Originally published on www.sayerji.substack.com
How regulators approved irreversible genetic editing for a disease modifiable through reversible food-based mechanisms--while a fatal adverse event remained background detail.
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Introduction: The Narrative We Were Given
On November 8th, WIRED published a headline that captured the promise of medical progress: "A Gene-Editing Therapy Cut Cholesterol Levels by Half."[1]
Notwithstanding the intellectual bankruptcy of treating high cholesterol as the primary driver of heart disease--a premise demonstrably contradicted by five decades of epidemiological data showing the cholesterol-mortality paradox--within hours, The Washington Post confirmed the story: "A promising step toward editing people's genes to treat a common disease."[2] Followed by a battery of similarly exuberant headlines.
The narrative was compelling. CRISPR Therapeutics' experimental therapy, CTX310, offered the tantalizing prospect of a one-time genetic edit replacing lifelong medication (increasingly linked to hundreds of adverse effects). A molecular snip. A permanent fix. Progress.
Yet buried in both reports--and more tellingly, in the details neither outlet emphasized--was a different story: one that reveals how institutions minimize adverse signals when the narrative of innovation is at stake, and how a technology that permanently rewrites human biology is being normalized without the scrutiny such permanence demands.
THE BURIED SIGNAL
What Happened in the Trial
According to WIRED, the Phase 1 trial enrolled just fifteen participants with uncontrolled cholesterol and triglycerides despite medication.[1] Each received a single intravenous infusion of CTX310--a formulation of CRISPR-Cas9 mRNA packaged in lipid nanoparticles (LNPs), delivered directly to the liver to disable the ANGPTL3 gene, which regulates lipid metabolism.
Within two weeks, those given the highest dose saw approximately a 50 percent reduction in cholesterol and triglyceride levels, effects that persisted through the 60-day observation window.[1]
The trial, published in the New England Journal of Medicine in November 2025, was described by study co-author Steven Nissen of Cleveland Clinic as a "revolution in progress."[1]
The Death
Yet buried mid-article in WIRED, this detail appeared:
"One trial participant, a 51-year-old man, died six months after receiving the lowest dose of the treatment... The death was related to his existing heart disease, not the experimental CRISPR treatment."[1]
The Washington Post provided additional clinical context:
"A 51-year-old man with a rare genetic condition that causes high cholesterol died suddenly while on a walk, but it was not deemed related to the treatment by study investigators because he died six months after receiving the lowest dose of the treatment."[2]
The Post notes the man had "four coronary stents between ages 32-41 and a bypass surgery at 48"--significant cardiovascular disease, certainly. But the death itself was sudden, and the attribution of causality rested entirely on investigator judgment rather than independent analysis or autopsy data.[2]
Why This Attribution Matters
In a fifteen-person trial, one death represents 6.7 percent mortality--a rate that would typically trigger serious scrutiny.
Yet the published trial conclusion stated the therapy was "associated with few adverse events."[3]
The discrepancy reveals a crucial mechanism: narrative minimization and willful disregard of the precautionary principle. A fatal event in a first-in-human genetic editing trial was reframed--through careful word choice and structural omission--into a story of safety and progress.
THE LEGITIMACY OF CONCERN
Why Independent Causality Assessment Matters
The attribution that the death was "unrelated" to treatment relies on several assumptions that warrant scrutiny:
1. Timing Does Not Exclude Causality
Six months post-dosing is plausible for delayed treatment-related harm, especially with a novel, irreversible intervention:
- CRISPR-edited liver cells may generate chronic inflammatory signals over time
- Lipid nanoparticles have been documented to trigger delayed immune responses, including interferon production and complement activation
- Off-target genetic edits in cardiac tissue (if LNPs distributed there) could manifest as arrhythmia or ischemia weeks or months later
As Fyodor Urnov, director of technology and translation at UC Berkeley's Innovative Genomics Institute, told The Washington Post:
"The particular gene-editing technology used… could result in edited cells that are still able to make a mutated version of the protein -- and that could trigger a harmful immune reaction."[2]
Delayed immune activation is a known risk of LNP delivery (Ndeupen et al., 2021). The 6-month sudden death, while attributed to CVD, cannot be definitively ruled out as treatment-related without autopsy or immune marker data.
2. No Independent Adjudication
The causality attribution comes solely from the study sponsors' investigators--researchers funded and employed by CRISPR Therapeutics.[3]
Standard practice for first-in-human trials, especially those involving irreversible genetic modification, requires independent adjudication by external safety boards. No such review is mentioned in published reports.
This creates a structural conflict of interest: the very researchers whose company benefits from trial success are the ones determining whether a death is "related" to treatment.
3. No Transparent Data
The Australian and New Zealand Clinical Trials Registry for this study explicitly states:
"Will the study consider sharing individual participant data? -- No."[4]
This means independent scientists cannot review:
- Autopsy findings (if performed)
- Off-target mutation analysis
- Immune markers (cytokines, inflammatory proteins)
- Cardiac imaging
- Any other data that might clarify mechanism
In gene-editing trials--where off-target effects may take months to manifest--such opacity is scientifically indefensible.
Parallel Safety Signals in Related Programs
The Washington Post contextualizes this death within a broader pattern:
- Intellia Therapeutics paused its CRISPR trial after a participant developed "severe liver toxicity" and subsequently died.[2]
- Verve Therapeutics halted a similar base-editing study in 2024 after patients developed low platelets and liver injury linked to lipid nanoparticle carriers.[2]
These parallel signals--all involving the same delivery technology (LNPs), similar tissue targets (liver), and similar adverse events (immune and hepatic toxicity)--suggest a class effect rather than isolated coincidence.
THE TRANSGENIC THRESHOLD
CRISPR as More Than a Medical Tool
While CRISPR is often framed as a precision instrument for treating disease, CTX310 crosses into transgenic territory--and the distinction matters philosophically and practically.
Transgenic means an organism has genetic material permanently integrated into its genome. Once edited, those cells carry the change indefinitely. The edit cannot be reversed, detoxified, or withdrawn.
This is fundamentally different from drug therapy:
- Drugs are temporary modulators; stop taking them, and the effect dissipates
- Genetic edits are permanent rewrites of the biological code
But the implications extend far beyond the individual recipient.
A landmark study by Cai et al. (2015) published in Nature Cell Biology titled 'Soma-to-Germline Transmission of RNA in Mice Xenografted with Human Tumour Cells: Possible Transport by Exosomes' demonstrates a mechanism that classical genetics long considered impossible: somatic (body) cells can transfer genetic information directly to germline (reproductive) cells through exosome-mediated pathways.
The study found that exosomes--nanoparticles released by all cells--can carry RNA and DNA molecules from somatic tissue into mature sperm cells, where this information is stored and transmitted to the next generation. As the authors note, this reveals 'a flow of information from somatic cells to gametes,' demonstrating that 'spermatozoa act as vectors not only of their own genome, but also of foreign genetic information.'
The implications for in vivo CRISPR editing are profound and concerning:
If CRISPR-edited liver cells generate exosomes containing edited RNA and off-target mutation sequences, these information-carrying particles could theoretically enter the germline and be transmitted to offspring--making the edits heritable and transgenerational, even if not formally a germline edit.
This means:
- A single person's CRISPR treatment could permanently alter their descendants' genomes
- Off-target mutations induced in somatic tissue could propagate across generations
- Unintended consequences could manifest not in the treated individual but in their children or grandchildren
- The 12-month trial follow-up would be utterly inadequate to detect multi-generational harm
The CTX310 trial registry makes no mention of:
- Exosome monitoring
- Germline genetic analysis in offspring
- Long-term multigenerational tracking
- Reproductive safety protocols
This silence is itself revealing. The institutional apparatus approving permanent genetic edits has not even accounted for the possibility--now experimentally validated--that somatic edits could become heritable through natural exosome-mediated mechanisms.
We may be deploying irreversible technology based on incomplete understanding of its transmission pathways.
The LNP-mRNA Parallel
CTX310 uses a delivery system strikingly similar to mRNA vaccine platforms:
- Synthetic RNA (either instructing cells to make viral protein, or to edit their own DNA)
- Encapsulated in lipid nanoparticles for cellular uptake
- Introduced directly into the human body to reprogram cell behavior
- Promoted as "safe and effective" based on short-term endpoints while long-term consequences remain unstudied
The critical difference:
- mRNA vaccines are largely believed to produce only transient protein expression (cells stop making viral protein after days/weeks) - although recent research titled "Expression of SARS‑CoV‑2 Spike Protein in Cerebral Arteries: Implications for Hemorrhagic Stroke Post‑mRNA Vaccination", reveals the presence of spike protein in cerebral arteries up to 17 months after the last mRNA vaccination.
- CRISPR edits the genome itself (the edit remains in the cell and its descendants indefinitely).
The Washington Post notes that similar LNP technologies have triggered delayed immune responses, suggesting that the delivery mechanism itself--not just the genetic cargo--carries inherent risks.[2]
Transgenic vs. Transhumanistic: The Philosophical Distinction
CTX310 operates at the intersection of two different uses of CRISPR:
Transgenic (Restoring Function): Editing out 'disease-causing mutations,' restoring metabolic function.
Transhumanistic (Enhancing Capacity): Transcending biological limits--optimizing intelligence, appearance, aging, or human performance beyond natural capacity.
CTX310 presents as transgenic but operates as infrastructure for transhumanistic ends--establishing precedent for permanent edits for lifestyle conditions affecting millions.
The Alternative CRISPR Obscures: Food as Gene Expression Modulator
Research documents that food modulates gene expression through exosome-mediated pathways--the same mechanism by which genetic information transmits across generations.
Plant exosomes containing non-coding RNAs:
- Cross kingdom barriers into human cells
- Directly target and modulate gene expression without altering DNA
- Survive digestion and circulate systemically
- Transmit information to germline cells (Cai et al., 2015)
A 2012 study (Zhang et al.) showed rice-derived miR-168a targets LDLRAP1, modulating LDL receptor expression in lipid pathways--overlapping with but distinct from CTX310's ANGPTL3 target.
If food can modulate LDL receptor expression reversibly with the result of safely improving blood lipid profiles, permanent genetic editing is unnecessary.
Food-based interventions:
- Modulate without editing DNA
- Are reversible
- Transmit through the same exosome pathways
- Accumulate evolutionary refinement
- Distribute through accessible food systems
The evidence supporting this alternative is substantial. GreenMedInfo's research database documents over 500 peer-reviewed studies demonstrating safe and effective food-based and lifestyle approaches to modulating blood lipid profiles--without permanent genetic modification, without adverse events, and without institutional dependency. These interventions span nutritional strategies, plant compounds, behavioral modifications, and food-based information transfer through exosome mechanisms. The clinical efficacy and safety profile of these approaches are extensively documented and verifiable.
Yet regulators approved permanent genetic editing for a condition these reversible, food-based mechanisms already address safely and effectively.
The Institutional Choice
By approving CTX310--permanent genetic edit for a lifestyle disease already addressable through reversible food-based mechanisms--regulators establish:
- Permanent modification is preferable to lifestyle choice
- Corporate one-time interventions are preferable to food-based autonomy
- Irreversible technological control supersedes reversible biological regulation
This is institutional preference for centralizing control over human biology through pharmaceutical systems rather than distributing agency through food-based mechanisms.
The irony: Using irreversible technology to treat what food--refined through millennia--already addresses reversibly.
We are choosing permanent institutional control over biological autonomy.
THE INSTITUTIONAL PATTERN
How Adverse Signals Are Minimized
This trial does not exist in isolation. It operates within a larger institutional apparatus that has demonstrably minimized adverse signals across multiple pharmaceutical domains.
The most instructive historical parallel is cholesterol research:
Over 50 years (1970s-2025), systematic institutional mechanisms:
- Corporate funding of researchers -- Statin manufacturers funded researchers who promoted the cholesterol hypothesis
- Editorial board capture -- Medical journals published selective studies, with editorial boards stacked with industry-funded researchers
- Media amplification without scrutiny -- Major outlets reported breakthroughs verbatim without investigating trial design
- Surrogate endpoint approval -- Regulatory agencies approved statins based on LDL reduction (a lab value) rather than patient outcomes
- Systematic reframing of contradictory evidence -- When data emerged showing low cholesterol correlates with higher mortality, it was reframed as "reverse causation" rather than investigated
Result: $200 billion in statin sales while 350+ documented adverse health effects--depression, suicide, infection mortality, cancer--remained systematically minimized or reframed.[5]
The Cholesterol Conspiracy: How Big Pharma's $200 Billion Lie Is Killing Us
Sayer Ji · Aug 20
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The Same Apparatus, Operating in Real Time
The cholesterol pattern is not historical--it's operating now, in November 2025. Consider the melatonin case:
In early November, the American Heart Association released preliminary, non-peer-reviewed data claiming melatonin caused heart failure risks. Within hours, major media outlets amplified the findings:
Severity bias: Only counted prescription melatonin use (rare in U.S.), not the millions using over-the-counter supplements
Uncontrolled confounders: Failed to account for Ambien, Lunesta, trazodone--pharmaceuticals with documented cardiometabolic risks commonly used by insomnia patients
Methodological flaws: Non-representative sample, no peer review
Yet ~900 peer-reviewed studies document melatonin's extensive therapeutic profile, including extensive research on its cardioprotective properties. A 2022 meta-analysis found melatonin broadly cardioprotective, not cardiotoxic.[6]
The pattern is identical: attack what cannot be monetized (melatonin: inexpensive, non-patentable), protect what generates profit (Ambien: patent-protected, despite FDA boxed warnings for sleepwalking, sleep-driving, death).
This demonstrates the apparatus operating in observable real time--the same mechanisms that buried cholesterol harm for 50 years are now minimizing melatonin safety and advancing CRISPR approval.
Sayer Ji · Nov 6
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THE STAKES OF PERMANENCE
Why 12 Months Is Inadequate
The CTX310 trial followed participants for 12 months post-treatment. For a permanent genetic edit, this window is inadequate to assess:
Off-Target Mutations Documented rates in peer-reviewed literature range from 0.01% to several percent, depending on guide RNA design and delivery method. In a liver containing ~240 billion cells, even a 0.1% off-target rate means 240 million cells with unintended edits.[7]
These mutations cannot manifest as disease immediately; carcinogenesis typically requires years.
Immune System Activation Lipid nanoparticles trigger innate immune responses (TLR activation, interferon production, complement activation). Delayed or chronic immune dysregulation may not become clinically apparent for months or years.[8]
The sudden cardiac death at six months may represent a delayed immune cascade.
Epigenetic Instability Permanent edits to one gene can trigger downstream epigenetic shifts affecting other genes. Long-term metabolic or cardiovascular consequences may emerge years later.
Historical Precedent Gene therapy history demonstrates this risk:
- 1999: Jesse Gelsinger died 4 days after adenoviral gene therapy from immune reaction
- Recent: Patients receiving AAV gene therapies developed liver inflammation and immune toxicity months to years post-treatment
The 12-month follow-up captures none of this.
THE QUESTION OF TRANSMISSION
What We Don't Know
A critical gap in published trial reporting: Are the edits heritable?
If CTX310 affects stem cell populations or germline tissues (however unlikely, given liver targeting), the edits could theoretically transmit to offspring--creating the first generation of deliberately edited humans.
Additionally, preclinical data (Cossetti et al., 2014) raise the theoretical possibility of exosome-mediated RNA/DNA transfer from somatic to germline cells. No human data exist. CTX310 trial did not assess germline penetration or exosome cargo.
The trial registry makes no mention of:
- Reproductive assessments
- Germline penetration of LNPs
- Offspring monitoring
- Exosome-mediated off target effecxts
This silence itself is informative. If transmission risk had been rigorously excluded, it would be reported. The absence suggests it was not comprehensively studied.
THE DEEPER LAYER
CRISPR as a Mirror
At its essence, CRISPR is believed by its proponents to not be inherently transgenic or transhumanistic. It is a tool--capable of restoring biological integrity or of rewriting what it means to be human, they say.
Assuming this is true, technology is morally neutral. One thing is certain, the consciousness wielding it is not.
The current trajectory--from mRNA vaccines to gene-editing therapies--signals a civilizational shift:
- From asking, "How do we support the body's inherent intelligence?"
- To asking, "How do we override it?"
This is not progress. It is a choice--one made not through democratic deliberation but through the quiet normalization of permanent genetic modification, framed as medical necessity. Even when natural, time-tested, safe, effective and food-based approaches are freely available, and have their own robust body of science backing them up. Consult my book REGENERATE and enroll in the next cohort (November 24 - November 30, 2025) of my free masterclass -- REGENERATE YOURSELF -- to learn more on this topic.
Biological Sovereignty
There exists what might be called a code of life--the accumulated wisdom of billions of years of evolution, encoded in DNA. This code carries not just mechanical instruction but evolutionary memory, biological wisdom.
When we permanently alter this code:
- Without adequate safety assessment
- Without true informed consent (which requires understanding consequences we cannot predict)
- Without respecting the autonomy of future generations who will carry these edits indefinitely
We are making a metaphysical choice, not merely a medical one.
We are asserting: Our current understanding of biology is sufficient to improve upon evolution. Our institutions are trustworthy enough to make permanent decisions for all descendants. Our wisdom exceeds billions of years of accumulated intelligence.
This is not empirically justified. It is ideological.
Conclusion: The True Experiment
The real experiment here is not on cholesterol.
It's on consent.
Fifteen people received a permanent genetic alteration under the banner of innovation. One died, and the death was minimized. The rest became data points in humanity's unfolding experiment in self-reengineering.
Yet for the public, the message was simple: "Cholesterol cut in half."--a surrogate marker, not a health outcome. This follows the familiar pattern that normalized statin prescriptions: reduce a laboratory value, frame it as medical progress, and rely on media to distribute the claim without scrutiny. Mainstream outlets obliged, their reporting reflecting the interests of their primary advertisers: pharmaceutical corporations.
Such reductionism--wrapped in techno-optimism and delivered through trusted medical journals and mainstream media--is how irreversible technologies are normalized without resistance.
Not through force. Through the illusion of care.
The question is not whether CRISPR will be deployed. It will be.
The question is whether we will demand genuine transparency, genuine safety assessment, and genuine consent before we allow permanent rewriting of human biology.
The data from WIRED, The Washington Post, and the trial itself suggest we will not.
But the story is still being written. And we are still characters in it.
Final Note on Principles and Evidence
My ongoing conversations with researchers including Paul Werbos (inventor of back-propagation within artificial intelligence systems) and engagement with voices in the regenerative medicine community confirm that serious scientists with humanitarian intentions believe there may be legitimate applications in monogenic rare diseases--cystic fibrosis, sickle cell disease, and others where single-gene mutations cause severe disease without alternative treatment. (Note: even in these so-called "incurable conditions," here is profound hope for nutrition-based epigenetic reversal of misfolded proteins from 'mutated genes.' Learn more here)
I remain deeply skeptical of CRISPR, especially at this highly preliminary and experimental stage, for reasons this article details: inadequate safety assessment, institutional capture of regulatory processes, and the systematic choice of permanent technological control over reversible biological mechanisms. That skepticism is grounded both in evidence and ideology.
But I acknowledge I am not omniscience. The future may reveal applications I cannot currently envision. Legitimate scientists disagree about CRISPR's appropriate scope, and most important is to maintain open debate instead of canceling one another, which is the beginning of all violence, intellectual and otherwise, in my opinion.
What I will not do is treat that disagreement as a reason to accept permanent genetic editing for problems already solved reversibly. The existence of legitimate debate about monogenic applications does not validate the institutional choice to edit genes for a lifestyle disease.
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References
[1]: Emily Mullin, "A Gene-Editing Therapy Cut Cholesterol Levels by Half," WIRED, November 8, 2025.
[2]: Carolyn Y. Johnson, "How a 'One and Done' Gene-Editing Treatment Could Lower Cholesterol," The Washington Post, November 8, 2025.
[3]: Luke J. Laffin et al., "Phase 1 Trial of CRISPR-Cas9 Gene Editing Targeting ANGPTL3," New England Journal of Medicine, November 8, 2025.
[4]: ANZCTR Trial Registration: ACTRN12623000809639, "A Safety and Tolerability Study Evaluating CTX310 in Subjects With Refractory Dyslipidemias," registered July 27, 2023, updated May 11, 2025.
[5]: Sayer Ji, "The Cholesterol Conspiracy: How Big Pharma's $200 Billion Lie Is Killing Us," GreenMedInfo, 2025. For peer-reviewed evidence on cholesterol and mortality: Korean study (12.8M adults); U.S. study (19,000 adults, LDL <70 = 37% higher death risk); depression and suicide correlation (Swedish study, 80,000 adults; MRFIT study, 350,000 men); infection mortality (ICU study, 46% higher in lowest cholesterol quintile).
[6]: Reiter RJ, Tan D-X, Rosales-Corral S. "Melatonin: A mitochondria-targeted antioxidant and bioenergetic modulator," Journal of Pineal Research, 2022;73:e12805. GreenMedInfo Melatonin Research Database documents ~1,000 peer-reviewed studies on melatonin benefits.
[7]: Off-target mutation rates documented in: Cho et al., "Analysis of off-target effects of CRISPR/Cas-derived RNA-guided endonucleases and nickases," Genome Research, 2014; zebrafish studies (1.1-2.5% off-target rates); animal models (up to 6% structural variants). In 240 billion liver cells: 0.1% = 240 million unintended edits.
[8]: Ndeupen S, Qin Z, Fontes-Garfias C, et al. (2021). "The mRNA-LNP platform's lipid nanoparticle component used in preclinical vaccine studies is highly inflammatory." iScience, 24(12), 103479. The study documents TLR activation, interferon production, and inflammatory responses to the lipid nanoparticle component--responses particularly concerning for permanent genetic editing where delayed immune activation could manifest as hepatic or cardiac toxicity beyond standard trial follow-up windows.
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