By Monish Chhabra ǀ 31st July 2017

In a graduation speech given recently, Bill Gates cited three fields that contain the biggest promise today – artificial intelligence, energy and biosciences. He believes these three can make the same revolutionary impact on the world over the next few decades, as ‘digital revolution’ has done since Gates started his career.

To help people live longer and healthier lives is an eternal human quest. The advances in bioscience have become much faster in the recent times, due to the application of computing technology to it.

Google hosts a competition every year, which aims to bring together the best early-stage startups implementing machine learning. The winner this year was PicnicHealth. It creates training data for the machine learning algorithms, to make precision medicine. Biology is no longer distinct from computing.

Bioscience research is advancing so rapidly that medical knowledge, which in 1950 used to take 50 years to double, now doubles every 3 years. Of particular mention is the progress in genomic research.

There are 5000 genetic tests available today that can be used to diagnose genetic disorders. 20 years ago, there were only 500. There are 150 personalized medicines available today. 10 years ago, none.

The turning point was the decoding of the human genome in 2003. Human genome is one complete set of DNA that contains all the instructions as to how our bodies are made and maintained. The first step to understand this blueprint, is to decode it or ‘sequence’ it.

‘DNA sequencing’ is to record, in precise order, the 3 billion nucleotides within all the DNA molecules, comprising 20,000 genes, of an individual human being. This constitutes the entire genetic makeup of a person. It is the instruction manual for our cells.

The first human genome sequencing was done at a cost of 3 billion dollars and took 15 years to complete. Just 5 years later in 2008, the cost of sequencing came down to 10 million dollars per person. Today, the full DNA of a person can be sequenced for just about a thousand dollars, and can be completed in a matter of days.

If this one DNA sequence is printed on A4 paper, double-sided and compiled as a book with 500 pages; there would be 500 such books. That is the amount of information stored in a single cell. There are 10 trillion such cells in our body, each of which contain this full DNA information. The data compression done by nature is magical!

Such sequencing or testing of DNA has found many applications; forensic testing, evolution research and most importantly, medicine.

‘Personalized or precision medicine’ is driven by genomic diagnosis. It involves studying the genomic design of an individual to predict health risks (so that these can be addressed before they manifest), diagnose a disease if it happens (early and accurately), and propose treatment that is specifically suitable to that person’s body.

For example, it can reveal mutations in DNA that may cause diseases, and predict risk of a particular disease to a person. It can also be used to find the exact source or nature of a disease, how will that person’s body respond to a certain drug or treatment, detect the body’s resistance to various drugs, possible side effects, etc.

In future, genomic diagnosis would become standard part of any major medical diagnosis. A gene test would be just like a blood test.

The UK government’s chief medical adviser recently outlined plans to make DNA sequencing as routine as MRI or CT scans, in 5 years’ time. They want all cancer patients to be able to get their DNA sequenced, in order to get the most personalized treatment. They also called for every clinician in the country to be trained in genomics.

Further beyond lies ‘genetic engineering’. It involves modifying the DNA, which can be used to cure diseases by replacing defective genes with healthy ones. Or, it can also be used to design human babies.

Such efforts have been going on for at least 40 years. Most methods were too difficult, inefficient or too costly. But now all that has changed with the invention of a new technology called CRISPR/ Cas9.

CRISPR is a tool to delete or insert specific bits of DNA into cells with incredible precision. It can completely change the physical attributes of the body. It has been used to successfully create genome-engineered plants and animals. It is efficient, viable and not too difficult. This has given its inventors some fright.

They have called for a moratorium on any use of CRISPR on human embryos, until there is some standard of using it responsibly. However, there are already 3 cases in China and 1 in the US, where the DNA of a human embryo was edited using CRISPR. CRISPR based applications are expected to be in the market within 10 years.

DNA is not the only way we are changing our biological design. Some scientists are working on planting microchips inside the brains of Parkinson’s and Alzheimer’s patients, to restore some of their lost abilities. The long-term goal is to have such chips inside the brain of any person, in order to increase his or her mental powers.

A team in Boston recently announced that they have figured out how to make human blood in the laboratory. They can now ‘reprogram’ embryonic stem cells into making blood cells. Not only we can make blood now, we are also making machines to swim inside our blood.

Scientists are building tiny robots called ‘nanobots’ that can be injected in our blood to deliver medicine to a particular spot in our body. Such drug delivery would be less invasive (than surgery) and more targeted (than flooding the entire body with medicines). Such bots can also roam autonomously in our blood stream, checking up on things and sending a signal if they spot an infection or a tumour. This is police patrol inside our body…in self-driven cars!

Mind, Body & Soul

Carolyn Dicey Jennings, a professor of philosophy and cognitive science, posits that a person’s ‘self’ is not determined only by a mix of genes and environment.

Self is a unique emergent entity that has powers beyond those of its parts or history. It has a status independent of its microphysical underpinnings, as well as, its macro-level objects.

She believes that the ‘self’ comes into being with the first act of ‘attention’. Attention is what one uses to drown out distracting sights and sounds, to focus on whatever it is one needs to focus on.

We force a resolution between conflicting things that draw our attention, and choose to focus on one. The narrative we build through our attention constructs the ‘self’.

The Last Word

Genomics may one day explain all about our ‘nature’. And a lot else may be attributable to our ‘nurture’. However, we are more than the combination of these two.

Regardless of where we land at any moment, we choose what we board in the next. We choose where we look, we choose what we attend to.

That ‘attention’ is our compass. Its course charts our manifestation, as well as the conclusion.