Chapter 201: Moratorium (6)

Inside Synchronization Mode, Young-Joon was examining the body of Mimi, the Cas9 baby who was the very first genetically modified baby in the world. Cas9 and RNA fragments wrapped in exosomes were gradually being injected into the lymph nodes and bone marrow in five hundred microliter volumes of injection fluid. There were going to be seventy-two injections over her entire body, and they had to do this again in two days.

‘It’s a lot for a newborn baby’s body to take, but...’

There was no better way. The only way to normalize the CCR5 gene in this baby with a compromised immune system was this.

Rosaline focused on the lymph nodes under her chest. The exosomes were binding to the membranes of the cells in the lymph nodes, injecting Cas9 and the RNA complex into the cell.

‘Using exosomes was a good choice.’

Exosomes were essentially a kind of written communication between cells. They were particularly common in cancer cells, and in this case, Young-Joon used them to safely introduce Cas9 into the cell without disrupting the structure.

The Cas9, which was now inside the body, searched through all three billion bases of DNA as guided by the RNA and found CCR5 in a matter of seconds.

Crackle!

Phosphoric acid and sparks flew as the phosphate backbone of the DNA molecule broke. Now, Synchronization Mode allowed Young-Joon to see phenomena at the atomic level.

The tearing of DNA was one of the most serious emergencies for a cell. As such, various intracellular substances began to move and set off alarm bells. Numerous macromolecules such as ATM/ATR, MRE11, and Ku70/80 rushed to the site of the DNA break. They were called macromolecules, but DNA was much larger than that. So from their perspective, looking at DNA breaks was like an architect analyzing a building.

The macromolecules began determining the catastrophic cracks in the megastructure of DNA caused by Cas9.

“The break is in the CCR5 gene. The damage isn’t too severe, but both strands of the DNA are broken.”

They began exchanging signals. And now, they were debating. Some were arguing that they should destroy the building and rebuild it from scratch as the building was worthless now: these people were in charge of apoptosis. On the other hand, some argued that it could be repaired and used with a few extra things: these people were in charge of DNA repair.

“This cell is a hematopoietic cell, which plays an important role in making blood. There’s also only one cut, so we shouldn’t destroy it so recklessly. Let’s fix it,” said p53, a gene.

This gene was the macromolecule that had the final say in the cell’s fate when DNA was destroyed. Here in the microworld, an order given by p53 was absolute.

However, there was still a problem. They needed nucleotides, the building blocks of DNA, and a repair blueprint for the structure. Originally, they would have to look at the structure of another chromosome, which was very distant, and they would also have to bring in nucleotides from far away. But surprisingly, there were several pieces of DNA that were in perfect condition.

“They came in along with CCR5 when it was destroyed,” said nuclease, the macromolecule involved in the processing of DNA’s terminal regions.

“We can take this and put it in,” said BRCA, the top expert in repairing DNA breaks. “Let’s repair it by homology-directed repair (HDR).”

They placed the floating pieces of DNA on top of the break and sealed it together by gluing the phosphate backbone. It was fascinating to see everything fit perfectly in the break, like the last piece of the puzzle.

The DNA, which went into the break like a replacement for a broken part, had slightly different genetic information than the original: Delta-32, along with a few other mutations, had disappeared.

‘The Wildtype CCR5 fragment.’

It was the treatment that Young-Joon had put in the exosome with Cas9.

“It worked.”

The macromolecules in the DNA damage response center went away, satisfied with the results. The repair of the broken CCR5 wasn’t just happening in one cell, but it was happening in all of Mimi’s lymph nodes and bone marrow simultaneously. The same thing was occurring in millions of cells. Some of those cells were completely destroyed by p53, which had strict standards, but it was only a few. The immune cells were more than capable of cleaning up the mess.

‘Ugh, I feel nauseous.’

Young-Joon closed his eyes, feeling a little dizzy.

Rosaline looked at Young-Joon.

—You’ve been watching what’s happening at the atomic level for too long. It was probably a bit too much to keep up with human cognition.

‘True, this is the longest I’ve done it.’

—But the treatment itself seems like a success.

‘She still needs a few more injections, but I think we’ve put out the fire for now.’

Young-Joon took a deep breath and relaxed.

* * *

Mimi’s condition improved dramatically. On the afternoon of the third day after the first injection, Young-Joon was at a meeting with the medical team, talking to the doctors. He had brought Alice with him to interpret just in case, but there was no room for her as everyone was speaking in English.

Zhang Haoyu, Mimi’s doctor, said, “The amount of CD4 T-cells has almost reached normal levels...”

It was one of the most representative indicators of checking for immunity, and until now, Mimi’s body had less than one-tenth the amount of normal people. But after just one treatment injection, she had recovered up to almost ninety-percent of a normal person’s levels. Her overall production of immune cells had increased dramatically, and her antibodies were working properly.

“That’s good to hear,” Young-Joon said calmly.

There was silence among the medical staff, a mixture of bewilderment and shock.

“How did you decide on the drug’s formulation?” Dong Weimin asked.

Formulation referred to the formula of a drug that was suitable for administration.

“To be honest, it wasn’t strictly determined because there was no preclinical data. It was determined by comparing the differences in human body weight and the immune system based on the data from the successful rat experiments and finding estimated values in

in silico

experiments,” Young-Joon said.

However, this explanation wasn’t enough; the doctors were still in awe.

“Right now, the Chinese government is being criticized by the international community for Mimi’s health problems,” said Dong Weimin. “Doctor Ryu, if she is cured, the Chinese government is going to promote it heavily. ‘We brought in Doctor Ryu Young-Joon and cured this baby, and she is healthy.’ They’re going to say that the government has done its part, making it sound like the Chinese government pushed for this.”

“...”

“Please announce it before they do, Doctor Ryu.”

“I will,” Young-Joon said. “It’s not just a matter of self-praise, but this clinical trial showed a new milestone in the treatability of genetic diseases, so of course we need to write a medical paper.”

Dong Weimin smiled.

“That’s a relief.”

“And I’ll add both of your names when I write the paper,” Young-Joon said.

“Us?” Zhang Haoyu asked in surprise.

“The first authors will be Jacob and two other scientists, and they will be co-authors. I will be the corresponding author. But since you are the ones who conducted this trial, you should be recognized as authors.”

“... Thank you,” said Dong Weimin. “It’s an honor to be named in a paper like this, treating a genetic disease that causes immune deficiency with Cas9,” Zhang Haoyu exclaimed.

“There’s a second round of injections this afternoon,” Young-Joon said.

“Is it necessary?” Dong Weimin asked.

“It is. We can’t cure her with one round of injections. The number of T cells will decrease with time.”

“Okay,” Dong Weimin said.

“Her immune system will be stabilized once we do the third round of treatment. Please keep up the good work until then.”

~

On the way out of the meeting, Young-Joon found Zhi Xuan in the hallway crouched.

“Hello.”

As Young-Joon greeted her, she jumped to her feet and bowed.

“Hello, Doctor.”

“I’m sorry, I didn’t get a chance to greet you when you were doing the procedure before. Did you just come back from testifying at the trial in Korea?”

She nodded as Alice translated Young-Joon’s words.

“Yes. I came here right after the trial. They said my baby was having surgery, so I wanted to see it...”

“Were you uncomfortable or anything when our employees brought you here?”

“Oh, no no. Attorney Park took good care of me...”

Young-Joon grinned.

“That’s a relief.”

“I heard my baby is getting better. Is that true?” Zhi Xuan asked.

“It’s probably just as you heard. You can ask Professor Zhang Haoyu for more details.”

“Okay...”

Zhi Xuan took a deep breath, her body trembling.

“Thank you,” she said. “Thank you so much. My baby was so sick because I was stupid, but it’s all thanks to you.”

“Ms. Zhi Xuan,” Young-Joon said. “Are you taking Apanoctin?”

“Apanoctin?”

“It’s an HIV suppressant.”

Young-Joon bent over to where Zhi Xuan was sitting. What he picked up was a small pill bag.

[Apanoctin]

“Yes... I am. Sorry, I’ll throw it away.”

“It’s not because of that.”

Young-Joon picked up the wrapper and threw it in the trash.

“You should switch to Karampia. It has better efficacy, and it’s easier on the body in the long run as well. Most importantly, it’s very cheap because it’s a treatment for the World Health Organization’s HIV eradication project.”

To be exact, it was cheap because Young-Joon had developed a production method and revolutionized the unit price.

“You can take that medication to manage your HIV, then if possible, you should cure it with stem cell therapy.”

“That’s... I’ve heard of that, but they say it’s a very expensive procedure...”

“There should be a hospital in Beijing that’s participating in the World Health Organization’s project as well. If you go there, you’ll get a big discount and be able to get the procedure at about six thousand yuan.”

Six thousand yuan was equal to about a million won.

“...”

Zhi Xuan hesitated, fiddling with her dirty skirt.

Young-Joon figured out that she didn’t have that kind of money. She could now cure her HIV, but she couldn’t because she didn’t have money.

“I—I’ll look into it. Thank you so much.”

Zhi Xuan bowed.

“Come with me. Mimi is going to have her second round of injections soon,” Young-Joon said.

* * *

After the second treatment, Mimi’s immune cell levels temporarily increased to one hundred ten percent. After that, it remained steady around normal levels. By dawn on Saturday morning, the numbers were starting to drop again, but Dong Weimin had goosebumps watching this. It was because it was around the time for the third injection.

“This is the last procedure. I’ll be watching from outside through the monitor,” Young-Joon said.

Dong Weimin, who was starting to feel more confident, began the procedure. He didn’t make a single mistake.

And when the procedure was completed, around five in the evening, Zhi Xuan came to Zhang Haoyu’s office.

“Come on in.”

There were only two people in the room: Dong Weimin and Zhang Haoyu.

“The procedure went well, and she’s stable for now,” Dong Weimin said. “We did a tissue biopsy when we did the second procedure, and the CCR5 gene came back normal in most of the lymph nodes and bone marrow that we did the procedure on. The mutation rate was around five percent, and now that we’ve done the third procedure, we’re hoping to get it down to zero.”

“Then... She’s all better now?”

“We’ll observe her for about a week, then transfer her over from the sterile room to a regular room. We’ll observe her for another month or so, and if everything is fine, we’ll discharge her,” Zhang Haoyu said.

𝙧𝙚𝙚𝔀𝒆𝓫𝓷𝙤𝓿𝒆𝙡.𝒄𝙤𝓶

“Discharge...”

It was like a dream. Zhi Xuan bit her lip as she was getting choked up.

“Where is Doctor Ryu now? I need to thank you.”

“You didn’t see him earlier? I think he left Sichuan earlier today,” Zhang Haoyu said.

“He left?”

“He said that he didn’t have much time until he had to return to Korea, and he had to have at least one meeting about the Asian tiger mosquito extinction before he left...”

Thud!

The chair was pushed back noisily as Zhi Xuan jumped to her feet.

“C—Can I go after him now?” she asked.

“I don’t know, but he left right after the procedure.”

“But...”

“Oh, speaking of which, we have something to give you,” said Zhang Haoyu.

“To me?”

“This.”

He held out an envelope.

“A-GenBio is giving you this through the Chinese health authorities. It’s for Mimi’s participation in the clinical trial.”

“...”

Zhi Xuan opened the envelope. It had two thousand yuan in it.

“...”

“This is the maximum amount the Chinese health authorities can give you for participation in a clinical trial. We would like to give you more given your situation, but the law... It could be ethically problematic if people involved in a clinical trial exchange gifts.”

“... Thank you.”

Zhi Xuan took the envelope.

“And this is from an anonymous foreign scientist.”

Dong Weimin held out another envelope.

“A foreign scientist? Doctor Ryu?”

“I don’t know. It was anonymous.”

Dong Weimin smiled and shrugged.

Zhi Xuan’s hands trembled a little as she took the envelope and opened. It contained a small card.

[Special Organization of Beijing University International Hospital to Combat AIDS: Hematopoietic Cell Therapy Voucher]

“The World Health Organization has issued a voucher to receive the procedure to cure HIV before,” Dong Weimin said. “The anonymous scientist got it from somewhere and gave it to you.”

“...”