Episode 8: Abortion|Aspirin|CRISPR

Episode 8: Abortion|Aspirin|CRISPR

May 24, 2019

 

Modern-day healthcare brings about many questions. As technology and research increase we are able to answer questions we have not thought of before, we can experiment, and gather literature on a given topic. Many of the past treatments and recommendations have been proven ineffective or contraindicated, like aspirin. Healthcare should be more about prevention, taking a bigger focus on diet and promoting self-change. Nutrition is becoming geared towards saving the planet, like using plant-based milk. As medicine and technology become more advanced there becomes room for ethical debate, is abortion right or wrong. Medical technology is advancing towards the age of genetic engineering, we now have CRISPR. These advances give about many answers but give rise to many questions.

Aspirin

For decades, it has been a healthcare standard to recommend and prescribe low-dose aspirin (75-100 mg with US 81 mg/day) for heart attack and stroke. Heart attacks and strokes are usually caused by atherosclerotic cardiovascular disease. It has been hypothesized that aspirin is beneficial for optimal cardiovascular health.

How do heart attacks and strokes happen?

In our body, we have vessels, arteries, and veins, that have the potential to get occluded. When we eat a diet that is high in sugar, cholesterol, and processed foods we are more susceptible to developing plague and causing occlusions. Plaques can grow large enough to significantly reduce the blood flow through an artery. A plaque has the potential to break off, the most significant damage occurs when a plaque becomes fragile and ruptures. Plaques that rupture cause blood clots to form which can impede blood flow or travel to another part of the body and cause havoc elsewhere. When an occlusion gets big enough it is called a thrombus(stationary clot) and when a thrombus ruptures it becomes an embolism(moving clot).

Why not Aspirin?

Aspirin is part of a class of drugs called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). It was thought that aspirin was a great way to reduce the risk of heart attack and stroke because it has an effect on the clotting system in our body. Aspirin irreversibly inhibits platelet function. Platelets are in our blood and are the main way our body stops bleeding, platelets form clots in bleeding vessels, but they also adhere to plaques. Aspirin reduces risk of atherothrombosis but at the risk of bleeding, particularly in the gastrointestinal (GI) tract. No medication is perfect and each one comes with side effects. On one side you have a decreased chance of clots, on the other, you are more prone to bleeding. Should we be taking a closer look at who should be receiving aspirin?

Aspirin has been well established for secondary prevention. Currently, The American Heart Association¹ and The American College Of Cardiology no longer recommend aspirin because of the risk of bleeding Aspirin therapy is not recommended if you have never had a heart attack or stroke. If you’re over 70, taking aspirin to prevent a first heart attack or stroke could do more harm than good. Aspirin inhibits helpful substances that protect the stomach's delicate lining.

Abortion

Alabama² recently passed a near-total ban on abortion by Governor Kay Ivey. The legislation makes no exceptions for victims of rape or incest. The law criminalizes the procedure, reclassifying abortion as a Class A felony, punishable by up to 99 years in prison for doctors.

On May 7th Georgia Gov. Brian Kemp on Tuesday signed a bill that would ban abortions if a fetal heartbeat can be detected. The fetal heartbeat can typically be seen on an ultrasound at around six weeks into a pregnancy, but many women have no idea they're pregnant at that time.  

Abortion is a very hard topic to discuss with many good points on either side of the spectrum. Abortion is currently a grey area of healthcare, we know how to abort but when or why should we do it? Who should decide if an abortion is appropriate? Those are just some of the questions you should ask yourself. There currently is no wrong answer only opinion and speculation but these are questions that need to be asked.

All life has value, that all life matters, and that all life is worthy of protection”

Almond Milk

Is plant-based milk better than cows milk for us and the environment? Most people that drink plant-based milk are motivated by environmental reasons. Cows are a major use of land, water, and a key source of methane emission, which is a potent greenhouse gas. Those motivated by environmental reasons argue that eliminating cows milk would be a good way to reduce our toxic footprint.

Almond milk, unfortunately, is not the best answer. The main issues associated with almond milk production are water use and pesticide use, which may produce long-lasting effects on the environment. More than 80% of the world’s almond crop is grown in California, which has been experiencing its worst drought on record. It takes 1.1 gallons (5 liters) to grow one almond³.

Water isn’t the only issue, there has been much speculation on the ingredients and nutrition content of almond milk. A typical serving of almonds has 160 calories per serving. By comparison, a cup of almond milk contains just about 30 calories. And while a serving of almonds has 14 grams of total fat and 6 grams of protein, a serving of the milk has 2.5 grams of fat and just 1 gram of protein. In 2015 the British Almond Breeze website revealed that almonds only accounted for 2 percent of the ingredients in the carton.

Almond milk proclaims to have more potassium and more of the vitamins A and D, the truth is almond milk is fortified with these nutrients — they've been added during the production process.

A good alternative to almond milk is pea milk. Growing peas require up to six times less water than almonds, and this milk alternative has a much smaller carbon footprint than dairy.

CRISPR-Cas9

Short for “Clustered Regularly Interspaced Short Palindromic Repeats

DNA is a sequence of nucleotides that makes up our genetics. There are 4 different nucleotides that make up our DNA and there are billions of nucleotides in our genome. Our genetics decide on the color of our eyes and if we will develop MS in the future. Natural selection and random mutations are the way our DNA is created and that decides what we will be.

CRISPR gives us the power to go from natural selection and random mutation to unnatural selection with nonrandom mutation.

What is it?

To learn what CRISPR is you have to take into consideration our bodies, specifically our immune system. When our body is under attack or infected we use different types of mechanisms and white blood cells to fight off these foreign invaders. We even sacrifice our own cells for the benefit of the whole body, as multicellular organisms we can afford to lose a few cells. Single-celled organisms, like bacteria,  don't have that ability. They have a different approach to staying alive.

CRISPR is an immune response system where the bacteria saves a portion of viral DNA and archives it, the mechanism is called CRISPR. When a virus attacks again the bacteria can recognize and destroy it. It goes into its archives finds the DNA, makes a copy of RNA and then goes to chase down the virus. The Cas9 is a protein that works with the CRISPR system and unwinds, cuts, and destroys the viral DNA.  

  • CRISPR is a feature in prokaryotic cells such as bacteria and its immune function.
  • CRISPR functions as a defense system for the bacteria to protect itself from viruses.
  • memories of prior viral DNA get copied to protect itself in the future. Those copies are turned to RNA and put into a protein called CAS9. CRISPR is a system Cas9 is the protein.
  • When a new viral infection occurs, the bacteria produce special attack enzymes, known as Cas9, that carry around those stored bits of viral genetic code like a mug shot. When these Cas9 enzymes come across a virus, they see if the virus’s RNA matches what’s in the mug shot. If there’s a match, the Cas9 enzyme starts chopping up the virus’s DNA to neutralize the threat.

Significance

  • CRISPR-Cas9 is a genome-editing tool that is creating a buzz in the science world. It is faster, cheaper and more accurate than previous techniques of editing DNA and has a wide range of potential applications.
  • Crisper can be done in any cell by reprogramming the target, it can cut any DNA sequence in our genome.
  • What we can do is introduce DNA into CRISPR and create guide RNA with specific targets.
  • When CRISPR Cas9 cuts the DNA the cell has to try and reconnect the 2 ends. This is prone to issues which leads to mutations which can damage the cell, but this also allows researchers to understand the function. These errors or mutations are random but precision is needed.
  • We have the potential to replace a mutant gene that correlates with genetic diseases and insert a healthy copy of a RNA so the cell inserts the proper nucleotides.

Capabilities

  • Cut DNA with errors that are linked to disease
  • Adding/replacing DNA
  • Alter the amount of gene expression
  • So, for instance, scientists could tell the Cas9 enzyme to snip out a gene that causes Huntington’s disease and insert a “good” gene to replace it.

Limits

  • Not 100% accurate
  • Can cut wrong DNA/ inserted it backward

Current capabilities?

  • CRISPR can be done with cultured cells like stem cells, or fertilized eggs.
  • CRISPR can target many genes at a time
  • We can dit crops and plants: Make them tastier, more resistant, increased nutrition
    • Scientists used CRISPR on ground cherries. Ground Cherries are uncommon because they are hard to control and sprawl wildly. The scientists were able to make the plant more compact and increased its size by 25%.
    • Change in Japanese morning glory color from violet to white. Scientists were able to use CRISPR and change the gene responsible for color.
  • Turning animals into organ donors: One barrier to animal organ donation is rejection the second barrier is transmitting disease.
    • Researchers were able to use CRISPR to produce porcine endogenous retrovirus free pigs, PERV is a virus that can affect both pig and human cells.
  • Altering genes that cause diseases in humans.
    • Researchers were able to restore dystrophin in muscle and heart tissue in 92 percent of dogs which is the major player in Muscular Dystrophy.
    • Doctor in China was able to edit the genes of embryos with CRISPR to make them resistant to HIV. These twins were the first babies born after having their genome edited.

To repair every cell in the body modifications have to be done early embryonic development. The changes we create will forever be engraved in the DNA, passed down from one generation to the next.


CRISPR opens up tough questions
How should we control/manage genetic diseases?
Should we have an influence on our children's genetic makeup?
Who decides what is a better baby?
What if genetic engineering is only for the wealthy?
Should we be allowed to determine a baby's genetic future?

It is no longer if we can control a piece of our genetic future but if we will?


References

  1. https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2019/03/07/16/00/2019-acc-aha-guideline-on-primary-prevention-gl-prevention
  2. https://www.cbsnews.com/news/alabama-abortion-law-2019-chaos-on-senate-floor-today-while-state-lawmakers-debate-near-total-abortion-ban-2019-05-09/
  3. https://www.paesta.psu.edu/podcast/how-much-water-does-it-really-take-grow-almonds-paesta-podcast-series-episode-43
  4. https://www.foodnavigator-usa.com/Article/2015/07/22/Almond-milk-only-contains-2-almonds-claims-lawsuit-v-Blue-Diamond
  5. https://www.nature.com/articles/s41477-018-0259-x
  6. https://www.nature.com/articles/s41598-017-10715-1
  7. https://wyss.harvard.edu/removing-62-barriers-to-pig-to-human-organ-transplant-in-one-fell-swoop/


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