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Insulin affordability remains a significant challenge for many individuals with diabetes, creating interest in alternative production technologies that may reduce costs and expand supply. This study examines consumer acceptance of insulin produced via a gene-edited production system compared with insulin produced using conventional genetically modified microbial methods. A discrete choice experiment was administered to U.S. adults diagnosed with diabetes (n = 386), in which respondents evaluated insulin alternatives varying by production technology and out-of-pocket cost. A mixed logit model was used to estimate willingness to pay and assess preference heterogeneity. Results indicate that out-of-pocket cost was the primary factor influencing insulin choice, with respondents exhibiting strong sensitivity to out-of-pocket costs. On average, respondents expressed acceptance of gene-edited insulin, and relative perceived safety was positively associated with willingness to pay for the product. Additional analysis revealed substantial heterogeneity in consumer preferences across respondents. Collectively, these findings suggest that affordability plays a more influential role than perceived safety in shaping consumer acceptance of emerging biotechnology-based insulin production systems and provide insights for stakeholders considering future commercialization pathways for insulin.
New technologies in gene editing, vertical farming, and digital solutions promise resilience to climate change, higher yields, and reduced environmental impact. Gene editing enables precise crop improvements, while vertical farming aims to produce food in controlled urban environments. Digital and artificial intelligence (AI) tools are already providing farmers with data-driven insights, market access, and automation. However, neither widespread adoption nor beneficial outcomes are guaranteed. Venture capitalists have invested billions, but the very nature of the industry risks instability and missed opportunities. The viability of many of these technologies is clear, but market adoption will depend on finding ways to provide tangible benefits to consumer groups. The future these technologies create – one of widespread prosperity or deeper inequality – hinges on our choices today. We must build trust, forge partnerships, and develop financing models that ensure these tools benefit all humanity, not just a privileged few.
CAR-T cell gene therapy has advanced from an experimental concept to a standard curative treatment for selected hematologic malignancies. Substantial clinical evidence has established CAR-T therapy as a cornerstone for relapsed/refractory B-cell malignancies and multiple myeloma, demonstrating durable, long-term remissions. In 2025, the U.S. Food and Drug Administration (FDA) eliminated the Risk Evaluation and Mitigation Strategy (REMS) requirement, reflecting improved clinical management of Cytokine Release Syndrome (CRS) and Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS). Yet, the widespread adoption of these therapies has unveiled a new landscape of long-term and next-generation challenges.
Methods
This review critically analyzes CAR-T therapy’s clinical trajectory and the bioengineering strategies redefining its safety, scalability, and translational potential.
Results
A major hurdle is therapeutic resistance driven by antigen escape, notably through alternative splicing and lineage switching. The emergence of long-term safety signals, specifically secondary T-cell malignancies, has necessitated rigorous surveillance, exemplified by the European Medicines Agency’s (EMA) mandate for lifelong patient monitoring. The therapeutic landscape is further complicated by histopathological and immunological barriers limiting the expansion and persistence of engineered cells. These include deficient T-cell trafficking, an immunosuppressive tumor microenvironment (TME), and antigen heterogeneity, which have historically constrained efficacy in solid tumors. To address these hurdles, the field is leveraging CRISPR-enhanced allogeneic platforms, cytokine-secreting armored CARs (TRUCKs), and logic-gated systems showing early clinical promise.
Conclusion
Building on these developments, we hypothesize that CAR-T therapy is undergoing a paradigm shift from single-target cytotoxicity toward a multi-functional, programmable framework capable of overcoming resistance, enhancing safety, and enabling effective penetration of solid tumors.
Commenting on Cargill’s article, this Commentary examines how gene therapy research is regulated in the United States and how oversight of the field has developed. It discusses recent applications of gene therapy technologies and their implications for oversight, and of the impact of ordered cuts to NIH-funded research on gene therapy developments more broadly. Ultimately, it underscores the need for adaptive oversight frameworks for research involving emerging biotechnologies that balance scientific innovation, safety, and ethical considerations, and for effective public engagement on the acceptable use of these technologies, notwithstanding the discontinuation of NIH’s advisory mechanism established for this purpose.
Policymakers often consult university scientists as they design and administer policies to address issues facing contemporary democracies, including climate change and global pandemics. Subsequently, democratic theorists have become interested in how science advising generates both challenges and opportunities for democratic governance. As a work of applied political theory, this article contributes to current debates over the political implications of scientific expertise—and engages with Zeynep Pamuk’s writings, in particular—through a sustained focus on impending regulatory decisions surrounding novel gene editing technologies. I show how political decisions have created incentives for university scientists to commercialize research and develop partnerships with biotechnology corporations. In turn, the academic-industrial complex has both compromised the integrity of scientific research and also impaired scientists’ capacities to offer disinterested advice in the public interest. I conclude by recommending the development of a more robust and expansive regulatory environment that can restore public trust in scientific expertise.
Genome editing has recently evolved from a theoretical concept to a powerful and versatile set of tools. The discovery and implementation of CRISPR-Cas9 technology have propelled the field further into a new era. This RNA-guided system allows for specific modification of target genes, offering high accuracy and efficiency. Encouraging results are being announced in clinical trials employed in conditions like sickle cell disease (SCD) and transfusion-dependent beta-thalassaemia (TDT). The path finally led the way to the recent FDA approval of the first gene therapy drug utilising the CRISPR/Cas9 system to edit autologous CD34+ haematopoietic stem cells in SCD patients (Casgevy). Ongoing research explores the potential of CRISPR technology for cancer therapies, HIV treatment and other complex diseases. Despite its remarkable potential, CRISPR technology faces challenges such as off-target effects, suboptimal delivery systems, long-term safety concerns, scalability, ethical dilemmas and potential repercussions of genetic alterations, particularly in the case of germline editing. Here, we examine the transformative role of CRISPR technologies, including base editing and prime editing approaches, in modifying the genetic and epigenetic codes in the human genome and provide a comprehensive focus, particularly on relevant clinical applications, to unlock the full potential and challenges of gene editing.
Since the eighteenth century, animal breeding has significantly evolved, culminating in the use of gene editing (GE) technologies like CRISPR-Cas9. These technologies offer unprecedented capabilities to modify animal genomes, potentially revolutionising breeding practices by achieving desired traits much faster compared to traditional selective breeding (SB). Because breeding programmes focussed on productivity traits have often compromised animal welfare, this article provides an analysis of the ethical issues underpinning the use of GE in animal breeding, and the current laws regulating such practices. In doing so, this article critically examines the European Union (EU)’s regulatory framework for SB and GE in farm animals, highlighting significant gaps and inconsistencies. Specifically, the use of GE animals is currently regulated under the EU’s GMO legislation, while SB is more loosely regulated, posing substantial risks to animal welfare. The authors advocate for a regulatory framework that prioritises animal welfare goals and proposes reforms to enhance animal protection objectives by ensuring a more consistent and humane approach to farm animal breeding.
Various in-vitro (induced pluripotent stem cells–derived) and in-vivo genetic models (animal models like Caenorhabditis elegans, Drosophila melanogaster, zebrafish, rodents, and non-human primates) have been used to study movement disorders such as Parkinson’s disease, hereditary ataxia, Huntington’s disease, dystonia, and essential tremor. These genetic models have provided important clues on the underlying pathophysiologic mechanisms of these diseases and serve as useful platforms to unravel potential therapeutic targets. The next generation of genetic models is promising with the advancement of gene-editing techniques, such as CRISPR-Cas9, brain organoid technology, and identification of novel genes and loci from large-scale genetic studies will facilitate development of new genetic models.
Utilizing online survey data of US consumers, this study examines the extent to which consumers' acceptance of genetically modified (GM) and gene-edited (GE) food is driven by their risk attitudes. Our results indicate that individuals with high-risk propensity are more likely to accept both GM and GE food than individuals with low- and medium-risk propensity. Our results also find differences in consumers' attitudes toward plants and animal products in the context of both GM and GE. Intriguingly, these attitudinal differences can be explained by consumers' risk propensities. Specifically, both low- and medium-risk propensity consumers differentiate between plants and animal products; the latter is less acceptable than the former, indicating a tendency to have more concerns about the application of biotechnology to animals than plants. However, individuals with high-risk propensity do not differentiate between GM and GE plants and animal products. Our results suggest that policymakers, the food industry, and researchers need to consider these attitudinal differences while studying consumer attitudes toward GM and GE food. Failing to capture these attitudinal differences in studies focusing on consumer behavior toward GM and GE food may result in either overestimating or underestimating consumer response.
New breeding methods have provided scientists with opportunities to improve traits in a wide range of crops, however, there remains resistance to foods that are produced from these crops, and mandates on labels used to describe such processes continue to be a source of policy debate. Here we focus on gene editing and examine (i) whether consumer acceptance varies when the technology is applied to different ingredients (unrefined versus highly refined ingredients) and (ii) the impact of two different claims related to gene editing (health-focused claim versus an environment-focused claim). Our results show that consumers are less likely to purchase a food product that includes gene-edited ingredients, yet the ingredient that is gene-edited is not important. We also find evidence that both of our selected claims about foods produced using gene-edited ingredients would increase consumers’ likelihood to purchase relative to the case with no claims.
Philosophers have used thought experiments to examine contentious examples of genetic modification. We hypothesised that these examples would prove useful in provoking responses from lay participants concerning technological interventions used to address welfare concerns. We asked 747 US and Canadian citizens to respond to two scenarios based on these thought experiments: genetically modifying chickens to produce blind progeny that are less likely to engage in feather-pecking (BC); and genetically modifying animals to create progeny that do not experience any subjective state (i.e. incapable of experiencing pain or fear; IA). For contrast, we assessed a third scenario that also resulted in the production of animal protein with no risk of suffering but did not involve genetically modifying animals: the development of cultured meat (CM). Participants indicated on a seven-point scale how acceptable they considered the technology (1 = very wrong to do; 7 = very right to do), and provided a text-based, open-ended explanation of their response. The creation of cultured meat was judged more acceptable than the creation of blind chickens and insentient animals. Qualitative responses indicated that some participants accepted the constraints imposed by the thought experiment, for example, by accepting perceived harms of the technology to achieve perceived benefits in reducing animal suffering. Others expressed discomfort with such trade-offs, advocating for other approaches to reducing harm. We conclude that people vary in their acceptance of interventions within existing systems, with some calling for transformational change.
What are genes? What do genes do? These questions are not simple and straightforward to answer; at the same time, simplistic answers are quite prevalent and are taken for granted. This book aims to explain the origin of the gene concept, its various meanings both within and outside science, as well as to debunk the intuitive view of the existence of 'genes for' characteristics and disease. Drawing on contemporary research in genetics and genomics, as well as on ideas from history of science, philosophy of science, psychology and science education, it explains what genes are and what they can and cannot do. By presenting complex concepts and research in a comprehensible and rigorous manner, it examines the potential impact of research in genetics and genomics and how important genes actually are for our lives. Understanding Genes is an accessible and engaging introduction to genes for any interested reader.
Regulatory agencies aim to protect the public by moderating risks associated with innovation, but a good regulatory regime should also promote justified public trust. After introducing the USDA 2020 SECURE Rule for regulation of biotech innovation as a case study, this essay develops a theory of justified public trust in regulation. On the theory advanced here, to be trustworthy, a regulatory regime must (1) fairly and effectively manage risk, must be (2) “science based” in the relevant sense, and must in addition be (3) truthful, (4) transparent, and (5) responsive to public input. Evaluated with these norms, the USDA SECURE Rule is shown to be deeply flawed, since it fails appropriately to manage risk, and similarly fails to satisfy other normative requirements for justified trust. The argument identifies ways in which the SECURE Rule itself might be improved, but more broadly provides a normative framework for the evaluation of trustworthy regulatory policy-making.
To understand what genes “do,” we have to consider what happens during development. The first and most striking evidence that the local environment matters for the outcome of development was provided by the experiments of embryologists Wilhelm Roux and Hans Driesch in the late nineteenth and early twentieth centuries. Roux had hypothesized that during the cell divisions of the embryo, hereditary particles were unevenly distributed in its cells, thus driving their differentiation. This view entailed that even the first blastomeres (the cells emerging from the first few divisions of the zygote – that is, the fertilized ovum) would each have different hereditary material and that the embryo would thus become a kind of mosaic. Roux decided to test this hypothesis. He assumed that if it were true, destroying a blastomere in the two-cell or the four-cell stage would produce a partially deformed embryo. If it were not true, then the destruction of a blastomere would have no effect. With a hot sterilized needle, Roux punctured one of the blastomeres in a two-cell frog embryo that was thus killed. The other blastomere was left to develop. The outcome was a half-developed embryo; the part occupied by the punctured blastomere was highly disorganized and undifferentiated, whereas those cells resulting from the other blastomere were well-developed and partially differentiated. This result stood as confirmation for Roux’s hypothesis.
During the 1970s, more puzzling observations were made. The first was that the genome of animals contained large amounts of DNA with unique sequences that should correspond to a larger number of genes than anticipated. It was also observed that the RNA molecules in the nuclei of cells were much longer than those found outside the nucleus, in the cytoplasm. These observations started making sense in 1977, when sequences of mRNA were compared to the corresponding DNA sequences. It was shown that certain sequences that existed in the DNA did not exist in the mRNA, and that therefore they must have been somehow removed. It was thus concluded that the genes encoding various proteins in eukaryotes included both coding sequences and ones that were not included in the mRNA that would reach the ribosomes for translation. These “removed” sequences were called introns, to contrast them with the ones that were expressed in translation, which were called exons. The procedure that removed the intron sequences from the initial mRNA and that left only the exon sequences in the mature mRNA was named “RNA splicing.”
One important, and for some the most surprising, conclusion of genome-wide association studies (GWAS) has been that in most cases numerous single nucleotide polymorphism (SNPs) in several genes were found to be associated with the development of a characteristic or the risk of developing a disease. As already mentioned, the main conclusion has been that the relationship between genes and characteristics or diseases is usually a many-to-many one, as many genes may be implicated in the same condition, and the same gene may be implicated in several different conditions. In fact, the same allele may be protective for one disease but increase the risk for another. For example, a variation in the PTPN22 (protein tyrosine phosphatase, nonreceptor type 22) gene on chromosome 1 seems to protect against Crohn’s disease but to predispose to autoimmune diseases. In other cases, certain variants are associated with more than one disease, such as the JAZF1 (JAZF1 zinc finger 1) gene on chromosome 7 that is implicated in prostate cancer and in type 2 diabetes. Therefore, we should forget the simple scheme of gene 1 → condition 1/gene 2 → condition 2, and adopt a richer – and certainly more complicated – representation of the relationship between genes and disease. Additional GWAS on more variants in larger populations might provide a better picture in the future. But insofar as we do not understand all biological processes in detail, all we are left with are probabilistic associations between genes and characteristics (or diseases). The “associated gene” may be informative, but its explanatory potential and clinical value are limited – at least for now.
This chapter is about the public image of genes. But what exactly do we mean by “public”? Here, I use the word as a noun or an adjective vaguely, in order to refer to all ordinary people who are not experts in genetics. I thus contrast them with scientists who are experts in genetics – that is, who have mastered genetics-related knowledge and skills, who practice these as their main occupation, and who have valid genetics-related credentials, confirmed experience, and affirmation by their peers. I must note that both “experts” and “the public” are complex categories that depend on the context and that change over time. There is no single group of nonexperts that we can define as “the” public, as people around the world differ in their perceptions of science, depending on their cultural contexts. We had therefore better refer to “publics.” The differences among experts nowadays might be less significant than those among nonexperts, given today’s global scientific communities, but they do exist. Finally, both the categories of experts and publics have changed across time, depending, on the one hand, on the level of experts’ knowledge and understanding of the natural world, and, on the other hand, on publics’ attitudes toward that knowledge and understanding.
If you were taught Mendelian genetics at school (see Figures 2.1 and 2.2) you should be aware that it is an oversimplified model that does not work for most cases of inherited characteristics. Human eye color is a textbook example of a monogenic characteristic. It refers to the color of the iris – the colored circle in the middle of the eye. The iris comprises two tissue layers, an inner one called the iris pigment epithelium and an outer one called the anterior iridial stroma. It is the density and cellular composition of the latter that mostly affects the color of the iris. The melanocyte cells of the anterior iridial stroma store melanin in organelles called melanosomes. White light entering the iris can absorb or reflect a spectrum of wavelengths, giving rise to the three common iris colors (blue, green–hazel, and brown) and their variations. Blue eyes contain minimal pigment levels and melanosome numbers; green–hazel eyes have moderate pigment levels and melanosome numbers; and brown eyes are the result of high melanin levels and melanosome numbers. Textbook accounts often explain that a dominant allele B is responsible for brown color, whereas a recessive allele b is responsible for blue color (Figure 4.1). According to such accounts, parents with brown eyes can have children with blue eyes, but it is not possible for parents with blue eyes to have children with brown eyes. This pattern of inheritance was first described at the beginning of the twentieth century and it is still taught in schools, although it became almost immediately evident that there were exceptions, such as that two parents with blue eyes could have offspring with brown or dark hazel eyes.
Perhaps you were taught at school that genetics began with Gregor Mendel. Because of his experiments with peas, Mendel is considered to be a pioneer of genetics and the person who discovered the laws of heredity. According to the model of “Mendelian inheritance,” things are rather simple and straightforward with inherited characteristics. Some alleles are dominant – that is, they impose their effects on other alleles that are recessive. An individual who carries two recessive alleles exhibits the respective “recessive” characteristic, whereas a single dominant allele is sufficient for the “dominant” version of the characteristic to appear. In this sense, particular genes determine particular characteristics (e.g., seed color in peas), and particular alleles of those genes determine particular versions of the respective characteristics. Mendel, the story goes, discovered that characteristics are controlled by hereditary factors, the inheritance of which follows two laws: the law of segregation and the law of independent assortment.
A large and highly heterogeneous group of individuals conducts genetic and genomic research outside of traditional corporate and academic settings. They can be an important source of innovation, but their activities largely take place beyond the purview of existing regulatory systems for promoting safe and ethical practices. Historically the gene-targeting technology available for non-traditional biology (NTB) experiments has been limited, and therefore they have attracted little regulatory attention. New techniques such as CRISPR-cas9, however, may create a need for alternate governance approaches. This chapter explores whether alternate governance approaches might be needed and, if so, what governance approaches would be most likely to enable non-traditional experiments to be conducted safely and ethically.