Torah Tidbits

1 August 2014 / 5 Av 5774
Issue 1056
Shabbat Parshat Shoftim
August 08, 2013

"From Machon Puah"

Treating Mitochondrial Disease

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Treating Mitochondrial Disease

As we saw last week, the cell contains extremely small structures that hold the cell’s energy like little batteries. In addition, the mitochondria contain small amounts of DNA which is the map to building a new life - but in extremely rare cases this DNA is damaged. When damaged DNA is passed on to the next generation there is the possibility of having a child with a range of diseases some of which are very serious and even potentially fatal.
In cases where the faults are in the nucleus of the cell, today there is no available treatment. In cases where the fault is in the mitochondrial DNA current research is investigating the possibility of replacing the damaged mitochondria with healthy mitochondria using a donor. This is performed by using two new medical techniques, termed pro-nuclear transfer (PNT), and maternal spindle transfer (MST).
Pro-nuclear transfer involves transferring the pro-nuclei from an embryo with unhealthy mitochondria and placing them into a donor embryo, which contains healthy mitochondria and has had its pro-nuclei removed. A pro-nucleus is a small round structure in the cell containing nuclear DNA seen within an embryo following fertilization. A normal embryo should contain two pro-nuclei, one from the egg (maternal pro-nucleus) and one from the sperm (paternal pro-nucleus).
The maternal spindle is a structure within the egg containing the mother’s nuclear DNA. Maternal spindle transfer involves transferring the spindle from the intending mother’s egg, with unhealthy mitochondria, and placing it into a donor egg with healthy mitochondria.
These techniques are at the cutting edge, both of science and ethics and are currently only being performed and permitted in research.
The question has been raised recently as to whether this procedure is ethical and whether it can and should be permitted. If permission is granted it would lead to this procedure being adopted not only in a research capacity as it is today, but also in a clinical setting which would lead to this research being used by couples who have had children suffering from mitochondrial diseases.
In the UK, the Human Fertilisation and Embryology Act (HFEA) is the official body that draws up government policy in areas of fertility research and treatment. So they attempted to reach a consensus and suggest how the law should be decided in the question of mitochondrial replacement.
In the end they suggested that the law should be changed to permit this treatment and that was indeed what was adopted as law in the UK. Britain is one of the first countries in the world that has a permissive law in this area of research and treatment.
What is fascinating is the way that they arrived at their suggestion which lead to the law being changed. More on this next week.

Rabbi Gideon Weitzman

The Puah Institute is based in Jerusalem and helps couples from all over the world who are experiencing fertility problems. Puah offers free counseling in five languages, halachic supervision, and educational programs. Offices in Jerusalem, New York, Los Angeles and Paris. Contact: (02) 651-5050 (Isr). http://www.puahonline.org

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