Genes as drugs: the social shaping of gene therapy and the reconstruction of genetic disease

This paper examines the utility of using concepts from the sociology of technology to investigate how new technologies and new disease concepts are co-constructed. For researchers to introduce gene therapy into experimental clinical practice, they had to engage in a process of heterogeneous social-technical engineering. This included: the construction of local networks of regulators, genes, firms, clinicians and patients; the social shaping of gene therapy technology as a novel form of drug delivery; the creation of a new industry; and the re-conceptualisation of many common acquired diseases as being genetic in some way. These changes marked a shift from an account of genetic disease based on the inheritance of deleterious genes, to one which explained acquired conditions in terms of a ‘molecular pathology’, resulting from errors in the way genes are regulated. This process of socio-technical change has resulted in the construction of a new type of ‘genetic body’.

[1]  Hermann J. Muller,et al.  Out of the night : a biologist's view of the future , 1935 .

[2]  Jon Turney,et al.  Frankenstein's Footsteps: Science, Genetics and Popular Culture , 1998 .

[3]  J. Ashkenas.  Crafting science: A sociohistory of the quest for the genetics of cancer. , 1997 .

[4]  Ann Rudinow Sætnan,et al.  Rigid Politics and Technological Flexibility: The Anatomy of a Failed Hospital Innovation , 1991 .

[5]  P. Wright,et al.  THE PROBLEM OF MEDICAL KNOWLEDGE. EXAMINING THE SOCIAL CONSTRUCTION OF MEDICINE , 1985, American Journal of Sociology.

[6]  W. Szybalski.  Use of the HPRT gene and the HAT selection technique in DNA-mediated transformation of mammalian cells: first steps toward developing hybridoma techniques and gene therapy. , 1992, BioEssays : news and reviews in molecular, cellular and developmental biology.

[7]  J. Leonard.  Garrod's Inborn Factors in Disease , 1990 .

[8]  Jon Turney,et al.  Molecular politics: developing American and British regulatory policy for genetic engineering, 1972–1982 , 1996, Medical History.

[9]  A. Capron.  The impact of the report, Splicing Life. , 1990, Human gene therapy.

[10]  Paul Thompson.  Controlling Life: Jacques Loeb and the Engineering Ideal in Biology , 1987 .

[11]  D. MacKenzie,et al.  The social shaping of technology : how the refrigerator got its hum , 1985 .

[12]  Marc Berg,et al.  Rationalizing Medical Work: Decision-support Techniques and Medical Practices , 2022 .

[13]  M. Callon.  Society in the making: The study of technology as a tool for sociological analysis , 1987 .

[14]  A. Clarke,et al.  The Many Faces of RU486: Tales of Situated Knowledges and Technological Contestations , 1993, Science, technology & human values.

[15]  P. Libby,et al.  Implantation of vascular grafts lined with genetically modified endothelial cells. , 1989, Science.

[16]  F. Ledley,et al.  Retroviral gene transfer into primary hepatocytes: implications for genetic therapy of liver-specific functions. , 1987, Proceedings of the National Academy of Sciences of the United States of America.

[17]  'Definite and material'. Coronary thrombosis and cardiologists in the 1920s. , 1992, Hospital practice.

[18]  E. Tatum.  Molecular Biology, Nucleic Acids, and the Future of Medicine , 2015, Perspectives in biology and medicine.

[19]  P. L. Chen,et al.  Suppression of the neoplastic phenotype by replacement of the RB gene in human cancer cells. , 1988, Science.

[20]  J. B. S. Haldane,et al.  Daedalus; or, Science and the Future , 1924 .

[21]  P. Harper.  In the Name of Eugenics , 1987 .

[22]  E. Nabel,et al.  Recombinant gene expression in vivo within endothelial cells of the arterial wall. , 1989, Science.

[23]  M. Perricaudet,et al.  Adenovirus-mediated transfer of a recombinant alpha 1-antitrypsin gene to the lung epithelium in vivo. , 1991, Science.

[24]  D Stemerding,et al.  The sociology of entrenchment: a cystic fibrosis test for everyone? , 1994, Social science & medicine.

[25]  F. Gage,et al.  Grafting genetically modified cells to the brain: Possibilities for the future , 1987, Neuroscience.

[26]  Kathleen W. Jones,et al.  Framing Disease: Studies in Cultural History , 1994 .

[27]  Ronald G. Crystal,et al.  Transfer of Genes to Humans: Early Lessons and Obstacles to Success , 1995, Science.

[28]  W. Anderson,et al.  Prospects for human gene therapy. , 1984, Science.

[29]  J. Roth,et al.  Gene replacement strategies for the prevention and therapy of cancer. , 1994, European journal of cancer.

[30]  T. Pinch,et al.  The Social Construction of Facts and Artefacts: or How the Sociology of Science and the Sociology of Technology might Benefit Each Other , 1984 .

[31]  F. C. S. Schiller.  Daedalus, or science and the future , 1924 .

[32]  Michael G. Rosenfeld,et al.  Dramatic growth of mice that develop from eggs microinjected with metallothionein–growth hormone fusion genes , 1982, Nature.

[33]  E. Tatum.  A case history in biological research. , 1958, Science.

[34]  H. Sutton.  Garrod's inborn factors in disease. , 1992 .

[35]  Stuart S. Blume,et al.  Insight and Industry: On the dynamics of technological change in Medicine Cambridge , 1991 .

[36]  R. Westrum.  The Social Construction of Technological Systems , 1989 .

[37]  Lily E. Kay,et al.  The molecular vision of life : Caltech, the Rockefeller Foundation, and the rise of the new biology , 1994 .

[38]  M. A. Elston,et al.  The sociology of medical science and technology , 1999 .

[39]  A. Prout,et al.  Actor-network theory, technology and medical sociology : an illustrative analysis of the metered dose inhaler , 1996 .

[40]  Points to consider in the design and submission of human somatic cell gene therapy protocols. , 1985, Recombinant DNA technical bulletin.

[41]  P. Russell,et al.  Implantation of genetically engineered fibroblasts into mice: implications for gene therapy. , 1987, Science.

[42]  Brian Balmer,et al.  The Genetic Body , 2000 .

[43]  Nelly E.J. Oudshoorn,et al.  Beyond the Natural Body: An Archaeology of Sex Hormones , 1994 .

[44]  R. Cook-Deegan.  Human gene therapy and congress. , 1990, Human gene therapy.

[45]  Joan H. Fujimura,et al.  Constructing `Do-able' Problems in Cancer Research: Articulating Alignment , 1987 .

[46]  C. Rosenberg,et al.  Framing Disease: Studies in Cultural History , 1994 .

[47]  Olaf Stapledon,et al.  Last and First Men , 1930 .

[48]  R. Hotchkiss.  Portents for a genetic engineering. , 1965, The Journal of heredity.