讓孩子有三個父母的MRT技術

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SINGAPORE—This small city state could become the second country—after the United Kingdom—to explicitly legalize mitochondrial replacement therapy (MRT), a controversial assisted reproduction technique that allows women who are carriers of some rare genetic disorders to give birth to healthy babies.

新加坡——這個小國家將可能成為第二個—繼英國之後—明確將線粒體替換療法（MRT）合法化的國家，這種療法是一種有爭議的輔助生殖技術，可以讓那些懷有先天罕見疾病的孩子的孕婦們生出健康的寶寶。

Members of the Singaporean public and religious groups have until 15 June to provide their feedback about MRT to the Bioethics Advisory Committee (BAC).

新加坡的公共和宗教團體成員們在7月15號之前還可以將他們的關於MRT的意見提交給生物倫理顧問委員會。（BAC）

Based on its findings, a 13-member BAC review committee will make formal recommendations to the government later this year about whether to legalize the technology.

根據其調研，這支13名成員的BAC複核委員會今年下半年將向政府正式提出關於是否將該技術合法化的建議。

「Our position is to keep a close watch on what happens in the U.K., to track the U.K. experience, and to learn from what they have done,」 says Oi Lian Kon, who studies human genetics at the National Cancer Centre Singapore and is leading the BAC review group.

「我們的職責就是密切關注英國，追蹤英國的進展，並學習他們的做法，」歐連孔說道，他在新加坡國立腫瘤中心研究人類遺傳學，也是BAC複核委員會的會長。

MRT is used to address devastating genetic diseases that arise from abnormalities in the DNA in mitochondria, the cell』s power sources, and that commonly affect energy-intensive organs such as the brain and heart, as well as muscles.

MRT是用來治療一種嚴重的遺傳疾病的技術，這種疾病來源於線粒體DNA的異常，而線粒體是細胞的動力來源，這種疾病通常會影響高耗能的器官比如大腦，心臟還有肌肉。

Children inherit mitochondria only from their mothers; replacing faulty mitochondria in an egg or embryo with normal ones from a donor can result in healthy babies.

孩子只會從他們的母親那裡繼承線粒體；用捐贈者的正常線粒體替換卵子或者胚胎中的異常線粒體就可以得到健康的寶寶。

But it also means that offspring will bear DNA from three 「parents,」 which makes MRT a controversial procedure.

不過這樣也意味著這個後代會含有來自三個「父母」的DNA，也使得MRT成為了具有爭議的手術。

In 2015, the United Kingdom gave MRT the go-ahead, and the first two babies resulting from the technique are likely to be born there later this year.

2015年時，英國法律通過了MRT技術，用這種技術產生的頭兩個寶寶將於今年後半年降生。

MRT has already been used in other countries that don』t explicitly legalize it, but have more relaxed laws on genetic modification.

MRT也在別國被採用，他們沒有明確將其合法化，不過對於基因修飾有更寬鬆的法律條令。

In 2016, a female carrier of Leigh syndrome, a severe neurological disorder, received treatment in Mexico and gave birth to a healthy boy.

2016年，一名孩子患有亞急性壞死性腦脊髓病的孕婦，這是一種嚴重的神經疾病，在墨西哥接受了治療，剩下了一個健康的男孩。

The following year, a Ukrainian team reported two successful births from MRT as well.

下一年，一支烏克蘭團隊報道稱也有兩個利用MRT順利生育的案例。

No other countries have adopted laws specifically about MRT.

還沒有其他的國家有專門針對MRT的立法。

Many have a blanket ban on changing the human germline that includes the technique.

很多國家還盲目地禁止所有改變人類種系的技術，包括MRT這種技術。

Thailand is the only country that does not explicitly prohibit altering the human genome, whereas Italy and Israel permit it under certain conditions.

泰國是唯一沒有明確禁止改變人類基因組的國家，而義大利和以色列在某些情形下對其許可。

In Singapore, MRT is theoretically possible today, says BAC review panel member Tracey Evans Chan, who studies biomedical law and ethics at the National University of Singapore.

在新加坡，MRT從理論上來說是可能的，BAC審查小組成員特雷西.伊萬斯.陳說，他在新加坡國立大學研究生物醫學法律和倫理。

The country does not allow human germline modification in the clinical setting, but it does—unlike the United States and many European countries—permit genetic tinkering for research purposes, so MRT could be done if it were formally part of a scientific study.

該國不允許臨床條件下改變人類種系，不過它—不像美國和很多歐洲國家—允許為了研究目的進行基因修補，因此MRT如果作為科學研究的一個正式部分是可以進行的。

「But in order for the therapy to be mainstreamed,」 he says, the law needs to change.

「但要想讓這種治療成為主流，」他說道，就需要改變法律。

Singapore』s BAC has held two public dialogue sessions in the past month; they are also soliciting written feedback.

在過去幾個月里，新加坡的BAC已經舉辦了兩次對話會議；他們也在徵求書面意見。

「The most common concern expressed among the lay public whom we have consulted is the issue of self-identity and the fact that children who are born from such a method would, in theory, have part of the genomes of three individuals,」 Kon tells us.

「我們就這個問題詢問的大眾群體所表達出來的最普遍的擔憂就是，自我認知的問題還有這種方法生出來的孩子從理論上說會有第三方的一部分基因這個事實，」孔告訴我們。

Two MRTs are now approved for use in the United Kingdom: maternal spindle transfer, in which the nucleus from the mother』s egg is placed inside a donor egg whose nuclear material has been removed, followed by fertilization; and pronuclear transfer, in which an egg is fertilized first, after which the nucleus of the embryo is transferred inside the enucleated donor egg cell.

在英國有兩種MRT技術是許可的：孕婦核心移植，來自媽媽的卵子的細胞核被放置在捐贈者的卵細胞內，捐贈者卵細胞的細胞核材料已經被移除，然後再人工授精；還有就是原核移植，先將卵細胞受精，然後再將受精卵的核移植到捐贈者去核的卵細胞中。

Singapore is considering a third, newer method called polar body transfer (PBT), in which a tiny cell from the recipient called a 「polar body」—which forms when an egg cell divides—is placed inside a donor egg cell, before or after fertilization.

新加坡還考慮通過第三種，一種新的叫做極體移植（PBT）的技術，該技術是將接受者的一個叫做「極體」的微小細胞—它是在卵細胞分裂時形成的—放置在捐贈者的卵細胞中，要麼在受精前，要麼在受精之後。

Polar bodies have very little cytoplasm and contain few, if any, mitochondria, which makes PBT potentially simpler and safer.

極體的胞質很少，線粒體也幾乎沒有，這就使得PBT可能會更簡單而安全。

That the United Kingdom has not approved PBT is 「really a matter of timing,」 says Andy Greenfield of the Medical Research Council"s Harwell Institute in the United Kingdom, who led the country』s Human Fertilisation and Embryology Authority review of MRT.

英國通過PBT是「遲早的是」，安迪.格林菲爾德說，他來自英國的哈維爾研究所的醫學研究委員會，也是英國的人類生殖和胚胎管理局MRT方面的帶頭人。

「The possibility of using PBT came rather too late in the process to permit its smooth introduction into law,」 he says.

「要將它順利法律通過，所以利用PBT的可能性來得有點遲」他說道。

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