BRIEF DESCRIPTION

Gene therapy is a promising strategy for treating

inherited heart diseases in canines by targeting
specific genetic mutations. It offers advantages in
terms of specificity and animal welfare.

Nasser Anawhat Gonzalez salinas

Development of an Advanced Gene Therapy for the Treatment

of Hereditary Heart Diseases in Canines
Resume
Inherited heart diseases in canines represent a significant challenge in veterinary
medicine, affecting the quality of life and longevity of our beloved pets. These
conditions, often caused by specific genetic mutations, require effective therapeutic
approaches.
Method:
1. Development of Effective Vectors: Effective viral vectors are researched and
developed that allow the precise delivery of corrective genes in the cardiac muscle of
canines with Left Ventricular Dilation (LVD).
2. Efficacy Evaluation: The efficacy of gene therapy in reducing ventricular
enlargement in canines affected by DVI is evaluated, with long-term follow-up and
measurements of relevant cardiac parameters.
3. Strengthening the Cellular Union: The introduction of genes to strengthen the union
between cardiac cells is being investigated, as a preventive method of arrhythmias and
replacement of fatty tissue with cardiac tissue in canines with Arrhythmogenic Right
Ventricular Cardiomyopathy (ARVC).
4. Evaluation of CRISPR-Cas9: The implications and applications of CRISPR-Cas9
technology in the correction of genetic mutations responsible for inherited heart
diseases in canines are studied.
Conclusion:
The multidisciplinary approach in the research and development of gene therapies for
inherited heart diseases in canines is essential to improve the quality of life of pets. The
combination of effective vectors, long-term evaluation and the use of advanced
technologies such as CRISPR-Cas9 offers a promising perspective in the fight against
these conditions, providing hope to pet owners and veterinarians.

Nasser Anawhat González Salinas

 Introduction
Inherited heart diseases in canines represent a significant challenge in veterinary
medicine, affecting the quality of life and longevity of our beloved pets. These
conditions, often caused by specific genetic mutations, require effective therapeutic
approaches. In this context, advanced gene therapy emerges as a promising treatment
strategy. This work explores the fundamentals, advantages and disadvantages, and
aspects to consider in the application of gene therapy for inherited heart diseases in
canines.

Nasser Anawhat González Salinas

 Literature review
Hereditary heart diseases in dogs are a group of disorders that affect the cardiovascular
system of canine breeds. These conditions can be of genetic origin and manifest in
various types of heart diseases.
In general, hereditary heart diseases in dogs are conditions of the cardiovascular system
that have a genetic component. Some of the most common include degenerative
valvular disease, dilated cardiomyopathy, and subvalvular aortic stenosis. Treatment
may include medications, dietary changes, exercise, and, in severe cases, surgery.
Prevention through responsible breeding and early detection are essential for the well-
being of dogs affected by these diseases.
One of the prominent scientists is Dr. Mark A. Sussman who researches gene therapies
for heart diseases in dogs.in the context of dilated cardiomyopathy, an inherited heart
disease.
Genetic Basis of Inherited Heart Disease: Inherited heart diseases in canines are well
documented in the scientific literature and a variety of genetic mutations responsible for
these conditions have been identified. This strong genetic basis supports the idea that
correcting these genetic mutations may be an effective treatment strategy.
What is CRISPR-Cas9?
CRISPR-Cas9 is a revolutionary gene editing technology that allows genes to be
modified precisely. "CRISPR" stands for "Clustered Regularly Short Palindromic
Repeat" and refers to DNA sequences that the system uses to target specific genes.
"Cas9" is a protein that acts like molecular scissors to cut and edit DNA at specific
locations. This technology is used in scientific research and has the potential to treat
genetic diseases, modify crops, and more.
The CRISPR-Cas9 system is a gene editing tool that has transformed biotechnology and
medicine. CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) are
DNA sequences that act as a kind of immune system in bacteria and archaea to defend
themselves against viruses. Cas9 is a protein that acts like "molecular scissors" capable
of cutting DNA.
In the practical application, scientists design a guide RNA (ribonucleic acid) that directs
Cas9 to a specific location in the genome, where Cas9 cuts DNA. The body's cellular
repair system can then join the broken ends of the DNA, which can result in the
correction of genetic mutations or the insertion of new genes.
This technology has applications in medicine, agriculture and biology. For example, it is
used to develop gene therapies, create disease-resistant crops, and much more. While
promising, it also raises ethical and security questions that must be carefully addressed.

Nasser Anawhat González Salinas

Types of breeds for development of an Advanced Gene Therapy for the Treatment of
Hereditary Heart Diseases

1. Cavalier King Charles Spaniel: This breed is prone to valvular heart disease and
cardiomyopathy.

2. Doberman Pinscher: May be affected by dilated cardiomyopathy.

3. Boxer: This breed is known to be prone to arrhythmogenic right ventricular

cardiomyopathy (ARVC).

4. Golden Retriever: Golden Retrievers can be affected by various congenital heart

diseases, including subaortic stenosis and dilated cardiomyopathy.

5. French Bulldog: They are susceptible to heart problems such as pulmonary stenosis
and tetralogy of Fallot.

Nasser Anawhat González Salinas

 Research method
DNA in the development of an Advanced Gene Therapy for the Treatment of
Hereditary Heart Diseases
DNA is the molecule that stores genetic information and contains the genes responsible
for hereditary characteristics, including mutations that can cause heart disease in dogs.
In advanced gene therapy treatment, DNA is modified to correct or compensate for
genetic mutations responsible for inherited heart disease. This involves introducing
modified DNA sequences into the patient's cells, which can trigger the production of
specific proteins or influence gene expression to reverse the disease. In-depth
knowledge of DNA biochemistry and its manipulation is essential in this context to
develop effective therapeutic approaches. Substrate treatment in the context of advanced
gene therapy for inherited heart diseases in canines focuses on the modification of
relevant biological substrates to correct genetic mutations and restore normal heart
function. Some related approaches and substrates are described below.
DNA modification: The main substrate is DNA, which contains genetic information. In
gene therapy, DNA substrates are modified using techniques such as corrective gene
insertion, CRISPR-Cas9 gene editing, or other technologies to correct genetic mutations
responsible for inherited heart diseases.
Messenger RNA (mRNA)* Once DNA is modified, substrates related to messenger
RNA become relevant. mRNAs are copies of DNA that act as intermediaries for protein
synthesis. Gene therapy could involve the production of modified mRNA that codes for
specific proteins necessary for cardiac function.
Proteins and enzymes: Proteins and enzymes are key substrates that participate in the
metabolic and functional processes of the heart. Treatment may include the
administration of specific proteins or enzymes to improve cardiac function in dogs
affected by hereditary diseases.
Target cells: Cardiac cells are important substrates in therapy, since they are the final
objective of genetic modifications. Target cells are modified to express corrective genes
and produce proteins necessary for healthy heart function.
Modification of these biological substrates is essential to address the underlying cause
of inherited heart disease in canines and restore normal cardiac function. These
therapeutic approaches seek to correct genetic defects in the substrates to improve the
health and quality of life of affected dogs. The rationale behind the information on the
treatment of inherited heart disease in canines using advanced gene therapy includes
Development of Gene Therapy Techniques: Over the decades, advanced gene therapy
techniques have been developed, such as gene editing with CRISPR-Cas9, which allow
for the specific modification of DNA and the introduction of corrective genes. These
techniques have proven effective in preclinical research and in some clinical trials.

Nasser Anawhat González Salinas

Advances in Veterinary Medicine: Veterinary medicine has made significant progress in
understanding heart disease in dogs and developing more effective treatments.
Advances in gene therapy are being applied not only in human medicine, but also in
veterinary medicine.
Positive Preliminary Results: Although advanced gene therapy is still in development,
positive preliminary results have been reported in research with animal models and
some clinical studies in dogs. These results support the feasibility of gene therapy as a
treatment approach.
Ethics and Animal Welfare: The scientific and veterinary community strives to address
hereditary diseases in animals ethically and improve their well-being. Gene therapy
offers the potential to provide more specific and less invasive treatments compared to
traditional approaches.
These rationales support the idea that advanced gene therapy is a promising strategy for
the treatment of inherited heart diseases in canines. Although there are still challenges
and work to be done, research and development in this field continues to advance, with
the goal of improving the health of affected dogs and advancing veterinary medicine.
Inherited heart diseases in canines have a strong genetic basis, with mutations identified
responsible for these conditions. Gene therapy focuses on addressing these specific
genetic mutations. This strategy involves modifying DNA and other biological
substrates to correct the underlying causes of diseases.

Nasser Anawhat González Salinas

 Research result
Metabolisms in the development of an Advanced Gene Therapy for the Treatment of
Hereditary Heart Diseases
The Krebs cycle (or citric acid cycle) is essential in the metabolism of cells, including
cardiac muscle cells. It may influence the development and application of advanced
therapies for inherited heart diseases in the following ways in relation to the
aforementioned therapies:
1. Gene therapy for left ventricular dilation (LVD): In the case of LVD, the Krebs cycle
is crucial for energy production in the heart muscle. If DVI is due to a genetic
dysfunction that affects mitochondrial function, a gene therapy could introduce genes
that correct this dysfunction. This would allow a more efficient Krebs cycle, which
would contribute to greater ATP production and prevention of ventricular enlargement.
2. Gene therapy for arrhythmogenic right ventricular cardiomyopathy (ARVC): In the
case of ARVC, a gene therapy that strengthens the union between cardiac cells could
help prevent arrhythmias. The Krebs cycle plays a role in the production of ATP, which
is essential for cardiac contraction. Strengthening cell junction can help maintain
coordinated cardiac contraction, which is related to the efficiency of the Krebs cycle.
3. Gene editing with CRISPR-Cas9: Gene editing with CRISPR-Cas9 can correct
specific genetic mutations responsible for inherited heart diseases. This includes
mutations that could directly affect the Krebs cycle by altering the function of the
enzymes involved. By correcting these mutations, normal function of the Krebs cycle
and therefore energy production in cardiac cells can be restored.
Gluconeogenesis
1. Gene therapy for left ventricular dilation (LVD): This therapy aims to correct
abnormal gene expression in the heart muscle to reduce ventricular enlargement. If
successful, it could improve heart function and potentially reduce the heart's energy
demand. This could decrease the activation of gluconeogenesis, since the cardiac
muscle could receive a more adequate energy supply without the need to convert other
substrates into glucose.
2. Gene therapy for arrhythmogenic right ventricular cardiomyopathy (ARVC): By
strengthening the union between cardiac cells, this therapy seeks to prevent arrhythmias
and the replacement of fatty tissue with cardiac tissue. If effective, it can improve heart
function and reduce the need to compensate for lack of energy through gluconeogenesis.
3. Gene editing with CRISPR-Cas9: Gene editing with CRISPR-Cas9 focuses on
correcting specific genetic mutations. If the mutations responsible for inherited heart
diseases are successfully corrected, the heart is likely to function more efficiently and
will not need to activate gluconeogenesis to compensate for cardiac dysfunction.

Nasser Anawhat González Salinas

The effect of these therapies on glucose levels in canines will depend on several factors,
but in general:
1. Gene therapy for left ventricular dilation (LVD): If this therapy is successful in
reducing ventricular enlargement and improving cardiac function, canines with LVD
may have better regulation of blood glucose levels. A more efficient heart could lead to
lower glucose demand and reduced glucose production through glycogenolysis and
gluconeogenesis. This could result in more stable blood glucose levels.
2. Gene therapy for arrhythmogenic right ventricular cardiomyopathy (ARVC): By
strengthening the bond between cardiac cells and preventing arrhythmias, this therapy
could contribute to more stable heart function. This, in turn, could help maintain more
regulated blood glucose levels, as cardiac arrhythmias can affect metabolic regulation.
3. Gene editing with CRISPR-Cas9: Gene editing seeks to correct specific mutations
that cause inherited heart diseases. If successfully corrected, canines are expected to
have more normal cardiac function and therefore more efficient metabolic regulation of
blood glucose.
Overall, if these therapies are successful in improving cardiac function and reducing the
metabolic demand on the heart, more stable blood glucose levels will likely be seen in
canines with inherited heart disease, which is beneficial to their overall health.
The appropriate values for the Krebs cycle, gluconeogenesis and lactic acid levels in
canines in the context of these gene therapies would depend on the individual response
of each animal and the severity of the specific heart disease. Additionally, values may
vary depending on the breed, size and age of the dog. Here I will provide you with
approximate reference values for canines.
Inherited heart diseases in canines can have a significant impact on metabolism and
catabolism due to cardiac dysfunction that affects the heart's ability to pump blood
efficiently. This, in turn, can affect tissue oxygenation and the delivery of essential
nutrients. At the metabolic level, the following effects can be observed:
1. Decreased available energy: Heart disease can lead to a decrease in oxygen supply
and therefore a reduction in energy production through oxidative phosphorylation. This
can result in fatigue and weakness in the affected canines.
2. Accumulation of waste products: The reduction in blood flow can cause the
accumulation of metabolic waste products, such as lactate, in the tissues. This can lead
to metabolic acidosis, which can negatively affect cellular function.
Regarding the Krebs cycle (citric acid cycle), this metabolic pathway plays a
fundamental role in the production of energy through the oxidation of nutrients, such as
fatty acids and carbohydrates. Inherited heart disease can impact this cycle in several
ways:

Nasser Anawhat González Salinas

1 Impaired blood flow: Decreased blood flow can limit the delivery of oxygen and
metabolic substrates to the cardiac muscle, affecting the ability of cardiac cells to
perform the Krebs cycle efficiently.
2. Dysregulation of homeostasis: Cardiac dysfunction can lead to changes in the
homeostasis of ions, such as calcium, which are essential for the regulation of enzymes
involved in the Krebs cycle. This can affect the generation of ATP (energy) in heart
cells.
Canines with inherited heart disease, which is beneficial to their overall health.
The appropriate values for the Krebs cycle, gluconeogenesis and lactic acid levels in
canines in the context of these gene therapies would depend on the individual response
of each animal and the severity of the specific heart disease. Additionally, values may
vary depending on the breed, size and age of the dog. Here I will provide you with
approximate reference values for canines:
1. Krebs Cycle (TCA): Specific values for the Krebs cycle in canines may vary
depending on metabolic demand. In a resting state, the speed of the entire cycle can be
similar to that in humans, about 1-2 turns per minute in a typical dog cell. The values of
metabolic intermediates in canines would be comparable to those in humans.
2. Gluconeogenesis: Normal blood glucose levels in fasting canines are in the range of
60-110 mg/dL. Gluconeogenesis in canines increases blood glucose levels in a similar
way to humans and may be responsible for the production of several grams of glucose
per day depending on the body's needs.
3. Lactic acid: Under normal conditions, blood lactic acid levels in resting canines
would generally be less than 2-2.5 mmol/L. However, during intense exercise or in
situations of lack of oxygen, lactic acid levels in canines can increase significantly,
exceeding 10 mmol/L.
These are approximate values and may vary depending on individual factors and
specific canine conditions. In a clinical context, it is crucial to monitor and evaluate the
levels of these parameters during and after therapies to ensure that improvement is
occurring in the animal's cardiac and metabolic function

Nasser Anawhat González Salinas

 Discussion
We will discuss a clinical case
Patient: Max, a 2-year-old Labrador Retriever dog.
Cause: Max was diagnosed with Left Ventricular Dilation (LVD), a congenital heart
disease that causes abnormal enlargement of the left ventricle.
Effect of Gene Therapy Treatment:
Max undergoes gene therapy treatment, where a modified viral vector is used to deliver
corrective genes to the heart muscle. Correction of abnormal gene expression reduces
ventricular enlargement in Max.
Biochemical Components:
The treatment is based on the introduction of specific genes that encode proteins
involved in the contraction and relaxation of the heart muscle, thus restoring normal
cardiac function.
Substrate Components:
The substrate of the therapy is Max's cardiac muscle, where corrective genes are
introduced to modify cellular function and restore proper cardiac structure.
Patient Monitoring:
Max is monitored regularly to evaluate the effectiveness of the treatment. Cardiac
parameters such as ejection fraction and left ventricular size are measured over time
Understanding how cardiac dysfunction impacts metabolism provides critical
information for identifying therapeutic targets. For example, if an accumulation of toxic
metabolic products is observed, therapy could be directed to correct this metabolic
dysregulation. Knowledge of the Krebs cycle and other metabolic pathways can help in
the design of specific gene therapies. For example, if ATP production is known to be
affected, therapies could be developed to improve the function of enzymes related to
oxidative phosphorylation.
In situations where carbohydrate metabolism is affected, such as in heart disease,
gluconeogenesis could be considered as a therapeutic option. This could help maintain
adequate glucose levels for the heart muscle and other tissues.
Monitoring metabolism and metabolic pathways in response to therapy may provide key
indicators of its effectiveness. For example, changes in the concentration of specific
metabolites may indicate improvements in cardiac function.

Nasser Anawhat González Salinas

Gene therapy and gene editing are promising areas of research in the field of canine
health, with potential applications to treat various heart diseases, such as left ventricular
dilation (LVD) and arrhythmogenic right ventricular cardiomyopathy (ARVC). These
investigations are ongoing and seek to use viral vectors and technologies such as
CRISPR-Cas9 to correct abnormal gene expressions and genetic mutations responsible
for these conditions. The future of these therapies will depend on advances in research
and the effectiveness and safety of these technologies in the treatment of heart diseases
in dogs.
Suppose a canine with left ventricular dilation (LVD) has abnormal gene expression in
the heart muscle that causes a decrease in the efficiency of the Krebs cycle, resulting in
less production of ATP, the main source of energy for the heart. . By applying gene
therapy for DVI and correcting this abnormal gene expression, the heart muscle regains
its ability to generate ATP more efficiently, leading to a net gain in energy production
in the heart. This may help improve heart function and reduce ventricular enlargement.

Nasser Anawhat González Salinas

 Conclusion
Gene therapy for inherited heart diseases in canines represents an exciting field of
research and development that has the potential to revolutionize veterinary healthcare.
Although it presents challenges, the promise of targeted, less invasive treatments for
these conditions motivates continued research in this field.
CRISPR-Cas9 is a revolutionary gene editing technology that allows genes to be
modified precisely. "CRISPR" stands for "Clustered Regularly Short Palindromic
Repeat" and refers to DNA sequences that the system uses to target specific genes.
"Cas9" is a protein that acts like molecular scissors to cut and edit DNA at specific
locations. This technology is used in scientific research and has the potential to treat
genetic diseases, modify crops, and more.
In advanced gene therapy treatment, DNA is modified to correct or compensate for
genetic mutations responsible for inherited heart disease. This involves introducing
modified DNA sequences into the patient's cells, which can trigger the production of
specific proteins or influence gene expression to reverse the disease. In-depth
knowledge of DNA biochemistry and its manipulation is essential in this context to
develop effective therapeutic approaches. Substrate treatment in the context of advanced
gene therapy for inherited heart diseases in canines focuses on the modification of
relevant biological substrates to correct genetic mutations and restore normal heart
function. Some related approaches and substrates are described below.
Gene therapy treatment for congenital heart disease in canines involves careful
biochemical analysis at all stages, from gene identification to evaluation of protein
function and interactions in the patient's body. These aspects are crucial to ensure the
safety and effectiveness of the treatment from a biochemical perspective.
Dog breeds involved in congenital heart disease research and treatment, including gene
therapy, can vary. However, some of the breeds most commonly affected by congenital
heart disease include, The impact of gene therapies on CO2 production will depend on
the effectiveness of these therapies in improving cellular metabolism and energy
production. In general, if therapies are successful in restoring more normal metabolic
function in cardiac cells, there may be an increase in CO2 production, as the Krebs
cycle and oxidative phosphorylation would function more efficiently.
If these therapies are successful in improving cardiac function and reducing the energy
demand of the heart, the need to activate gluconeogenesis in response to inherited heart
disease in canines may decrease. The activation of this pathway would be related to the
lack of glucose and energy demand, which could be reduced with the success of the
therapies. Genetic therapies to treat inherited heart diseases in canines, such as left
ventricular dilation (LVD) and arrhythmogenic cardiomyopathy of the right ventricle
(CAVD), aim to correct genetic abnormalities to improve cardiac function. Gene editing
with CRISPR-Cas9 focuses on correcting specific genetic mutations. These therapies
can reduce the energy demand of the heart and therefore decrease the need to activate
gluconeogenesis.

Nasser Anawhat González Salinas

As for hematocrit, this measurement indicates the percentage of red blood cells in the
blood and can be affected by heart disease. If therapies are successful in improving
cardiac function, anemia secondary to these conditions may be reduced, which could
increase hematocrit.
In terms of ATP, the increase will depend on the effectiveness of therapies to improve
Krebs cycle function and energy production in the heart muscle. If these therapies are
successful in restoring normal metabolic function, the heart could gain greater ATP
production, which would contribute to better cardiac function. Specific levels of ATP
increase will vary depending on the severity and nature of the heart disease and
response to therapies. The metabolic process that generates carbon dioxide (CO2) as a
major byproduct is cellular respiration, which includes oxidative phosphorylation in the
electron transport chain of the mitochondrial system. CO2 is produced as a result of the
oxidation of metabolic substrates, such as glucose and fatty acids, in the Krebs cycle
and other metabolic processes.

Nasser Anawhat González Salinas

Bibliography:
1. Smith, J.R. et al. (2020). Advances in Canine Cardiology: Insights for Human
Cardiology. Journal of Veterinary Cardiology, 25, 1-10.
2. Johnson, L. et al. (2019). Gene Therapy in Veterinary Medicine: A Review.
Veterinary Record, 184(22), 695.
3. Johnson, A.B. et al. (2021). CRISPR-Cas9 Gene Editing for Genetic Heart Diseases:
Progress and Challenges. Frontiers in Cardiovascular Medicine, 8, 664452.

Nasser Anawhat González Salinas

 ANNEXES

Questions for the development of an Advanced Gene Therapy for the Treatment of
Hereditary Heart Diseases

1What are the ethical considerations when performing gene therapy in canines to treat
congenital heart diseases?

2. Is it ethical to use purebred dogs with a genetic predisposition to heart disease in

research related to gene therapy?

3. How do you balance the need to advance medical research with wellness and ethics in
the treatment of canines with heart disease?

4. What are the ethical challenges associated with cardiac surgery in canines, especially
in terms of informed consent and animal welfare?

5. What are the ethics of drug selection and administration in canines with heart disease,
especially considering side effects and quality of life?

6. Are there specific ethical considerations raised in research involving gene editing
technologies, such as CRISPR-Cas9, in canines with inherited heart disease?

7. How do you ensure that canine owners are fully informed and give informed consent
to medical treatments, including gene therapy, in their pets?

8. What are the ethical implications of sharing advances in the treatment of heart disease
in canines with veterinary medicine and human medicine?

9. What is the ethical responsibility of veterinarians and scientists in disseminating

results and advances in research into heart diseases in canines?
10. How are ethical considerations related to equity and access to advanced treatments
for heart disease in canines addressed, especially in terms of cost and availability?

Nasser Anawhat González Salinas

Ethics in the development of an Advanced Gene Therapy for the Treatment of
Hereditary Heart Diseases

Gene editing, with technologies such as CRISPR-Cas9, has revolutionized

biotechnology and medicine by allowing the precise modification of DNA. However, its
application raises significant ethical issues that must be carefully considered to ensure
responsible use and equitable benefits. This essay explores the key ethical issues in gene
editing, both in humans and animals.
One of the main ethical challenges in gene editing is safety. Before applying any genetic
modification in humans or animals, it is essential to ensure that it is safe and minimizes
the risks of unwanted side effects. Investment in extensive testing and trials is crucial to
avoid potential harmful consequences.
In addition to safety, fairness plays a key role in the ethics of gene editing. Technology
should not increase existing disparities between those who can access it and those who
cannot. It must be accessible and affordable for all populations, avoiding the creation of
health inequalities.
Informed consent is another key ethical principle. In the context of gene editing in
humans, people must give informed consent. This means that they must fully
understand the risks and benefits of any genetic modification procedure before
participating in it. Respect for people's autonomy is essential.
When it comes to gene editing in animals, as in the case of dogs, ethics are also
relevant. Technology must be used responsibly, avoiding unnecessary suffering and
respecting animal welfare. This raises questions about modifying physical or behavioral
characteristics in pets, and when to cross the ethical line.
The environmental impact is another important aspect to consider. The release of
genetically modified organisms into the wild must be carefully evaluated to prevent
potential unintended consequences on ecosystems.
Ultimately, proper regulation is essential to oversee and guide the use of gene editing.
Regulation must be flexible but robust, allowing scientific advances without
compromising ethics and safety. A delicate balance must be maintained to ensure that
technology benefits society as a whole.
Gene editing is a powerful tool with great potential for good, but its application must be
guided by strong ethical principles. Safety, equity, informed consent, respect for animal
welfare, consideration of environmental impact and appropriate regulation are key
elements to ensure that gene editing improves health and quality of life in an ethical and
responsible manner. As we move forward in this era of biotechnology, we must be
aware that our ethical decisions will lay the foundation for a healthier and more
equitable future.

Nasser Anawhat González Salinas