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Record W1982857430 · doi:10.1136/bmj.330.7482.79

Recent developments in gene transfer: risk and ethics

2005· review· en· W1982857430 on OpenAlexaff
Jonathan Kimmelman

Bibliographic record

VenueBMJ · 2005
Typereview
Languageen
FieldBiochemistry, Genetics and Molecular Biology
TopicVirus-based gene therapy research
Canadian institutionsMcGill University
Fundersnot available
KeywordsGenetic enhancementClinical trialGene transferAdenosine deaminase deficiencyHaemophiliaVector (molecular biology)MedicineGeneTransplantationImmunologyOncologyBiologyGeneticsInternal medicineSurgeryRecombinant DNA

Abstract

fetched live from OpenAlex

Since the early 1990s, investigators have toiled to establish the transfer of genes to human somatic cells as a valid therapy (fig 1). The potential of gene transfer was highlighted by three trials, involving participants with haemophilia B and two types of severe combined immunodeficiency—X linked and adenosine deaminase deficient.1–3 Yet even the most successful trials of gene transfer have engendered questions about its prospects. In the haemophilia B trial the detection of vector—the agent which carries genes to cells (fig 2)—in participants' semen raised concerns about modifications of the germline.4 The results of the X linked severe combined immunodeficiency trial were offset by unexpected, vector induced leukaemia in two participants.5 Fig 1 Number of gene transfer trials approved worldwide has increased since 1989; 77% have been conducted in the United States and the United Kingdom. Most trials have used virus based vectors (70%), are phase 1 (63%), and involve investigational treatments for cancer (66%). Adapted from Wiley Gene Therapy Clinical Trial Database (http://www.wiley.co.uk/wileychi/genmed/clinical/) Fig 2 In a gene transfer, therapeutic DNA is combined with a vector (often of viral origin). Vectors can be injected into recipient's tissue directly or used to modify cells ex vivo for transplantation to the recipient Several hazards associated with gene transfer have been verified by clinical experience and others are predicted on theoretical grounds. It therefore may be worth considering whether risks shown in studies of human gene transfer present any unusual ethical and social challenges and, if so, what should be done to tackle them. In this article I review several matters relating to human gene transfer—safety features that distinguish traditional drugs from agents used to transfer genes, ethical issues raised by uncertainties about risk and toxicological properties, and studies on safety. I searched for relevant articles in Medline through PubMed …

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Other design · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.998
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.106
GPT teacher head0.428
Teacher spread0.322 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designOther design
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations80
Published2005
Admission routes1
Has abstractyes

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