Team:Nanjing NFLS/Human Practices

Team:Nanjing_NFLS 2017-igem.org

Human Practices.

Integrated Human Practices

Purpose

Inspiration

The Feb, 4 of every year is World Cancer Day. From 2016 to 2018, the theme of World Cancer Day is “We can, I can.” At NFLS, various popular science events were held by natural science student clubs and organizations on Feb, 5. Though we were happy to see such campaigns had raised public awareness of cancer, the statics release by China National Cancer Center still caused our vigilance— in the 288,243,347 population (about 21.07% of national population) covered by the cancer registries, a total of 3,804,000 new cancer cases were diagnosed, with a shocking incidence rate of 278.07/100,000, which is significantly higher than world standard; moreover, a 167.89/100,000 mortality rate (much higher than the world standard rate of 106.09/100,000) stresses the urgency of the challenge posed on China public health. Living in Nanjing, a city in East China, we were surprised to learn that this part of the country has the highest cancer mortality rate. We decided to base our project on gene cancer therapy.

Dr. Xi Zou

Before we proceeded to gene therapy, we investigated on current solution in hospitals. In late February, in order to learn more about current clinical status of cancer, we visited and interviewed Dr. Xi Zou, an oncologist of Jiangsu Province Hospital of TCM. She specializes in Gastrointestinal tumors, lung cancer, Gynecological tumors.

Dr. Zou walked us through common cancer treatment and the scenarios of application. Then she introduced a previous case in her department which caught our attention. A IV Stage lung cancer patient miraculously recovered after receiving gene therapy— though the case doesn’t represent the norm, she is confident that a more advanced gene therapy will ultimately ease the pain of curing cancer and save more such lives. However, after briefly introducing the its functioning organism, she mentioned the limitation of gene therapy— its requirement of patient’s physical situation, potential drug-resistance and high cost (10,000 RMB, about 1470 US dollars, per month); when we asked about patients’ attitude toward gene therapy, she told us that since gene therapy has a relatively short clinical history, many patients and their family haven’t heard of it or even resists to take it, so it would take longer than usual to communicate with them when settling down the treatment plan.

“New methods of curing cancer, represented by gene therapy and immunotherapy, definitely have huge prospect,” she said, “the pressing issue is not only lab research, but also raising public awareness and confidence.”

Interview with Dr. Xi Zou. Interviewer: Feifei Long (left 1) and Tiantian Wei (right 1).

Design and Execution

Survey Part I

We conducted survey in the Lanyuan community near East Beijing Road, where our school locates, to investigate people’s recognition and major concern, or pain points, of cancer treatment. 293 people responded (overall population of about 5,000).

Here are result highlights.

Survey result pie chart 1.

Analysis: Though worried about the damage major operations can have on human body, people trust it most as a cancer therapy. New approaches such as gene therapy, targeted therapy, and immunotherapy receive almost equal recognization.

Analysis: Toxic and side effects on other cells together with major surgery damages run the first two concerns of people. Pains to the patients and unaffordable costs follow: as a result of the popularity of the movie Dying to Survive, telling stories about broke CML patients.

The results indicate that people worry most about extra damages on human body in cancer treatment, based on which we designed our telomerase targeting system to maximally reduce side effects on normal cells with no telomerase activity. Moreover, we choose to directly cut the telomeres instead of inhibiting telomerase— in this way the interval between cancer cell apoptosis and the injection of the drug would shortened, thus easing the pain of patients.

Dr. Sheng Zhao

After we utilize telomerase activities in cancer cells to target-and-cut telomeres in cancer cells and received fair results, we had the chance to invite Dr. Zhao from Medical Department of SEU to a coffee talk. He looked at our project and the results we obtained by then and gave feedback. He pointed out that if we would like to test our system in vivo in the future, our constructed vector must be compatible with virus vector, which made our telomerase recognition stick end a tricky issue. He suggested that we find an enzyme that can create a telomerase recognizable sequence on our DNA construct. After extensive research and consulting our PI, we chose the HO enzyme to be part of our final system and obtained satisfactory results.

Sitting down with Dr. Sheng ZhaoInterviewer: Longqing Chen (left 2), Zixin Chen (right 1) and Yongyi Wang (taking picture).

Raising Awareness

Survey Part II— how “aware” are we?

In the survey mentioned above, we also included general questions concerning gene-editing, synthetic biology and gene-editing treatments to diseases.

Here are result highlights.

Survey result pie chart 2.
Survey result pie chart 3

The results reflected people’s uncertainty of synthetic biology and gene therapy in application. We supposed that this uncertainty comes from the lack of thorough understanding.

Since this survey was conducted in a community which basically overlaps with NFLS community, we interviewed NFLS Biology teacher, Ms. Wei Xin, to learn about the coverage of these topics in a common Chinese Biology course.

It turns out that in a total of 138 chapters of compulsory high school biology textbooks (Compulsory Textbook 1, 2 and 3), only 1 chapter covered transgenic-Bt insect-resistant cotton, which is barely an example of synthetic biology. The term synthetic biology and its definitions remain missing in the textbooks. In three optional courses available for students attending Advance Biology in high school, Optional Course 3, covers synthetic biology in several independent research introductions. No lab work in this field for any student is required. “Indeed,” said Ms. Xin Wei, a biology teacher of Grade 11 of Nanjing Foreign Language School, “our students are not familiar with a lot of cutting-edge technologies, synthetic biology included, and we are trying our best to fix the gap in class.”

Zixin Chen with Ms. Wei Xin after the interview

High School

Based on the result of the surveys, we think that high school students at NFLS do not have enough chance to closely look at gene editing techniques and its application. So we invited NJU-China iGem team to co-host a popular science session with us at NFLS Synthetic Biology club. The session was open for everyone on campus who was interested. For more details go to our collaboration with NJU.

NJU iGem team on their project.
We talk about gene therapies.

Cheng Xian Street Primary School

To interact with our community at a more personal level, we reached out to a local primary school, Chengxianjie Primary School, for three times to popularize Biology knowledge and cultivate awareness and confidence of gene editing therapy.

First visit: we took the introduction to cells as our main theme in order to help children build a knowledge foundation. We made models of plant and animal cells with plastic clay. By utilizing some simple metaphors, and introduced basic functions of organelles and structures.

Students looking at model of animal cell.

Second visit: we chose chromosome as an intro to genetics. To our astonishment, students had already grabbed a fundamental understanding of it so we carried on our discussion to a deeper level: the GMO (genetically modified organism) and its possible effects. We received a great heated repercussion after the meeting. However, we discovered that most children still perceive “gene editing” as “creating freak animals,” so we went a third time in September.

We talking about chromosomes.

Third visit: this time we showcased the various applications of gene editing. Children accepted the concepts easily as we assimilate gene editing as scissors, puzzles and glues.

Student matching genes with their functions.

We received positive feedback from Ms. Hong Miao, their homeroom teacher, and many parents.
Hopefully, our visits will kindle their interest in biology or even synthetic biology, and they will learn to critically think about gene editing as a useful tool.

Reference

Cancer incidence and mortality in China, 2014. Chin J Cancer Res 2018;30(1)