WARM UP

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Genedicine

P McCrory

Continuing my occasional forays into gene technology, I was interested to see that regulatory authorities in China have licensed a gene therapy based treatment. This is the first time anywhere in the world that such a treatment has been authorized.

Although the therapy relates to head and neck squamous cell carcinoma (a huge problem in southern China) the technology is relatively straightforward. The company, SiBiono GeneTech, uses an adenovirus as the vector to insert a gene designed to limit cancer cell growth. The results of trials have been published in the peer reviewed Chinese Medical Journal and show this technique to be dramatically effective compared with conventional radiotherapy. The beauty of the technique is that the virus does not integrate into the cell genome (thereby minimising the risk of leukaemia) but rather confines itself to the malignant cell line. The simplicity of the technique is echoed in the low cost (about US$ 360 per dose) and the ease by which virtually any doctor can administer the treatment.

Why is this of interest to practitioners of sports medicine? I have previously alluded to the issue of gene transfer technology as a threat to sports medicine.¹ What we are seeing now is the transition of gene therapy from a promising experimental concept to an established mainstream treatment. While there is little doubt that gene medicine (or "genedicine") holds promise for the treatment of many currently untreatable diseases, it is also arguably the greatest threat facing modern sports medicine.

Imagine a simple and cheap treatment that can boost your red blood cell mass or give you bigger muscles on demand. Imagine also that this ergogenic therapy is undetectable. That is what genedicine is and can do at present—not in the future—now.

If you are an elite athlete and the Olympics or World Championships are coming up why consider an anabolic agent that can be picked up in drug tests or else needs a retinue of scientists manipulating the dose schedule to avoid detection? Once the bugs are sorted out, gene therapy is the way to go. The idea that scientists and government bodies will self regulate this area to prevent athletes accessing such treatments is simply ludicrous. They haven’t done this with other ergogenic agents so why start here? The World Anti-Doping Agency (www.wada-ama.org) seems to adhere to this belief. Good luck to them, but I seriously doubt whether anyone else in the world takes that view seriously.

1. McCrory P. Super athletes of gene cheats? Br J Sports Med 2003;37:192–194.[Free Full Text]

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