‘Lifespan’

Tom’s Cribbed Book Notes

Every now and then I find a book that leads me into the land of complete wonder and admiration.  This book ‘Hacking Darwin- Genetic Engineering and the Future of Humanity’ is just such a book.  Yes these are detailed and yes this is a long post, but if you want some great foods for thought before you buy your own version, or listen to our interview, then here you go.

Thank you to Jamie Metzl for giving me permission to share these notes with you,,,,enjoy!!!

Chapter one-Where Darwin Meets Mendel

The order of the trains (DNA), the sequences of the DNA we call ‘Genes’, creates a unique set of instructions that are delivered by messengers called Ribonucleic Acid, or RNA, to the cells for making proteins. /Our human genes are then normally packaged together into twenty-three pairs of DNA strands in our cells—our Chromosomes—with each chromosome directing a specific set of functions in our bodies.  Humans have about 21,000 genes and 3.2 billion base pairs.//  The genes that impact us the most are those providing instructions to our cells to create proteins, but nearly 99 percent of the total DNA does not code for proteins at all.  These non-coding genes used to be called ‘junk’ DNA because scientists thought they had no significant biological function. Today we can think of non-coding genes like football players standing on the sideline giving encouragement, tips, and direction to their teammates on the field.  These non-coding genes play an important role directing creation of certain RNA molecules that carry instructions from our genes outside the nucleus and in regulating how the protein coding genes are expressed.///  Each of our cells that has a nucleus contains the blueprint for our whole body, but the result would be chaos if every cell were trying to create the whole person.  Instead, our genetic DNA is regulated by a process called ‘epigenetics’ for determining which genes are expressed.//// In our football team analogy, each player has the entire game plan but only needs to fulfill his or her particular function when instructed to do so.  Pg13

Cystic Fibrosis, Huntington’s disease, Muscular Dystrophy, Sickle cell disease, and Tay-Sachs are all examples of ‘single-gene mutation diseases, also known as ‘Mendelian diseases’ because they clearly follow Mendel’s rules of heredity.  Some of these disorders are called ‘dominant’ because a child will need to inherit just one copy of a mutation from a single parent to have the disease.  For recessive disorders, like Tay-Sachs, a child would need to inherit the mutation from both parents to be at risk./ Today  treatments exist only for around 5 percent of these.  Pg 17

In light of the proven benefits of genetic screening for Tay-Sachs, some researchers and policymakers are now calling for what they call ‘expanded carrier testing’ to assess whether other categories of prospective parents have the potential to pass Mendelian diseases and disease risks to their children. Pg 19

Genome sequencing and biochemical enzyme level measurement were monumental breakthroughs that began to help prevent the transmission of relatively simple genetic diseases, but genetic analysis alone couldn’t transform the way humans make babies unless paired with new options for applying that knowledge.  The paired revolutions of in vitro fertilization, or IVF, and embryo screening created the mechanism through which genetic analysis could fundamentally transform human baby-making. Pg 19-20

The screening process became known as ‘preimplantation genetic diagnosis, or PGD./ A parallel and related process called ‘preimplantation genetic screening’ or PGS, was also developed to screen embryos without a known disease risk to assess their chances of thriving.  PGD and PGS have more recently been grouped together semantically under the broader umbrella label of ‘preimplantation genetic testing’, or PGT. Pg 22

Vaccinations have saved millions of live since the first smallpox vaccine was introduced in nineteenth-century England.  Repeated studies around the world have clearly proven the safety and overwhelming individual and communal benefits of vaccination./ This type of conflict between groups of parents taking action to harness or reject as unnatural scientific advances will play out in embryo screening.// As the number of single-gene-mutation diseases that can be screened for during IVF and PGT continues to rise, the cost goes down, and the safety of IVF and PGT improves, the value of screening and selecting embryos in the laboratory prior to implantation will increase.  Pg 24

Babies with Down syndrome are born with an extra copy of a chromosome 21, which can lead to heart defects, developmental and cognitive impairments, increased cancer and mortality risk, and other challenges./ With its raging, religion-infused abortion debate, the United States is in many ways an outlier among developed countries.  Pg 25

Around 4 million children are born in the United States each year.  Assuming that two percent of them are born with genetic diseases, that would mean eighty thousand children.  If each of these children had a genetic disease equivalent in cost to the additional roughly $600,000 spent for lifetime care for a person cystic fibrosis, that would mean spending an additional $48billion over the next thirty-seven years.  If we created an embryo-screening bond to bring forward this future expenditure to apply it today, we’d have about $16,500 to spend on IVF and PGT for each American woman wanting to have a child.  If we included in our calculations the costs of many other genetic and partially genetic diseases that show up later in life—like diabetes, Alzheimer’s, and certain cancers—the $16,500 figure would go up farther.  Pg29

The intersection of inexpensive and ubiquitous genome sequencing, IVF, embryo selection, and shifting cultural attitudes and financing models will propel more of us to make babies in the future very differently than how we have to date.  Pg 30

Chapter 2- Climbing the Complexity Ladder

Reliably linking single gene mutations to specific genetic diseases represents decades of hard-won progress.  But this story is more complicated that it first seems.  Because many of the genes linked to particular genetic diseases have been found in people showing symptoms of these diseases, researchers don’t know as much as they should about other types of people who might carry similar genetic mutations but who don’t get the particular diseases for one reason or another, perhaps because they have some other gene protecting them.  Pg 31

The more we move from looking at how a single genetic mutation causes a disease or trait to how a complex pattern of genes and other systems creates a certain outcome, the less possible it becomes to establish causality using our limited human brains alone.  That’s why the intersection between the genetics and biotechnology revolutions on the one hand and the artificial intelligence (AI) and big-data analytics revolutions on the other are so critical to our story.  Pg 35

Today, it is quite clear that AI technology is not supplanting us; it is enhancing us.  Pg 36

Companies around the world are racing to accelerate this process.  The innovative Canadian company Deep Genomics, for example, is bringing together AI and genomics to uncover patterns in how diseases work because, in its words, “the future of medicine will rely on artificial intelligence, because biology is to complex for humans to understand.”/  As the genomic data set expands, scientists will use AI tools to better understand how complex genetic patterns can lead to specific outcomes.// “The worlds most valuable resource,” The Economist wrote in 2017, “is no longer oil, but data.”  Pg 38

In an ideal world, everyone would have their full genome sequenced and all personal and medical data recorded accurately in a standardized electronic medical record shareable with researchers in an open network. Pg 39

After years of delays, in spring 2018, the U.S. National Institute of Health began recruiting a targeted million Americans from all socioeconomic, ethnic, and racial groups to submit their sequenced genomes, health records, regular blood samples, and other personal information to the All of Us Research Program.  Congress has authorized a $1.45 billion ten-year budget for this program, and enrollment sites are being set up across the United States. Pg 40

Creative private-sector models are also emerging that try to balance the societal interest of accessible, big-data pools of genetic information with the interest of many individuals to maintain some level of control over their genetic data.  LunaDNA, a young San Diego-based company created by Illumina alumni, is seeking to bring the many small and disparate genetic daya sets held by multiple companies and clinics together into a searchable collective by rewarding the individuals willing to share their genetic information with cryptocurrency.  This type of approach makes particular sense because peoples sequenced genomes, just like their internet search history, will soon have a vey significant commercial value whose benefits deserve to be shared with consumers./ As a result of all these types of efforts around the world, it is estimated that up to two-billion human genomes might be sequenced within the coming decade.  Pg 41

Most everyone who is born through IVF and embryo selection or visits a doctors office or hospital at any point in their life will be sequenced as standard procedure-the way people routinely get their pulse tested today—in our collective shift from our system of generalized medicine to the new world of personalized, a.k.a. precision, medicine./ Our current medical world is based largely on averages.// Generalized medicine was our only way to do things when our understanding of how each individual human being works was low.  In the coming world of personalized medicine, this approach will seem the equivalent of leeches.  Instead of just seeing a doctor, you will see a doctor paired with an AI agent.  Your treatment for ailments from headaches to cancers will be chosen based on how well they work for a person like you.  Every persons individual biology-including your gender and age, the status of your microbiome, your metabolic indicators, and your genes—will be the foundation of your medical record and care. Pg42

What if, figuring out the right dose of medicine was as simple as taking our temperature?/ For the patients, finding potential future dangers can be useful and potentially lifesaving.  For the health system, sequencing patients potentially enables better care and could even lead to higher revenue from additional services provided in the short term and could provide savings down the line form preventing more serious conditions.  On a societal level, identifying genetic abnormalities early has the potential to make the overall population healthier and reduce the downstream costs of care. Pg 43

To grasp the genetics of cognitive decline, for example, we’ll need to understand the genetics of intelligence.  To assess the genetics of premature aging, we’ll need to understand the broader genetic mechanisms of aging itself. Pg44Seeking to understand genetic abnormalities and climbing the ladder of better understanding of our genetic complexity will, in other words, force us to understand the genetics of being.  Pg45

Chapter 3-Decoding Identity

Fixing our genetic diseases and potentially selecting genetic traits requires that we first figure the extent to which we and each of our disorders or traits are determined by our genes.  The process of assessing where biology ends and the environment begins is just another way of describing our age-old debate on the balance between nature and nurture.  Pg55

Using big-data analytics to better pinpoint the balance between genetic and environmental influences, they confirmed that all of the measured human traits are at least partly heritable, but some more than others.  At the high end, the measured neurological, heart, personality, ophthalmological, cognitive, and ear-nose-and-throat disorders were found to be mostly genetic.  Across all traits, the authors found that the overall average heritability of all of the measured traits was 49%./  Plato and Aristotle were both correct.  Pg 56

Perhaps an even more complicated human trait to understand and quantify is personality style./ A leading theory of personality dating from the 1950’s divides human personality styles into five major categories: extroversion, neuroticism, openness, conscientiousness, and agreeableness.// Per usual, the twins studies also have a lot to say about personality style.  “On multiple measures of personality and temperament, occupational and leisure-time interests, and social attitudes,” the Minnesota Twin researchers remarkably found, “monozygotic (identical) twins reared apart are about as similar as the monozygotic twins reared together,,,the effect of being reared in the same home is negligible for many psychological traits.”  Pg 84

When they compared the sequenced genomes of people who described themselves as having similar personality types, the researchers identified six genetic markers that were significantly associated with personality traits.  Extraversion was associated with variants in genes WSD2 and PCDH15, and neuroticism with variants in the L3MBTL2 gene./ But there is a high likelihood—a certainty even—that more genetic underpinnings of personality will be identified in the coming years.// Even if we don’t fully uncover the genetics underpinning these traits for many decades, we won’t need such a complete understanding to deploy our limited but growing knowledge of genetics in both our health care and reproduction with increasing confidence.   We will shift gradually from our generalized health care based on population averages to precision health care on responding proactively to our genetic predispositions.  Perhaps even more significantly, we will begin to integrate these genetic predictions into our reproductive decision-making. Pg 65

Chapter 4- The End of Sex

The point here is that biology is significantly more susceptible to hacking than initially meets the eye.  Pg 81

Chapter 5- Divine Sparks and Pixie Dust

This tango between our coevolving tools and ideas is also forever shifting our sense of ourselves as a species. [Emergence & Creativity] pg 89

Clustered regularly interspaced short palindromic repeats (CRISPR)/ A CRISPR is like an Old West most-wanted poster of virus that a bacterium stores in its own genetic code after initial exposure.  The bacteria archives fragments of the viral DNA from these past exposures into the bacteria’s own genetic code to create a series of genetic “mug shots of bad guy viruses.  If the virus rolls into cellular town, the bacteria sends an RNA probe to search for code in the virus’s DNA that matches the stored genetic CRISPR target list.  When it finds one, the bacteria uses an enzyme to bind to the virus’s matching code and cut apart the viral DNA just at the site where the bacterial and viral codes match.  When this works, the viral attackers are cut to pieces, the bacteria survive the attack, the piano starts up again, and the saloon customers go back to their card games./ If we had to summarize CRISPR into a single sentence, it would be this: CRISPR systems deploy the same tiny scissors bacteria use to cut up attacking viruses to snip any genetic code in a targeted place and potentially insert new genetic code. Pg 92-3

Rather than an equivalent to scissors, the CRISPR system is now looking more like a versatile Swiss Army knife able to record changes within a cell over time, identify specific virus strains, test for infections, spatially reorganize the genome, and perform a host of other functions./ Epigenetic editing is on verge of reprogramming gene expression at will. Pg 95

Instead of the more traditional methods of treating diseases and surgery or drugs, gene therapies seek to use genes to treat or prevent disease by knocking out or tuning off a mutated gene, replacing a mutated gene with a healthy copy of the same gene, and/ or adding a new gene to help the body fight a particular disease. Pg. 98

There is no doubt removing, editing and reintroducing genes will play a greater role in fighting cancer and other diseases going forward. Pg 99

These new companies, Wired noted in May 2018, are betting that “biology will be the next great computing platform, DNA will be the code that runs it and CRISPR will be the programming language.  Pg 100

Gene therapy will become a mainstay in treating and maybe curing, many of our most devasting and intractable diseases, FDA Commissioner Scott Gottlieb presciently declared in 2018. Pg 101

Chapter 6- Rebuilding the Living World

David Altschuler, for example, while a researcher at the Broad Institute of Harvard and MIT, recruited a cohort of elderly and overweight people who were statistically at a high risk of developing type 2 diabetes but hadn’t.  After sequencing the members of the group, to see how they might be genetically different from other people with the disease who were equally old and overweight, he came to believe that a single mutation in the SLC30A8 gene made his cohort 65 percent better able to regulate their insulin levels and less likely to get diabetes. Pg 111

Our biology is about as complex as it has been for millions of years but the sophistication and capacity of our tools is now advancing at exponential rates. [Moores Law]/ Each technological revolution enables the next, and the time between each revolution becomes shorter and the impact bigger.  Futurist Ray Kurzweil called this process the “Law of Accelerating Returns. Pg 120

As AI capacities grow, a future form of superintelligence may become more sophisticated than all humans put together, and new possibilities for remaking our world to emerge./ collectively as a species, we are today moving along the spectrum, from laying the technological foundation for the human genetic engineering to finding preliminary applications to imagining what might be possible in the future to making that imagined future real.// Chimera pg 121

Nearly a hundred years ago, insulin removed from cows was firs used to treat diabetes.  Extracted dog, pig, and cow insulin made it possible for humans to live with diabetes and saved countless lives for decades until E.coli bacteria could be genetically modified to produce human insulin at scale.  Pg 122

As of August 2017, there were more than 114,000 people waiting on organ-transplant lists across the United States.  Twenty people die every day while waiting for a transplant. Pg 123

Clinical trials for transplanting gene-edited pig kidneys and pancreases to humans are likely to begin soon, potentially saving thousands of human lives per year./ Growing human organs in other species will not happen tomorrow, but if it becomes possible for an individual person to have an organ grown inside an animal using his or her own genetics, people needing replacement parts because of illness or the ravages of age will quickly overcome any squeamishness they may have about crossing the human-animal barrier. Pg 124

Integrating whole genetic systems like those that give dogs special hearing abilities, eagles amazing vision, or dolphins sonar would be a lot more complicated and not possible any time soon.  But the transition of biology into yet another domain for human engineering will, over time, blur our sense of where science fiction ends and science begins./ The exploding field of ‘synthetic biology’.//Some of the early applications include current efforts to culture meat in a lab, engineer oil-secreting bacteria, manufacture yeast with spider DNA to make ultra-light silk stronger than steel, or induce bovine collagen to make nonanimal leather.  Synthetic biology is being used to create renewable microbes to produce acrylics for paints and custom engineer inexpensive synthetic sugars for biofuel.  Pg 125

The commercial implications fo this revolution are massive,  It is estimated that the global synthetic-biology market will grow from around $3 billion in 2013 to about $40 billion in 2020./ According to leading biologist Richard Kitney, synthetic biology has “all the potential to produce a new major industrial revolution.” Pg 126

Recent leaps in the biosciences, combined with big data analysis, have led us to the cusp of a revolution in medicine./ as the Chinese proverb goes, a journey of a thousand miles begins with a single step. Pg127

The computing, machine learning, AI, nanotechnology, biotechnology, and genetics revolution all have different names today, but these different technologies are currents converging into one mega revolutionary tidal wave, washing over what it means to be a human being.  If we ride this wave, the only limit for how far we can go is, perhaps, our collective imagination. Pg 128

The spaceship of our genetic revolution is already loading at the dock./ It’s also why that baby, if we feed and nurture her, will also very likely live significantly longer than any of us do today. Pg 129

Chapter 7- Stealing Immortality from the Gods

We all know people who are chronologically young but still seem or look old.  We also know people who are old but seem young.  At least superficially, that’s the difference between chronological and biological age.  While Chronological age measures the number of years since our birth, biological age seeks to assess the many genetic and environmental factors that make us age differently./ How relatively young you are. Pg 136

Studies have suggested that epigenetic markers measured in blood, the length of ‘genetic caps’ at the end of chromosomes called telomeres, walking speed, observable facial aging, and many other factors are preliminary biomarkers of aging that could, in the future, come together to help us solve the riddle of biological aging. Pg137

Elders are and have always been incredibly useful and important carriers of traditions and critical life lessons—and some smaller proportion of elders were likely needed to look after children while mothers were out foraging for food—but evolution was largely unaffected by whether most lived forty, fifty or eighty years. Pg 138

Scores of studies have shown repeatedly and for decades that calorie restriction, or CR, extends the life of yeast, flies, worms, mice, rats and other organisms./ A U.S. national institutes of Health-funded study called the ‘Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy’, or CALERIE, convinced thirty-four people to reduce their overall calorie intake by 15% for two years.// Based on all of this input, the researchers concluded that the 15% decrease in calorie intake translated into 10% lower metabolism, they concluded that lower metabolism led to a “decreased rate of living,” or less wear and tear on the cells, and possibility of longer and healthier lives for the human equivalent to the macaque monkeys. Pg 139

They say if you’d like to live to ninety, eat well, relax, sleep and exercise.  If you want to live past 100, choose your parents wisely./ We all know that no matter what our genetic predisposition, we can live longer and healthier lives if we make smart lifestyle choices often feel like a separate category from genetics, they are not.  Our lifestyle choices significantly impact the epigenetic instructions orchestrating how our genes work. Pg 142

Blue Zone 9 point list-

1. They have moderate, regular physical activity woven into their lives that nudge them into moving every twenty minutes of so—not necessarily going to the gym but getting around their towns or villages to take care of necessities;
2. They can articulate their life purpose, or ‘raison d’etre’—what the Japanese call ‘ikigaii’
3. They honor sacred, daily rituals that help them live relatively low-stress lives;
4. They only consume a moderate amount of calories per day;
5. They have plant -based, but not necessarily vegetarian diets, mostly consisting of whole grains, tubers, nuts, greens, and beans;
6. They consume alcohol only moderately, if at all;
7. They have engaged spiritual or religious lives;
8. They have active and integrated family lives; and
9. They were born into of joined committed circles of devoted friends and are embedded in regular, active and highly supportive social communities. 143

When reading a book about science, the last thing most people want is yet another reminder to get off their duffs.  But the hard science of longevity makes abundantly clear that smart lifestyle choices are the best first way to hack our own epigenetic signals./ Repeated studies have shown that these types of behavior changes also can lengthen our telomeres, the stretches of DNA at the end of our chromosomes.//  Although it is not entirely clear whether shortened telomeres are a cause or an effect of aging, shorter telomeres are associated with faster aging and higher risks of age-related disease.///  Out lifestyle choices help realize the POTENTIAL of our biology.  Pg 148

Intermittent fasting once in a while or for blocks of time each day might seem a more palatable way for people to get at least some of the potential benefits of calorie restriction without feeling miserable all of the time. Pg 149

A recent comprehensive study followed more than 650,000 people for an average of 10 years and analyzed nearly 100,000 death records in an attempt to quantify the input versus output benefits of exercise.  The study found that 75 minutes a week of moderate exercise, like a brisk walk, led to almost 2 years of added life expectancy compared to sitting on your couch.  The benefits went up form there.  Adding 2.5 to 5 hours of exercise a week added 3.5 years.  An hour a day, or 450 minutes a week , added 4.5 years to life expectancy.  Pg 150

Another drug that shifts the balance of cellular activity from growth to repair mode is the seeming wonder drug Metformin.  Pg 151

To answer the question of whether Metformin might be a systematic drug that helps enhance healthy life spans among nondiabetic populations, Nir Barzilai and his collaborators are now exploring how Metformin might delay the onset of multiple age-related diseases and stem decline in older people’s physical performance, cognitive clarity, and quality of life./ Another drug that’s proven to extend the life of animals tested in studies around the world is the miraculous drug Rapamycin. Pg152

Rapamycin’s natural ability to slow the proliferation and growth of targeted cells made in an ideal immunosuppressant, perfect for preventing people’s immune systems from rejecting transplanted organs./ The named the protein targeted in this process mTor. Pg 153

The race is now on to develop and test a new class of drugs called Senolytics, designed to prune senescent cells to treat specific diseases of aging and potentially expand both health span and life span./ A related potential approach to countering aging involves manipulating the way our cells recycle their own biomass to extract energy and remove harmful proteins, a process scientists call Autophagy. Pg 155

All of this work to expand the human health span will be sped up significantly if we as a global community invest more, and more smartly, in understanding aging and countering its more pernicious effects.  In 2017, for example, the U.S. National Institutes of Health only spent $183.1 million of its overall $32 billion budget, one-third of one percent, on aging biology, far less than the many billions it spent on cancer, arthritis, diabetes and hypertension.  Even within this small base, the National Institute on Aging spends over half of its budget on Alzheimer’s disease.  Cancer, arthritis, diabetes, hypertension, and Alzheimer’s are all terrible conditions that must be addressed, but eliminating any one of them entirely won’t extend most of our health spans by all that much because they are all correlated with age.  The older we are, the more likely we are to get all of them.  That’s why the return on investment for the overall population would be significantly greater if we invest relatively more than we are today in understanding and treating aging itself, rather than in each of its many cruel manifestations.  Pg 160

Based on their 2013 study, intervening to slow the aging process and push back the onset of the multiple diseases of aging by 2.2 years across the U.S. population would result in a whopping $7.1 trillion in savings over a 50 year period.  Put another way, if extending health span across the population proves as possible as it now appears, the anticipated savings coculd not only pay for a Manhattan Project that targets aging but also cover repairing all of America’s decaying infrastructure, provide universal preschool for every American child, and provide clean water to virtually everyone on Earth.  Pg 161

Perhaps the best investment we can make in our immortality is to have a child, write a book, help save the environment, or contribute positively to our communities and cultures.  Pg 162

Chapter 8- the Ethics of Engineering Ourselves

To realize the greatest upside of the genetic revolution we will have to articulate, celebrate, and affirm in our individual and collective choices the value of diversity in the coming genetic age in a far more profound manner than we do today. Pg 183

There are no easy answers, but it’s fair to ask whether preventing the first adopters from genetically enhancing their children would be the same as preventing the early adopters of smartphones and supercomputers from leveraging the advantages those technologies provided. / I could well be that some of us will want the coming decades and centuries, for our children to have enhanced abilities and traits. (Choice)  Pg 185

The entire history of human existence has been marked by our incessant struggle to increase our chances of survival by becoming better at securing calories, protecting ourselves from the elements, and procreating./ If genetic technologies help us live healthier and longer, retain knowledge, and do many other things better, or even just make us feel we have the capacity to fight back against the caprice of our own biology, the magnetic pull of using these technologies will prove collectively irresistible.  Use this as part of open!!! Pg 189

Chapter 9- We Contain Multitudes

The Chinese government classified “enhanced agriculture” as a strategic emerging industry in the governments most recent ‘Five-Year Plan’. Pg 197

Study after study over decades has repeatedly shown genetically modified crops are as safe as conventional ones. Pg 198

Reviewing more than twenty years of data from multiple studies around the world, the authors concluded that genetic modification actually increased yields and reduced carcinogenic toxins in corn. / GM is a tool with huge upside and a potential downside that requires thoughtful regulation.  Pg 199

Because genetic data will be so critical to both personalized health care of individuals and the deciphering of human genetics more generally and also susceptible to misuse by others, societies will have good reason to safeguard the genetic information of its citizens. Pg 218

For most people, the idea of a government or company tracking every aspect of our lives is frightening. / Whoever gets the biggest and best data sets will be best poised to lead the genetic revolution with all the wealth, prestige, power, and influence it will bring.  Pg 219

Chapter 10- The Arms Race of the Human Race

In 2014,  Uzbekistan became the first nation to announce it was integrating genetic testing into ins national sports program.  In conjunction with its national Olympic Committee and several sports federations, Uzbekistan’s Academy of Sciences said it would test children for fifty genes believed to impact athletic potential to help identify possible future stars.  In August 2018, China’s Ministry of Science and Technology announced that Chinese athletes aspiring to compete in the 2022 Winter Olympics would be required to have their genome sequence and profiled for “speed, endurance, and explosive force” as one factor in an official selection process guided by “genetic markers.”  This type of testing today has a low probability of success because we still know relatively  little about what genes do and because athletic success is such a complex mix of biological and environmental factors. Pg 229

The genetics of sports analogy isn’t just about sports.  It’s about life.  Pg 230

Those parents who opt-in for full genetic optimization might, to give one example, ensure their children don’t get certain diseases, live healthier longer, and have greater chances of excelling at a given task.  If opt-in benefits are great enough, we can imagine an accelerating curve of advantages. A generation of enhanced people could gain the advantages necessary to ensure that their children have greater access to the next generation of enhancements, and so on down the line.pg 235

“Increasingly , the U.S.-China relationship will not be defined by the ownership of 20^th century manufacturing industries but by a race in genetic and computing innovation that will drive the economy of the future.  Pg 240

Already, American companies like IBM and new Chinese companies like iCarbonX are positioning themselves to assume this mantle./ Founded by former BGI CEO Wang Jun in October 2015, iCarbonX seeks to “build an ecosystem of digital life based on a combination of an individual’s biological, behavioral and psychological data, the Internet and artificial intelligence”.  By combining comprehensive biological, patient-generated data with AI technology, it plans to help consumers better understand the medical, behavioral, and environmental factors in their lives to optimize their health and to help companies use genetic data to optimize their products and services.  Wang Jun’s plan is to ultimately build a “predictive digital avatar” of hundreds of millions of customers, allowing them to pass from sequencing to fully digitizing themselves.  “ We can digitize everyone’s life information,” Wang Jun says, “interpret the data, find more valuable law of life, and thus enhance the quality of people’s lives.” With Tencent and the private equity behemoth Sequoia capital as early investors, by 2017 iCarbonX quickly shot up to a $1 billion valuation, becoming China’s first biotechnology unicorn. pg 242

Chapter 11- The Future of Humanity

Like the nuclear arms race, an international competition in the field of genetics—a genetic arms race—has enormous potential to either improve people’s lives or do them harm.  Pg 250

A first, immediate step in this direction is to help every country develop its own national public-education program, bioethics commission, and regulatory framework for human genetic engineering that applies its own traditions, values, and interests./ Each of us must take individual responsibility for ensuring we are educating ourselves about what’s coming and bringing as many of our fellow humans as possible into the conversation.
We must each play a role in jump-starting a species-wide conversation on the future of human genetic engineering before it’s too late.  Pg 263

Become more active participants in the decision-making process about our common future./  Humans must and will embrace the genetic revolution, but will be far better off if we do it together.  Pg 267

Figuring out how to deploy genetic technologies in ways that enhance our dignity and respect for each other will require us to draw on the best of our humanist values and double down on our embrace of, respect for, and investment in our diversity, equality, and common humanity.  While the genetic engineering technologies are new, the values and philosophies we will need to use them wisely are very old./ Deploying our best values at this transitional moment for our species demands that we all understand what is happening now, what is coming, what’s at stake, and the role we each must paly in building a technologically enhanced future that works for all of us.//It will be a difficult, painful, and conflict ridden process, but we have no alternative.  We all need to participate.  We don’t have a moment to lose in getting started.

Fellow humans, let us together begin the conversation.  Pg 268