Editing Human genetic enhancement (section)

==Gene doping==
{{Main|Gene doping}}
Athletes might adopt gene therapy technologies to improve their performance.<ref name="Gene Doping">{{cite web|url=http://www.wada-ama.org/en/Science-Medicine/Science-topics/Gene-Doping/ |title=WADA Gene Doping |work=World Anti-Doping Agency |publisher=WADA |access-date=27 September 2013 |archive-url=https://web.archive.org/web/20091121094012/http://www.wada-ama.org/en/Science-Medicine/Science-topics/Gene-Doping/ |archive-date=21 November 2009 }}</ref> [[Gene doping]] is not known to occur, but multiple gene therapies may have such effects. Kayser et al. argue that gene doping could [[Level playing field|level the playing field]] if all athletes receive equal access. Critics claim that any therapeutic intervention for non-therapeutic/enhancement purposes compromises the ethical foundations of medicine and sports.<ref>{{cite journal | vauthors = Kayser B, Mauron A, Miah A | title = Current anti-doping policy: a critical appraisal | journal = BMC Medical Ethics | volume = 8 | issue = 1 | pages = 2 | date = March 2007 | pmid = 17394662 | pmc = 1851967 | doi = 10.1186/1472-6939-8-2 | doi-access = free }}</ref> Therefore, this technology, which is a subfield of genetic engineering commonly referred to as gene doping in sports, has been prohibited due to its potential risks.<ref name="pmid32399143">{{cite journal | vauthors = John R, Dhillon MS, Dhillon S | title = Genetics and the Elite Athlete: Our Understanding in 2020 | journal = Indian Journal of Orthopaedics | volume = 54 | issue = 3 | pages = 256–263 | date = May 2020 | pmid = 32399143 | pmc = 7205921 | doi = 10.1007/s43465-020-00056-z }}</ref> The primary objective of gene doping is to aid individuals with medical conditions. However, athletes, cognizant of its associated health risks, resort to employing this method in pursuit of enhanced athletic performance. The prohibition of the indiscriminate use of gene doping in sports has been enforced since the year 2003, pursuant to the decision taken by the World Anti-Doping Agency (WADA).<ref name="pmid32558587">{{cite journal | vauthors = López S, Meirelles J, Rayol V, Poralla G, Woldmar N, Fadel B, Figueiredo M, Costa Padilha MD, de Aquino Neto FR, Gualberto Pereira HM, Pizzatti L | display-authors = 6 | title = Gene doping and genomic science in sports: where are we? | journal = Bioanalysis | volume = 12 | issue = 11 | pages = 801–811 | date = June 2020 | pmid = 32558587 | doi = 10.4155/bio-2020-0093 | s2cid = 219911239 }}</ref> A study conducted in 2011 underscored the significance of addressing issues related to gene doping and highlighted the importance of promptly comprehending how gene doping in sports and exercise medicine could impact healthcare services by elucidating its potential to enhance athletic performance. The article elucidates, according to the World Anti-Doping Agency (WADA), how gene doping poses a threat to the fairness of sports. Additionally, the paper delves into health concerns that may arise as a consequence of the utilization of gene doping solely for the purpose of enhancing sports performance.<ref name="pmid22179292">{{cite journal | vauthors = Battery L, Solomon A, Gould D | title = Gene doping: Olympic genes for Olympic dreams | journal = Journal of the Royal Society of Medicine | volume = 104 | issue = 12 | pages = 494–500 | date = December 2011 | pmid = 22179292 | pmc = 3241516 | doi = 10.1258/jrsm.2011.110240 }}</ref> The misuse of gene doping to enhance athletic performance constitutes an unethical practice and entails significant health risks, including but not limited to cancer, viral infections, myocardial infarction, skeletal damage, and autoimmune complications. In addition, gene doping may give rise to various health issues, such as excessive muscle development leading to conditions like hypertonic cardiomyopathy, and render bones and tendons more susceptible to injuries<ref name="pmid23113049">{{cite journal | vauthors = Fallahi A, Ravasi A, Farhud D | title = Genetic doping and health damages | journal = Iranian Journal of Public Health | volume = 40 | issue = 1 | pages = 1–14 | date = 2011 | pmid = 23113049 | pmc = 3481729 | doi =  }}</ref> Several genes such as EPO, IGF1, VEGFA, GH, HIFs, PPARD, PCK1, and myostatins are prominent choices for gene doping. Particularly in gene doping, athletes employ substances such as antibodies against myostatin or myostatin blockers. These substances contribute to the augmentation of the athletes' mass, facilitation of increased muscle development, and enhancement of strength. However, the primary genes utilized for gene doping in humans may lead to complications such as excessive muscle growth, which can adversely impact the cardiovascular system and increase the likelihood of injuries.<ref name="pmid25435666">{{cite journal | vauthors = Brzeziańska E, Domańska D, Jegier A | title = Gene doping in sport - perspectives and risks | journal = Biology of Sport | volume = 31 | issue = 4 | pages = 251–9 | date = December 2014 | pmid = 25435666 | pmc = 4203840 | doi = 10.5604/20831862.1120931 | doi-broken-date = 1 November 2024 }}</ref> However, due to insufficient awareness of these risks, numerous athletes resort to employing gene doping for purposes divergent from its genuine intent. Within the realm of athlete health, sports ethics and the ethos of fair play, scientists have developed various technologies for the detection of gene doping. Although in its early years the technology used wasn’t reliable, more extensive research has been done for better techniques to uncover gene doping instances that have been more successful. In the beginning, scientist resorted to techniques such as PCR in its various forms. This was not successful due to the fact that such technologies rely on exon-exon junctions in the DNA. This leads to a lack of precision in its detection as results can be easily tampered using misleading primers and gene doping would go undetected.<ref>{{cite journal | vauthors = Perez IC, Le Guiner C, Ni W, Lyles J, Moullier P, Snyder RO | title = PCR-based detection of gene transfer vectors: application to gene doping surveillance | journal = Analytical and Bioanalytical Chemistry | volume = 405 | issue = 30 | pages = 9641–53 | date = December 2013 | pmid = 23912835 | doi = 10.1007/s00216-013-7264-8 | s2cid = 41151847 }}</ref> With the emerge of new technologies, more recent studies utilized Next Generation Sequencing (NGS) as a method of detection. With the help of bioinformatics, this technology surpassed previous sequencing techniques in its in-depth analysis of DNA make up. Next Generation Sequencing (NGS) focuses on using an elaborate method of analyzing sample sequence and comparing it to a pre-existing reference sequence from a gene database. This way, primer tampering is not possible as the detection is on a genomic level. Using bioinformatic visualizing tools, data can be easily read and sequences that do not align with reference sequence can be highlighted.<ref>{{cite journal | vauthors = de Boer EN, van der Wouden PE, Johansson LF, van Diemen CC, Haisma HJ | title = A next-generation sequencing method for gene doping detection that distinguishes low levels of plasmid DNA against a background of genomic DNA | journal = Gene Therapy | volume = 26 | issue = 7–8 | pages = 338–346 | date = August 2019 | pmid = 31296934 | doi = 10.1038/s41434-019-0091-6 | pmc = 6760532 }}</ref><ref>{{cite journal | vauthors = McCombie WR, McPherson JD, Mardis ER | title = Next-Generation Sequencing Technologies | journal = Cold Spring Harbor Perspectives in Medicine | volume = 9 | issue = 11 | pages = a036798 | date = November 2019 | pmid = 30478097 | pmc = 6824406 | doi = 10.1101/cshperspect.a036798 }}</ref> Most recently, One of the high-efficiency gene doping analysis methods conducted in the year 2023, leveraging cutting-edge technology, is HiGDA (High-efficiency Gene Doping Analysis), which employs CRISPR/deadCas9 technology.<ref name="pmid36933297">{{cite journal | vauthors = Yi JY, Kim M, Ahn JH, Kim BG, Son J, Sung C | title = CRISPR/deadCas9-based high-throughput gene doping analysis (HiGDA): A proof of concept for exogenous human erythropoietin gene doping detection | journal = Talanta | volume = 258 | issue =  | pages = 124455 | date = June 2023 | pmid = 36933297 | doi = 10.1016/j.talanta.2023.124455 | doi-access = free }}</ref>

The ethical issues concerning gene doping have been present long before its discovery. Although gene doping is relatively new, the concept of genetic enhancement of any kind has always been subject to ethical concerns. Even when used in a therapeutic manner, gene therapy poses many risks due to its unpredictability among other reasons. Factors other than health issues have raised ethical questions as well. These are mostly concerned with the hereditary factor of these therapies, where gene editing in some cases can be transmitted to the next generation with higher rates of unpredictability and risks in outcomes.<ref>{{cite journal | vauthors = Penticuff J | title = Ethical issues in genetic therapy | journal = Journal of Obstetric, Gynecologic, and Neonatal Nursing | volume = 23 | issue = 6 | pages = 498–501 | date = 1994 | pmid = 7965255 | doi = 10.1111/j.1552-6909.1994.tb01911.x }}</ref> For this reason, non-therapeutic application of gene therapy can be seen as a riskier approach to a non-medical concern.<ref>{{cite journal | vauthors = Fallahi A, Ravasi A, Farhud D | title = Genetic doping and health damages | journal = Iranian Journal of Public Health | volume = 40 | issue = 1 | pages = 1–14 | date = 2011-03-31 | pmid = 23113049 | pmc = 3481729 }}</ref>

In a study, from history to today, human beings have always been in competition. While in the past warriors competed to be stronger in wars, today there is competition to be successful in every field, and it is understood that this psychology is a phenomenon that has always existed in human history until today. It is known that although an athlete has genetic potential, he cannot become a champion if he does not comply with the necessary training and lifestyle. However, as competition increases, both more physical training and more mental performance are needed. Just as warriors in history used some herbal cures to look stronger and more aggressive, it is a fact that today, athletes resort to doping methods to increase their performance. However, this situation is against sports ethics because it does not comply with the morality and understanding of the game.<ref>{{cite journal | vauthors = Wells DJ | title = Gene doping: the hype and the reality | journal = British Journal of Pharmacology | volume = 154 | issue = 3 | pages = 623–631 | date = June 2008 | pmid = 18500383 | pmc = 2439520 | doi = 10.1038/bjp.2008.144 | doi-access = free }}</ref>

One of the negative effects is the risk of cancer, and as a positive effect is taking precautions against certain pathological conditions.Altering genes could lead to unintended and unpredictable changes in the body, potentially causing unforeseen health issues. Further effects of gene doping in sports is the constant fight against drugs not approved by the World Anti doping agency and unfairness regarding athletes that take drugs and don't. The long-term health consequences of gene doping may not be fully understood, and athletes may face health problems later in life.<ref>{{cite journal | vauthors = Ginevičienė V, Utkus A, Pranckevičienė E, Semenova EA, Hall EC, Ahmetov II | title = Perspectives in Sports Genomics | journal = Biomedicines | volume = 10 | issue = 2 | pages = 298 | date = January 2022 | pmid = 35203507 | pmc = 8869752 | doi = 10.3390/biomedicines10020298 | doi-access = free }}</ref>