of science rapidly evolving, we look at the trends breaking through right now, asking experts: where is the world of science headed?
Feeding the planet in a climate changing world
By some estimates the planet will need to produce 60% more food by 2050 to sustain the world’s growing population – an ask that will likely strain the already fatigued agriculture industry and place a heavy burden on natural resources. Major changes are necessary to keep up with such high demands – but where do we start?
One proposed approach is genetically modifying heat-resistant crops by “hacking” photosynthesis. Photosynthesis uses sunlight, water and carbon dioxide to make sugars and other molecules plants need, but in hot and dry conditions the necessity of water and carbon dioxide poses a problem. To let carbon dioxide in, plants must keep their pores open, but this can lead to water loss, which can ultimately kill the plant. By hacking the system, geneticists have been working to engineer plants like rice, wheat and maize to withstand extreme temperatures, while other vegetables that already have a high heat tolerance – like eggplant, sweet potatoes and okra – are being engineered to sustain longer periods of heat and increase yield. Just this month, a study published in Nature described the discovery of two-million year old DNA from an ancient ecosystem in Finland where temperatures at that time were of the levels we should expect if climate change were to continue. Researchers are hoping to use this data to show how plant species were able to adapt to better understand how genetically-modified modern species could withstand today’s increasing temperatures.
Putting resources into developing more sufficient and nutrient-rich food that is accessible and can withstand demand pressures is also encouraged by scientists. This can be achieved through actions beyond the farm, according to Dr. Patrick Webb, Alexander McFarlane professor of nutrition at Tufts University and director for USAID’s Feed the Future Nutrition Innovation Lab. “Much of what is produced today never reaches the consumer,” he said. “Around 30% of food is lost or wasted, and in addition much is fed to livestock, who contribute to greenhouse gas emissions. Some is used for alcohol and ethanol, and even more is used in creating ultra-processed foods that have little nutritional or health value. We need to change what is done to food in the supply chain, and help shift demand for higher quality diets, to support actions already being pursued on the farm.”
In other words, noticeable change could occur with a shift in subsidies towards nutrient dense foods, cutting out food waste and reducing meat and dairy consumption in countries that currently consume these at levels contributing to ill-health.
“All of this would substitute for the so-called needed “increases” in current production patterns, while at the same time making food systems contribute more positively to both human and planetary health,” Webb added.
Genome-editing takes a front seat in healthcare
Genome-editing techniques like CRISPR-Cas9 technology have gained further momentum in the last few years. The 2020 Nobel Prize in Chemistry was awarded jointly to Professors Emmanuelle Charpentier and Jennifer Doudna for discovering one of the gene technology’s most precise tools – the CRISPR-Cas9 genetic scissors. The number of clinical trials testing CRISPR-based therapeutics continues to grow each year, with the technology currently being tested against cancer, blood disorders, metabolic conditions and even urinary tract infections.
Just last year, the first clinical trial using a CRISPR-based therapy to treat blindness yielded positive results. The therapy targets mutations in the CEP290 gene, which causes a rare form of blindness known as Leber congenital amaurosis type 10 (LCA10) that is incurable. The clinical trial injected CRISPR machinery into the body to repair CEP290 mutations.
Another recent study tested a one-time treatment that uses an ex vivo approach to correct a defective gene behind sickle cell disease and beta thalassemia. Here, a patient’s cells are extracted and CRISPR-Cas9 is used to modify them such that they produce fetal hemoglobin. The study presented at the European Hematology Association (EHA) Congress, showed that both β-thalassemia patients had hemoglobin levels of 14.2 and 12.5 grams per deciliter, respectively, following the study, compared to a range of 12 to 15 grams, normally seen in healthy adults. Participants also saw continued benefits for up to three years after administration, with this approach being cited as a potentially safer treatment option than an allogeneic transplant from a donor.
While the ingenuity of CRISPR-Cas9 has proven successful in certain clinical trials, the technology faces barriers relating to ethics, precision and accessibility. These include the difficulty in delivering the technology to mature cells in large numbers, which can ultimately affect accuracy and efficiency. As of 2014, the EU Clinical Trials Regulation banned clinical trials of any gene therapy that might result in germline modifications – edits to reproductive cells that could be inherited – because of ethical and safety concerns. And “off target” edits, nonspecific and unintended genetic modifications, can have severe consequences, particularly in clinical settings.
In 2017, The National Academy of Sciences and National Academy of Medicine issued a 258-page report focused on human genome editing. It included recommendations for the US government and governments around the world on how best to handle the advances in genome editing and included recommendations for basic laboratory research like requiring broad public input prior to extending resources and limiting clinical trials to prevention and treatment of disease or disability at this time. The committee also discussed the issue of equity and access to genome-editing technology – which is currently priced highly due to the investments required for R&D that can be lengthy and expensive. Globally, it will need to be ensured that people with disabilities have an equal voice and equitable access. The report acknowledged the inevitable bottleneck that will occur as more people learn about emerging CRISPR-based therapeutics and request them.
Progress in global vaccination efforts
Infectious diseases remain the leading cause of death for people in low-income countries, with malaria and RSV killing as many as 1 in 50 children, according to a recent study. But experts are hopeful that immunization research and the introduction of new vaccines to the marketplace will provide relief in the years to come.
“I am excited about the new malaria vaccine, called R21,” said Dr. Gavin Yamey, professor of global health and public policy at Duke University. “Developed by scientists at Oxford University, it was found to be up to 80% efficacious at preventing malaria in young children in a clinical trial. We don’t yet know whether we’ll see the same level of benefit once the vaccine is rolled out in the real world, but if it turns out to be highly effective under real world conditions, it could have a dramatic impact.” The vaccine was the first to reach the World Health Organization (WHO)’s Malaria Vaccine Roadmap goal of a vaccine with at least 75% efficacy in 2021.
Dr. Yamey said that providing timely access to vaccines – like R21 – and medical care is crucial in preventing disease. He adds that a possible solution to ensuring better access and health resources come from the implementation of strong primary care systems in all countries that can deliver prevention, treatment and rehabilitation services to any and everyone in need.
Vaccine equity plays a major role in providing that. The WHO announced it has increased funding to initiatives working to scale-up vaccine production in disease afflicted countries, while data scientists are using technology to better understand and predict potential viral outbreaks that can originate in animals, with the ultimate goal of preventing any future pandemic outbreaks.
“We need globalized vaccine manufacturing capacity, so that all regions can make pandemic vaccines when needed,” added Yamey. “We need to agree up front on a fair global allocation of vaccine doses, and we need to share the intellectual property on any future pandemic vaccine.”
Consciousness-expanding medicines go mainstream
The use of marijuana for medical purposes has grown in popularity over the last decade, but researchers are now exploring psychedelics for a myriad of neurological and psychiatric conditions.
“Many drugs that are used recreationally can aid medical conditions, or they’re undergoing clinical trials to determine if they are safe and effective,” said Betty Aldworth, director of communications at the Multidisciplinary Association for Psychedelic Studies (MAPS). “In fact, this is true with drugs from every psychoactive class.”
While still in research, and not permitted for routine clinical practice, some psychoactive drugs have already demonstrated their potential for treating neurological disorders. The use of ketamine, a dissociative commonly used for induction and maintenance of anesthesia, showed significant improvement in depression and anxiety symptoms after a 0.5 mg/kg dose was administered six times over a two-week period in a 2019 study. Stimulants like amphetamines have also shown effectiveness in reducing ADHD symptoms, where the drugs work to increase levels of dopamine and norepinephrine in the brain.
In mid-November, MAPS Public Benefit Corporation announced that the second MAPS-sponsored Phase III trial of MDMA-assisted therapy for PTSD was complete. “In the first Phase III trial of MDMA-assisted therapy for PTSD, 88% of participants experienced a clinically significant reduction in PTSD symptoms and 67% no longer met the criteria for a PTSD diagnosis,” Aldworth said. “Psilocybin-assisted therapy for treatment resistant depression is entering Phase III trials.”
While no psychedelic has been FDA-approved, clinical trials so far have delivered promising results and it seems likely that FDA approval will happen in the coming years, said Aldworth: “FDA approval will also help dismantle the decades of disinformation, myths, and stigma associated with psychedelics.”
As the future of science continues to evolve and the field matures, leveraging technology against the world’s top problems will be the key to success. As Milton H. Saier, Jr. wrote, it won’t be enough to focus on just the science, but recognize the people it most directly affects: “They allow us to recognize what we have in common with each other and with other living beings,” he said.
