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Engineering medicine: The future of CAR-T and CRISPR technologies  Premium

Engineering medicine: The future of CAR-T and CRISPR technologies 
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<h2 class&equals;"sub-title">There is no doubt that CRISPR and CAR-T cell therapy are breakthroughs in the medical field&period; But because they are still in their initial stages&comma; they come with a million-dollar price tag&period; What does the future hold for such emerging trends that interweave different fields to pave the way for improving people’s lives&comma; if the outcomes are but accessible to a handful&quest; <&sol;h2>&NewLine;<p><&sol;p>&NewLine;<div id&equals;"content-body-69257064" class&equals;"articlebodycontent col-xl-9 col-lg-12 col-md-12 col-sm-12 col-12" itemprop&equals;"articleBody">&NewLine;<p>The fourth industrial revolution marked by the fusion of technologies is blurring the lines between the physical&comma; digital and biological worlds&period; And it is at this intersection that the future of medicine is being written&comma; with innovations like CRISPR and CAR-T therapy unlocking the potential to not only treat diseases but cure them&period; From editing the human genome to reprogramming immune cells to fight cancer&comma; these approaches promise to transform healthcare as we know it&period; But as we stand on the brink of this new era&comma; the question is no longer if these technologies will change lives — but how they will reshape the framework of human biology&comma; ethics&comma; and society itself&period; <&sol;p>&NewLine;<p>In 2012&comma; Jennifer Doudna and Emmanuelle Charpentier published their groundbreaking work&comma; revealing that CRISPR&sol;Cas9 could be re-engineered as a gene-editing tool&period; They won the Nobel Prize in Chemistry for this&comma; in 2020&period; <&sol;p>&NewLine;<p>On December 8&comma; 2023&comma; the United States’ Food and Drug Administration &lpar;FDA&rpar; approved of a gene therapy treatment for transfusion dependent beta-thalassemia and sickle cell anaemia &lpar;SCA&rpar; patients — a decision that will revolutionise medicine and change countless lives&period; <&sol;p>&NewLine;<p>Yet&comma; I find myself grappling with mixed emotions&period; While technology and medicine have always been intertwined&comma; never have we imagined breathing life into extinct creatures or mending&sol;tailoring our genes&comma; ideas nothing short of science fiction&period; <&sol;p>&NewLine;<div class&equals;"also-read print-hide" data-ga-label&equals;"AlsoReadArticle">&NewLine;<div class&equals;"element">&NewLine;<div class&equals;"title">&NewLine;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;Explained&colon; 2020 Nobel Prize in Chemistry<&sol;div>&NewLine;<div class&equals;"picture"><&sol;div>&NewLine;<&sol;div>&NewLine;<&sol;div>&NewLine;<h4 class&equals;"sub&lowbar;head">What is CRISPR&quest; <&sol;h4>&NewLine;<p>Casgevy and Lyfgenia&comma; the two cell-based gene therapies approved by the FDA&comma; utilise the CRISPR&sol;Cas9 genome editing technology&period; Clustered Regularly Interspaced Short Palindromic Repeats &lpar;CRISPR&rpar; &sol;CRISPR-associated protein 9 &lpar;Cas 9&rpar; evolved naturally as a defence mechanism in bacteria and archaea&period; It was first reported in E&period; Coli in 1987 by Ishino et&period;al&period; <&sol;p>&NewLine;<p>In a nutshell&comma; the system serves as a genetic memory for past infections by incorporating a part of the viral genetic material into its own&comma; so that the next time it is invaded&comma; the bacteria is capable of recognising the virus and destroying it&period; The bacteria&comma; in short&comma; has developed an immunisation mechanism to ward off unwanted viral invaders&period; <&sol;p>&NewLine;<p class&equals;"referpara"><strong><b>Watch&colon;<&sol;b>2020 Chemistry Nobel for developing CRISPR&sol;Cas9 genetic scissors<&sol;strong><&sol;p>&NewLine;<p>The CRISPR system is easy to manipulate&period; Researchers have adapted it as a tool to cut&comma; delete&comma; or add DNA sequences at precise locations opening doors to treating genetic disorders&comma; in diagnostics&comma; creating disease&sol;drought resistant plants&comma; or in de-extinction projects involving the woolly mammoth and the dodo&period; <&sol;p>&NewLine;<p>The progress in CRISPR has been rapid&period; In only a decade since its discovery&comma; we now have a technology with the potential to rewrite genetic code&period; As exciting as the prospect is&comma; conversations around ethical&comma; societal and safety issues must progress parallelly&period; <&sol;p>&NewLine;<h4 class&equals;"sub&lowbar;head">Ethical considerations <&sol;h4>&NewLine;<p>A siren rang across the scientific world in 2018&comma; when Chinese scientist He Jiankui announced he had altered a gene in three human embryos to render resistance to HIV&period; He was imprisoned for three years in 2019 by a court in China&period; The scientific community also condemned his actions&comma; and this self-regulation was crucial as it was a clear violation of guidelines that banned germline editing&period; But nonetheless &OpenCurlyDoubleQuote;designer babies” became a reality&period; The sole purpose of Jiankui and his team experimenting with the embryos was to monitor the evolution of two babies&comma; as the genetic intervention was different for each embryo&period; The idea of such tools in the hands of scientists like Jiankui is terrifying&period; In an article&comma; Françoise Baylis&comma; a bioethicist at Dalhousie University in Nova Scotia&comma; rightly pointed out &OpenCurlyDoubleQuote;There is a difference between making people better and making better people&period;” <&sol;p>&NewLine;<div class&equals;"also-read print-hide" data-ga-label&equals;"AlsoReadArticle">&NewLine;<div class&equals;"element">&NewLine;<div class&equals;"title">&NewLine;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;Why is China laying down gene editing rules&quest; <&sol;div>&NewLine;<div class&equals;"picture"><img src&equals;"data&colon;image&sol;gif&semi;base64&comma;R0lGODlhAQABAIAAAAAAAP&sol;&sol;&sol;ywAAAAAAQABAAACAUwAOw&equals;&equals;" fifu-lazy&equals;"1" fifu-data-sizes&equals;"auto" fifu-data-srcset&equals;"https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1&w&equals;75&resize&equals;75&ssl&equals;1 75w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1&w&equals;100&resize&equals;100&ssl&equals;1 100w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1&w&equals;150&resize&equals;150&ssl&equals;1 150w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1&w&equals;240&resize&equals;240&ssl&equals;1 240w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1&w&equals;320&resize&equals;320&ssl&equals;1 320w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1&w&equals;500&resize&equals;500&ssl&equals;1 500w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1&w&equals;640&resize&equals;640&ssl&equals;1 640w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1&w&equals;800&resize&equals;800&ssl&equals;1 800w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1&w&equals;1024&resize&equals;1024&ssl&equals;1 1024w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1&w&equals;1280&resize&equals;1280&ssl&equals;1 1280w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1&w&equals;1600&resize&equals;1600&ssl&equals;1 1600w" fifu-data-src&equals;"https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1" data-original&equals;"https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;uy57b5&sol;article26429442&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;HEALTH-DNA&quest;ssl&equals;1" alt&equals;"" data-device-variant&equals;"SQUARE~SQUARE~SQUARE~SQUARE" class&equals;"media-object lazy adaptive placeholder lazy" width&equals;"100&percnt;" height&equals;"100&percnt;"><&sol;div>&NewLine;<&sol;div>&NewLine;<&sol;div>&NewLine;<p>There is also concern amongst the public that the wealthy will exploit this technology for genetic enhancement&period; While CRISPR&comma; right now&comma; is being used to treat monogenic disorders&comma; it is capable of altering multiple genes&period; Admittedly however&comma; factors like intelligence are complex traits influenced by many genes and the environment&comma; making it difficult to tailor&period; In addition&comma; CRISPR has also got its own safety problems&comma; such as off-targeting&comma; that aren’t fully understood yet&period; <&sol;p>&NewLine;<p>While there is a consensus within the scientific community to use CRISPR for therapeutic purposes&comma; incidents like the Chinese case are always possibilities&period; <&sol;p>&NewLine;<p>And so&comma; when benefits outweigh the risks where will scientists draw the line&quest; Is it ethical to perform germline editing&comma; even for the purpose of treating diseases&quest; When it comes to human embryos&comma; we face numerous unresolved moral questions and have much to learn about what is right and wrong in this rapidly evolving field&period; <&sol;p>&NewLine;<p>For many in the disabled community&comma; their genetic anomalies are part of their identities&period; This raises important questions about the intersection of ableism and CRISPR&comma; particularly regarding the potential implications of societal attitudes towards disability as genetic technologies become common&period; While most would choose gene therapies&comma; there is a concern that such emerging technologies could reinforce the notion that disability is an abnormality rather than a natural aspect of human diversity&period; This makes it necessary to include disabled voices in discussions from the beginning&comma; prior to clinical applications&comma; and at the policy-making level&period; <&sol;p>&NewLine;<h4 class&equals;"sub&lowbar;head">The cost factor <&sol;h4>&NewLine;<p>Another factor is the exorbitant price of such technologies&period; Casgevy costs around &dollar;2&period;2 million&period; Sickle Cell Anaemia &lpar;SCA&rpar; is mostly seen in certain ethnic groups including people of African&comma; Mediterranean and Middle Eastern descent&period; In India&comma; SCA is relatively higher in tribal communities&period; Many people from these groups are economically disadvantaged and find it difficult to afford even primary healthcare&period; Indian researchers are working towards building a cost-effective treatment with CRISPR&period; But we are talking about a huge leap from basic &&num;8211&semi; hydroxyurea &&num;8211&semi; first line treatment in India to CRISPR&comma; an advanced tool requiring skilled experts&period; With CRISPR in the market&comma; it is of paramount importance to first initiate dialogues on health equity&period; <&sol;p>&NewLine;<p>According to fundamental cause theory&comma; health disparities persist because advancements in medicine tend to benefit the more advantaged segments of society&comma; leaving disadvantaged groups with less access to new interventions&period; As seen during events like the COVID-19 pandemic&comma; those with higher social status — who have more resources — can access healthcare more readily than minority populations&comma; who often face barriers in obtaining similar benefits&period; <&sol;p>&NewLine;<div class&equals;"also-read print-hide" data-ga-label&equals;"AlsoReadArticle">&NewLine;<div class&equals;"element">&NewLine;<div class&equals;"title">&NewLine;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;The era of CRISPR therapeutics is here – what can we expect&quest; &vert; Explained<&sol;div>&NewLine;<div class&equals;"picture"><img src&equals;"data&colon;image&sol;gif&semi;base64&comma;R0lGODlhAQABAIAAAAAAAP&sol;&sol;&sol;ywAAAAAAQABAAACAUwAOw&equals;&equals;" fifu-lazy&equals;"1" fifu-data-sizes&equals;"auto" fifu-data-srcset&equals;"https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1&w&equals;75&resize&equals;75&ssl&equals;1 75w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1&w&equals;100&resize&equals;100&ssl&equals;1 100w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1&w&equals;150&resize&equals;150&ssl&equals;1 150w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1&w&equals;240&resize&equals;240&ssl&equals;1 240w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1&w&equals;320&resize&equals;320&ssl&equals;1 320w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1&w&equals;500&resize&equals;500&ssl&equals;1 500w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1&w&equals;640&resize&equals;640&ssl&equals;1 640w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1&w&equals;800&resize&equals;800&ssl&equals;1 800w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1&w&equals;1024&resize&equals;1024&ssl&equals;1 1024w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1&w&equals;1280&resize&equals;1280&ssl&equals;1 1280w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1&w&equals;1600&resize&equals;1600&ssl&equals;1 1600w" fifu-data-src&equals;"https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1" data-original&equals;"https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;khmi75&sol;article67641459&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;crispr-5635795&lowbar;1920&period;jpg&quest;ssl&equals;1" alt&equals;"" data-device-variant&equals;"SQUARE~SQUARE~SQUARE~SQUARE" class&equals;"media-object lazy adaptive placeholder lazy" width&equals;"100&percnt;" height&equals;"100&percnt;"><&sol;div>&NewLine;<&sol;div>&NewLine;<&sol;div>&NewLine;<p>Will CRISPR help farmers&comma; or will it help the agribusiness giants that invest in it&quest; Will it find a way to reach the vulnerable or will it become a tool for the wealthy&quest; And do we really need de-extinction projects when we are failing to protect extant animals&quest; As we move into the future and CRISPR becomes easier to use and is better understood&comma; how will future generations choose to alter human embryos on which currently there is a moratorium&quest; <&sol;p>&NewLine;<p>The questions are numerous and the answers blurry&period; It is still early to say when CRISPR will be affordable to a larger section of people&period; As these technologies emerge and evolve at a rapid speed&comma; regulatory bodies must establish strict guidelines for ethical&comma; societal&comma; safety and environmental issues at the same pace&period; <&sol;p>&NewLine;<h4 class&equals;"sub&lowbar;head">CAR-T Cell Therapy <&sol;h4>&NewLine;<p>The same year that CRISPR’s use as a gene-editing tool was discovered&comma; a six-year-old’s battle with acute lymphoblastic leukaemia &lpar;ALL&rpar; would define the entire field of CAR-T cell therapy&period; Chimeric Antigen Receptor &lpar;CAR&rpar; T cell therapy genetically alters a patient’s T cells &lpar;a type of white blood cell&rpar; to fight malignant tumour cells by targeting a protein on the surface of cancer cells&period; <&sol;p>&NewLine;<p>When the experimental treatment was in its earliest days&comma; a doctor&comma; Stephen Grupp&comma; was approached by Emily Whitehead’s parents looking for a miracle to save their daughter as other doctors had given up all hope&period; The brand-new therapy began its phase I clinical trial and Emily was enrolled&period; She became the first paediatric patient to receive the treatment and the first ever patient of any age to receive it for ALL&period; <&sol;p>&NewLine;<p>Twelve years later&comma; it’s clear the Whiteheads found the miracle they sought&colon; Emily remains cancer-free&period; However&comma; the journey was far from easy&period; Even doctors were uncertain of the treatment’s outcome&comma; learning alongside Emily&comma; as challenges arose throughout her care&period; <&sol;p>&NewLine;<div class&equals;"also-read print-hide" data-ga-label&equals;"AlsoReadArticle">&NewLine;<div class&equals;"element">&NewLine;<div class&equals;"title">&NewLine;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;Explained &vert; Why CAR T-cell therapy is cancer treatment’s next moonshot<&sol;div>&NewLine;<div class&equals;"picture"><img src&equals;"data&colon;image&sol;gif&semi;base64&comma;R0lGODlhAQABAIAAAAAAAP&sol;&sol;&sol;ywAAAAAAQABAAACAUwAOw&equals;&equals;" fifu-lazy&equals;"1" fifu-data-sizes&equals;"auto" fifu-data-srcset&equals;"https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1&w&equals;75&resize&equals;75&ssl&equals;1 75w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1&w&equals;100&resize&equals;100&ssl&equals;1 100w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1&w&equals;150&resize&equals;150&ssl&equals;1 150w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1&w&equals;240&resize&equals;240&ssl&equals;1 240w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1&w&equals;320&resize&equals;320&ssl&equals;1 320w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1&w&equals;500&resize&equals;500&ssl&equals;1 500w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1&w&equals;640&resize&equals;640&ssl&equals;1 640w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1&w&equals;800&resize&equals;800&ssl&equals;1 800w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1&w&equals;1024&resize&equals;1024&ssl&equals;1 1024w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1&w&equals;1280&resize&equals;1280&ssl&equals;1 1280w&comma; https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1&w&equals;1600&resize&equals;1600&ssl&equals;1 1600w" fifu-data-src&equals;"https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1" data-original&equals;"https&colon;&sol;&sol;i1&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;sci-tech&sol;science&sol;f5flki&sol;article66481341&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;10080374656&lowbar;47b9456c75&lowbar;o&period;jpg&quest;ssl&equals;1" alt&equals;"" data-device-variant&equals;"SQUARE~SQUARE~SQUARE~SQUARE" class&equals;"media-object lazy adaptive placeholder lazy" width&equals;"100&percnt;" height&equals;"100&percnt;"><&sol;div>&NewLine;<&sol;div>&NewLine;<&sol;div>&NewLine;<p>In 2017&comma; the FDA approved the first CAR-T therapy&comma; paving the way for hundreds of patients to receive the treatment&comma; thanks in-part to courageous families like Emily’s&period; It is important to acknowledge though that not all outcomes are as happy as Emily’s&period; Some patients remain unresponsive or may relapse&period; Each case is unique and there is a learning curve with each patient&period; <&sol;p>&NewLine;<h4 class&equals;"sub&lowbar;head">How CAR-T therapy works <&sol;h4>&NewLine;<p>T cells possess receptors on their surface that can recognise antigens — proteins or molecules identified by the immune system — and when foreign antigens are detected&comma; the immune system signals the T cells to destroy them&period; <&sol;p>&NewLine;<p>However&comma; cancer cells can sometimes express antigens that the body does not recognise as abnormal&comma; preventing the immune system from sending T cells to attack them&period; In other instances&comma; even if T cells are present&comma; they may not be effective at eliminating cancer cells&period; <&sol;p>&NewLine;<p>CAR-T cells are genetically engineered in a laboratory to include a new receptor that enables them to bind to and kill cancer cells&period; The development of CAR-T cells involves a multi-step process that begins with collecting T-cells from the patient through a procedure called leukapheresis&period; These T-cells are then modified in the lab to express CARs on their surface&period; The gene encoding the CAR is synthesised in the lab&comma; and a vector — often a viral vector&comma; is used to deliver the CAR gene into the T-cells&period; <&sol;p>&NewLine;<p>Once re-engineered&comma; the T-cells are multiplied in the lab to generate millions of cells&comma; which are then sent back to the hospital for infusion into the patient&period; Typically&comma; patients undergo chemotherapy before receiving the CAR-T cells&period; Different types of cancer have unique antigens&comma; which means that each CAR-T cell therapy is designed to target a specific cancer antigen&period; <&sol;p>&NewLine;<div class&equals;"also-read print-hide" data-ga-label&equals;"AlsoReadArticle">&NewLine;<div class&equals;"element">&NewLine;<div class&equals;"title">&NewLine;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;Explained &vert; How gene therapy could cure cancer<&sol;div>&NewLine;<div class&equals;"picture"><img src&equals;"data&colon;image&sol;gif&semi;base64&comma;R0lGODlhAQABAIAAAAAAAP&sol;&sol;&sol;ywAAAAAAQABAAACAUwAOw&equals;&equals;" fifu-lazy&equals;"1" fifu-data-sizes&equals;"auto" fifu-data-srcset&equals;"https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1&w&equals;75&resize&equals;75&ssl&equals;1 75w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1&w&equals;100&resize&equals;100&ssl&equals;1 100w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1&w&equals;150&resize&equals;150&ssl&equals;1 150w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1&w&equals;240&resize&equals;240&ssl&equals;1 240w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1&w&equals;320&resize&equals;320&ssl&equals;1 320w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1&w&equals;500&resize&equals;500&ssl&equals;1 500w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1&w&equals;640&resize&equals;640&ssl&equals;1 640w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1&w&equals;800&resize&equals;800&ssl&equals;1 800w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1&w&equals;1024&resize&equals;1024&ssl&equals;1 1024w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1&w&equals;1280&resize&equals;1280&ssl&equals;1 1280w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1&w&equals;1600&resize&equals;1600&ssl&equals;1 1600w" fifu-data-src&equals;"https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1" data-original&equals;"https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;6dpv2j&sol;article66264177&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;iStock-1317149477&period;jpg&quest;ssl&equals;1" alt&equals;"" data-device-variant&equals;"SQUARE~SQUARE~SQUARE~SQUARE" class&equals;"media-object lazy adaptive placeholder lazy" width&equals;"100&percnt;" height&equals;"100&percnt;"><&sol;div>&NewLine;<&sol;div>&NewLine;<&sol;div>&NewLine;<p>CAR-T cell therapy costs anywhere between ₹3 to 4 crore&comma; excluding hospitalisation charges&comma; rendering it unavailable to most people&period; While a few insurance plans do cover the expenses of the treatment in the United States&comma; some procedures might not be covered&period; Logistics&comma; travel and food are other expenses one needs to keep in mind while undergoing this treatment&period; <&sol;p>&NewLine;<p>The unaffordability of CAR-T therapy fuelled Rahul Purwar’s vision of developing an indigenous version&period; Currently a professor at the Indian Institute of Bombay &lpar;IIT-B&rpar;&comma; Dr&period; Purwar returned to India in 2013 after completing his postdoctoral programme at Harvard Medical School&period; Along with his research students — Alka Dwivedi&comma; Atharva Karulkar — and haemato-oncologists Gaurav Narula and Hasmukh Jain from Tata Memorial Hospital&comma; it took a decade to bring this vision to fruition&period; <&sol;p>&NewLine;<p>The process of designing CAR-T cells requires expertise&period; The researchers collaborated with experts at the National Cancer Institute &lpar;NCI&rpar; to overcome the challenges they faced&period; The team had to then approach the Central Drugs Standard Control Organisation &lpar;CDSCO&rpar; for clinical trial approval&comma; which involved several rounds of revisions&period; It was also a first for CDSCO&comma; as guidelines were not framed with respect to cell therapy&comma; and they evolved along with the technology&period; <&sol;p>&NewLine;<p>In October 2023&comma; India got its first indigenous CAR-T therapy — NEXCAR19 — that costs around ₹45 lakh&comma; a fraction of its U&period;S&period; counterpart&period; This sum&comma; however&comma; still remains unaffordable for a majority of Indians&comma; for whom accessing even primary healthcare is difficult&period; Proximity to a well-equipped hospital is also necessary&comma; as some cases may require intensive care utilisation after the treatment and follow-ups on a regular basis&period; <&sol;p>&NewLine;<div class&equals;"also-read print-hide" data-ga-label&equals;"AlsoReadArticle">&NewLine;<div class&equals;"element">&NewLine;<div class&equals;"title">&NewLine;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;&Tab;President launches India&&num;8217&semi;s first homegrown CAR T-cell therapy for cancer treatment&comma; calls it &&num;8216&semi;new hope&&num;8217&semi;<&sol;div>&NewLine;<div class&equals;"picture"><img src&equals;"data&colon;image&sol;gif&semi;base64&comma;R0lGODlhAQABAIAAAAAAAP&sol;&sol;&sol;ywAAAAAAQABAAACAUwAOw&equals;&equals;" fifu-lazy&equals;"1" fifu-data-sizes&equals;"auto" fifu-data-srcset&equals;"https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1&w&equals;75&resize&equals;75&ssl&equals;1 75w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1&w&equals;100&resize&equals;100&ssl&equals;1 100w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1&w&equals;150&resize&equals;150&ssl&equals;1 150w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1&w&equals;240&resize&equals;240&ssl&equals;1 240w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1&w&equals;320&resize&equals;320&ssl&equals;1 320w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1&w&equals;500&resize&equals;500&ssl&equals;1 500w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1&w&equals;640&resize&equals;640&ssl&equals;1 640w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1&w&equals;800&resize&equals;800&ssl&equals;1 800w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1&w&equals;1024&resize&equals;1024&ssl&equals;1 1024w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1&w&equals;1280&resize&equals;1280&ssl&equals;1 1280w&comma; https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1&w&equals;1600&resize&equals;1600&ssl&equals;1 1600w" fifu-data-src&equals;"https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1" data-original&equals;"https&colon;&sol;&sol;i2&period;wp&period;com&sol;th-i&period;thgim&period;com&sol;public&sol;incoming&sol;b0ln2m&sol;article68028102&period;ece&sol;alternates&sol;SQUARE&lowbar;80&sol;PTI04&lowbar;04&lowbar;2024&lowbar;000121B&period;jpg&quest;ssl&equals;1" alt&equals;"" data-device-variant&equals;"SQUARE~SQUARE~SQUARE~SQUARE" class&equals;"media-object lazy adaptive placeholder lazy" width&equals;"100&percnt;" height&equals;"100&percnt;"><&sol;div>&NewLine;<&sol;div>&NewLine;<&sol;div>&NewLine;<p>And so as with CRISPR&comma; we circle back to the question of health equity with emerging medical technologies&period; Can we hope the prices will decrease once manufacturing increases&quest; Can these technologies be implemented in sub-urban and rural India&quest; <&sol;p>&NewLine;<p>There is no doubt that CRISPR and CAR-T cell therapy are breakthroughs in the medical field&period; But because they are still in their initial stages&comma; they come with a million-dollar price tag&period; Developing new therapies is expensive&period; In addition to the cost of research&comma; manufacturing&comma; labour&comma; logistics&comma; marketing&comma; distribution and intellectual property development&comma; comes the added work of regulatory approval&period; <&sol;p>&NewLine;<p>But what does the future hold for such emerging trends that interweave different fields to pave the way for improving people’s lives&comma; if the outcomes are but accessible to a handful&quest; <&sol;p>&NewLine;<p><i>&lpar;Soujanya Padikkal is a freelance content provider based in Hyderabad&rpar;<&sol;i> <&sol;p>&NewLine;<div class&equals;"articleblock-container" id&equals;"arthardpv"><&sol;div>&NewLine;<div class&equals;"update-publish-time article-published-time-end"><&sol;div>&NewLine;<div class&equals;"comments-shares share-page flex print-hide" data-artid&equals;"69257064" data-title&equals;"Engineering medicine&colon; The future of CAR-T and CRISPR technologies " data-url&equals;"https&colon;&sol;&sol;www&period;thehindu&period;com&sol;sci-tech&sol;health&sol;engineering-medicine-the-future-of-car-t-and-crispr-technologies&sol;article69257064&period;ece">&NewLine;<div class&equals;"left">&NewLine;<div class&equals;"share">&NewLine;<ul class&equals;"share-list bottom" style&equals;"display&colon; none&semi;">&NewLine;<li class&equals;"copy-link" onclick&equals;"if &lpar;&excl;window&period;&lowbar;&lowbar;cfRLUnblockHandlers&rpar; return false&semi; copytext&lpar;'https&colon;&sol;&sol;www&period;thehindu&period;com&sol;sci-tech&sol;health&sol;engineering-medicine-the-future-of-car-t-and-crispr-technologies&sol;article69257064&period;ece'&rpar;&semi;" data-cf-modified-ac29f62f1f2a6de36468058b-&equals;"">&NewLine; Copy link <&sol;p>&NewLine;<&sol;li>&NewLine;<li class&equals;"email">&NewLine; Email <&sol;p>&NewLine;<&sol;li>&NewLine;<li class&equals;"facebook" onclick&equals;"if &lpar;&excl;window&period;&lowbar;&lowbar;cfRLUnblockHandlers&rpar; return false&semi; openShareLink&lpar;'https&colon;&sol;&sol;www&period;facebook&period;com&sol;sharer&sol;sharer&period;php&quest;u&equals;https&percnt;3A&percnt;2F&percnt;2Fwww&period;thehindu&period;com&percnt;2Fsci-tech&percnt;2Fhealth&percnt;2Fengineering-medicine-the-future-of-car-t-and-crispr-technologies&percnt;2Farticle69257064&period;ece&amp&semi;t&equals;Engineering&percnt;20medicine&percnt;3A&percnt;20The&percnt;20future&percnt;20of&percnt;20CAR-T&percnt;20and&percnt;20CRISPR&percnt;20technologies&percnt;C2&percnt;A0'&rpar;" data-cf-modified-ac29f62f1f2a6de36468058b-&equals;"">&NewLine; Facebook <&sol;p>&NewLine;<&sol;li>&NewLine;<li class&equals;"twitter" onclick&equals;"if &lpar;&excl;window&period;&lowbar;&lowbar;cfRLUnblockHandlers&rpar; return false&semi; openShareLink&lpar;'https&colon;&sol;&sol;twitter&period;com&sol;intent&sol;tweet&quest;url&equals;https&percnt;3A&percnt;2F&percnt;2Fwww&period;thehindu&period;com&percnt;2Fsci-tech&percnt;2Fhealth&percnt;2Fengineering-medicine-the-future-of-car-t-and-crispr-technologies&percnt;2Farticle69257064&period;ece&amp&semi;text&equals;Engineering&percnt;20medicine&percnt;3A&percnt;20The&percnt;20future&percnt;20of&percnt;20CAR-T&percnt;20and&percnt;20CRISPR&percnt;20technologies&percnt;C2&percnt;A0'&rpar;" data-cf-modified-ac29f62f1f2a6de36468058b-&equals;"">&NewLine; Twitter <&sol;p>&NewLine;<&sol;li>&NewLine;<li class&equals;"telegram" onclick&equals;"if &lpar;&excl;window&period;&lowbar;&lowbar;cfRLUnblockHandlers&rpar; return false&semi; openShareLink&lpar;'https&colon;&sol;&sol;t&period;me&sol;share&sol;url&quest;url&equals;https&percnt;3A&percnt;2F&percnt;2Fwww&period;thehindu&period;com&percnt;2Fsci-tech&percnt;2Fhealth&percnt;2Fengineering-medicine-the-future-of-car-t-and-crispr-technologies&percnt;2Farticle69257064&period;ece&amp&semi;text&equals;Engineering&percnt;20medicine&percnt;3A&percnt;20The&percnt;20future&percnt;20of&percnt;20CAR-T&percnt;20and&percnt;20CRISPR&percnt;20technologies&percnt;C2&percnt;A0'&rpar;" data-cf-modified-ac29f62f1f2a6de36468058b-&equals;"">&NewLine; Telegram <&sol;p>&NewLine;<&sol;li>&NewLine;<li class&equals;"in" onclick&equals;"if &lpar;&excl;window&period;&lowbar;&lowbar;cfRLUnblockHandlers&rpar; return false&semi; openShareLink&lpar;'https&colon;&sol;&sol;www&period;linkedin&period;com&sol;shareArticle&quest;url&equals;https&percnt;3A&percnt;2F&percnt;2Fwww&period;thehindu&period;com&percnt;2Fsci-tech&percnt;2Fhealth&percnt;2Fengineering-medicine-the-future-of-car-t-and-crispr-technologies&percnt;2Farticle69257064&period;ece&amp&semi;title&equals;Engineering&percnt;20medicine&percnt;3A&percnt;20The&percnt;20future&percnt;20of&percnt;20CAR-T&percnt;20and&percnt;20CRISPR&percnt;20technologies&percnt;C2&percnt;A0'&rpar;" data-cf-modified-ac29f62f1f2a6de36468058b-&equals;"">&NewLine; LinkedIn <&sol;p>&NewLine;<&sol;li>&NewLine;<li class&equals;"whatsapp" onclick&equals;"if &lpar;&excl;window&period;&lowbar;&lowbar;cfRLUnblockHandlers&rpar; return false&semi; openShareLink&lpar;'https&colon;&sol;&sol;api&period;whatsapp&period;com&sol;&sol;send&quest;text&equals;Engineering&percnt;20medicine&percnt;3A&percnt;20The&percnt;20future&percnt;20of&percnt;20CAR-T&percnt;20and&percnt;20CRISPR&percnt;20technologies&percnt;C2&percnt;A0&percnt;20-&percnt;20https&percnt;3A&percnt;2F&percnt;2Fwww&period;thehindu&period;com&percnt;2Fsci-tech&percnt;2Fhealth&percnt;2Fengineering-medicine-the-future-of-car-t-and-crispr-technologies&percnt;2Farticle69257064&period;ece'&rpar;" data-cf-modified-ac29f62f1f2a6de36468058b-&equals;"">&NewLine; WhatsApp<&sol;p>&NewLine;<&sol;li>&NewLine;<li class&equals;"reddit" onclick&equals;"if &lpar;&excl;window&period;&lowbar;&lowbar;cfRLUnblockHandlers&rpar; return false&semi; openShareLink&lpar;'https&colon;&sol;&sol;reddit&period;com&sol;submit&quest;url&equals;https&percnt;3A&percnt;2F&percnt;2Fwww&period;thehindu&period;com&percnt;2Fsci-tech&percnt;2Fhealth&percnt;2Fengineering-medicine-the-future-of-car-t-and-crispr-technologies&percnt;2Farticle69257064&period;ece&amp&semi;title&equals;Engineering&percnt;20medicine&percnt;3A&percnt;20The&percnt;20future&percnt;20of&percnt;20CAR-T&percnt;20and&percnt;20CRISPR&percnt;20technologies&percnt;C2&percnt;A0'&rpar;" data-cf-modified-ac29f62f1f2a6de36468058b-&equals;"">&NewLine; Reddit <&sol;p>&NewLine;<&sol;li>&NewLine;<&sol;ul>&NewLine;<&sol;div>&NewLine;<&sol;div>&NewLine;<div class&equals;"right">&NewLine;<div class&equals;"read-later"><button class&equals;"btn read-later-btn" data-articleid&equals;"69257064" style&equals;"display&colon;none" data-ga-labelclick&equals;"ReadLater"><span>READ LATER<&sol;span><&sol;button><&sol;p>&NewLine;<div class&equals;"delete-tool-tip" style&equals;"display&colon; none&semi;"><a rel&equals;"nofollow noopener" target&equals;"&lowbar;blank" class&equals;"delete bookmarkdelete"><br &sol;>&NewLine; Remove<br &sol;>&NewLine; <&sol;a><br &sol;>&NewLine; SEE ALL&NewLine; <&sol;div>&NewLine;<&sol;div>&NewLine;<&sol;div>&NewLine;<&sol;div>&NewLine;<div class&equals;"spliter pt-0 mb-0 print-hide"><&sol;div>&NewLine;<div class&equals;"article-ad two-side text-ad print-hide">&NewLine;<div class&equals;"ad-text" id&equals;"artproduct2"><&sol;div>&NewLine;<&sol;div>&NewLine;<p><script data-cfasync&equals;"false">var totalPcount &equals; document&period;querySelectorAll&lpar;"&period;articlebodycontent>p"&rpar;&NewLine;if&lpar;totalPcount&period;length > 1&rpar;&NewLine; insertElementEnd&lpar;totalPcount&lbrack;1&rsqb;&comma;createElementScript&lpar;"div"&comma;""&comma;"artmeterpv"&rpar;&rpar;&NewLine;else&NewLine; insertElementbegin&lpar;document&period;querySelector&lpar;"&period;articlebodycontent"&rpar;&comma;createElementScript&lpar;"div"&comma;""&comma;"artmeterpv"&rpar;&rpar;&NewLine;<&sol;script><&sol;p>&NewLine;<div class&equals;"d-none d-lg-block d-xl-block"><script data-cfasync&equals;"false">&NewLine; totalPcount &equals; totalPcount &vert;&vert; &lbrack;&rsqb;&semi;if &lpar;isDeviceEnabled&lpar;"large"&rpar;&rpar; var container &equals; document&period;createElement&lpar;"div"&rpar;&semi;&NewLine; container&period;className &equals; "article-ad"&semi;container&period;appendChild&lpar;createElementScript&lpar;"div"&comma; "dfp-ad articleinlinead"&comma; "Desktop&lowbar;AT&lowbar;Mid01"&comma; minHeight&colon; '90px'&rpar;&rpar;&semi;&NewLine; insertElementEnd&lpar;totalPcount&lbrack;1 - 1&rsqb;&comma; container&rpar;&NewLine; <&sol;script><&excl;-- Begin DFP &colon; &sol;22390678&sol;TH&lowbar;Desktop&lowbar;AT&lowbar;Mid01&comma; publisher&colon; The Hindu --><script type&equals;"ac29f62f1f2a6de36468058b-text&sol;javascript">userIdentify&period;then&lpar;function&lpar;&rpar; if&lpar;isDeviceEnabled&lpar;"large"&rpar; && isNonSubcribedUser&lpar;&rpar;&rpar; googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &NewLine; googletag&period;display&lpar;'Desktop&lowbar;AT&lowbar;Mid01'&rpar;&semi;&NewLine; &rpar;&semi;&NewLine; &rpar;&semi;<&sol;script><&excl;-- End DFP &colon; &sol;22390678&sol;TH&lowbar;Desktop&lowbar;AT&lowbar;Mid01&comma; publisher&colon; The Hindu --><script data-cfasync&equals;"false">&NewLine; totalPcount &equals; totalPcount &vert;&vert; &lbrack;&rsqb;&semi;if &lpar;isDeviceEnabled&lpar;"large"&rpar;&rpar; var container &equals; document&period;createElement&lpar;"div"&rpar;&semi;&NewLine; container&period;className &equals; "article-ad"&semi;container&period;appendChild&lpar;createElementScript&lpar;"div"&comma; "dfp-ad articleinlinead"&comma; "Desktop&lowbar;Inarticle&lowbar;1x1"&comma; minHeight&colon; '250px'&rpar;&rpar;&semi;&NewLine; insertElementEnd&lpar;totalPcount&lbrack;3 - 1&rsqb;&comma; container&rpar;&NewLine; <&sol;script><&excl;-- Begin DFP &colon; &sol;22390678&sol;Hindu&lowbar;Desktop&lowbar;Inarticle&lowbar;1x1&comma; publisher&colon; The Hindu --><script type&equals;"ac29f62f1f2a6de36468058b-text&sol;javascript">userIdentify&period;then&lpar;function&lpar;&rpar; if&lpar;isDeviceEnabled&lpar;"large"&rpar; && isNonSubcribedUser&lpar;&rpar;&rpar; googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &NewLine; googletag&period;display&lpar;'Desktop&lowbar;Inarticle&lowbar;1x1'&rpar;&semi;&NewLine; &rpar;&semi;&NewLine; &rpar;&semi;<&sol;script><&excl;-- End DFP &colon; &sol;22390678&sol;Hindu&lowbar;Desktop&lowbar;Inarticle&lowbar;1x1&comma; publisher&colon; 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publisher&colon; The Hindu --><script data-cfasync&equals;"false">&NewLine; totalPcount &equals; totalPcount &vert;&vert; &lbrack;&rsqb;&semi;if &lpar;totalPcount&period;length > 0 && isDeviceEnabled&lpar;"large"&rpar; && Number&period;isInteger&lpar;9&rpar; && totalPcount&period;length >&equals; &lpar;8 &plus; 3&rpar;&rpar; var container &equals; document&period;createElement&lpar;"div"&rpar;&semi;&NewLine; container&period;className &equals; "article-ad"&semi;container&period;appendChild&lpar;createElementScript&lpar;"div"&comma; "dfp-ad articleinlinead"&comma; "Desktop&lowbar;AT&lowbar;Mid03"&comma; minHeight&colon; '90px'&rpar;&rpar;&semi;&NewLine; insertElementEnd&lpar;totalPcount&lbrack;9 - 1&rsqb;&comma; container&rpar;&NewLine; <&sol;script><&excl;-- Begin DFP &colon; &sol;22390678&sol;TH&lowbar;Desktop&lowbar;AT&lowbar;Mid03&comma; publisher&colon; The Hindu --><script type&equals;"ac29f62f1f2a6de36468058b-text&sol;javascript">if &lpar;totalPcount&period;length > 0 && Number&period;isInteger&lpar;9&rpar; 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publisher&colon; The Hindu --><script data-cfasync&equals;"false">&NewLine; totalPcount &equals; totalPcount &vert;&vert; &lbrack;&rsqb;&semi;if &lpar;totalPcount&period;length > 0 && isDeviceEnabled&lpar;"large"&rpar; && Number&period;isInteger&lpar;12&rpar; && totalPcount&period;length >&equals; &lpar;11 &plus; 3&rpar;&rpar; var container &equals; document&period;createElement&lpar;"div"&rpar;&semi;&NewLine; container&period;className &equals; "article-ad"&semi;container&period;appendChild&lpar;createElementScript&lpar;"div"&comma; "dfp-ad articleinlinead"&comma; "Desktop&lowbar;AT&lowbar;Mid04"&comma; minHeight&colon; '90px'&rpar;&rpar;&semi;&NewLine; insertElementEnd&lpar;totalPcount&lbrack;12 - 1&rsqb;&comma; container&rpar;&NewLine; <&sol;script><&excl;-- Begin DFP &colon; &sol;22390678&sol;TH&lowbar;Desktop&lowbar;AT&lowbar;Mid04&comma; publisher&colon; The Hindu --><script type&equals;"ac29f62f1f2a6de36468058b-text&sol;javascript">if &lpar;totalPcount&period;length > 0 && Number&period;isInteger&lpar;12&rpar; 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publisher&colon; The Hindu --><script data-cfasync&equals;"false">&NewLine; totalPcount &equals; totalPcount &vert;&vert; &lbrack;&rsqb;&semi;if &lpar;totalPcount&period;length > 0 && isDeviceEnabled&lpar;"large"&rpar; && Number&period;isInteger&lpar;15&rpar; && totalPcount&period;length >&equals; &lpar;14 &plus; 3&rpar;&rpar; var container &equals; document&period;createElement&lpar;"div"&rpar;&semi;&NewLine; container&period;className &equals; "article-ad"&semi;container&period;appendChild&lpar;createElementScript&lpar;"div"&comma; "dfp-ad articleinlinead"&comma; "Desktop&lowbar;AT&lowbar;Mid05"&comma; minHeight&colon; '90px'&rpar;&rpar;&semi;&NewLine; insertElementEnd&lpar;totalPcount&lbrack;15 - 1&rsqb;&comma; container&rpar;&NewLine; <&sol;script><&excl;-- Begin DFP &colon; &sol;22390678&sol;TH&lowbar;Desktop&lowbar;AT&lowbar;Mid05&comma; publisher&colon; The Hindu --><script type&equals;"ac29f62f1f2a6de36468058b-text&sol;javascript">if &lpar;totalPcount&period;length > 0 && Number&period;isInteger&lpar;15&rpar; 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googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &NewLine; googletag&period;display&lpar;'MWeb&lowbar;AT&lowbar;Middle01'&rpar;&semi;&NewLine; &rpar;&semi;&NewLine; &rpar;&semi;<&sol;script><&excl;-- End DFP &colon; &sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle01&comma; publisher&colon; The Hindu --><script data-cfasync&equals;"false">&NewLine; totalPcount &equals; totalPcount &vert;&vert; &lbrack;&rsqb;&semi;if &lpar;isDeviceEnabled&lpar;"small"&rpar;&rpar; var container &equals; document&period;createElement&lpar;"div"&rpar;&semi;&NewLine; container&period;className &equals; "article-ad"&semi;container&period;appendChild&lpar;createElementScript&lpar;"div"&comma; "dfp-ad articleinlinead"&comma; "Mweb&lowbar;Inarticle&lowbar;1x1"&comma; minHeight&colon; '250px'&rpar;&rpar;&semi;&NewLine; insertElementEnd&lpar;totalPcount&lbrack;3 - 1&rsqb;&comma; container&rpar;&NewLine; <&sol;script><&excl;-- Begin DFP &colon; &sol;22390678&sol;TH&lowbar;Mweb&lowbar;Inarticle&lowbar;1x1&comma; publisher&colon; The Hindu --><script type&equals;"ac29f62f1f2a6de36468058b-text&sol;javascript">userIdentify&period;then&lpar;function&lpar;&rpar; if&lpar;isDeviceEnabled&lpar;"small"&rpar; && isNonSubcribedUser&lpar;&rpar;&rpar; googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &NewLine; googletag&period;display&lpar;'Mweb&lowbar;Inarticle&lowbar;1x1'&rpar;&semi;&NewLine; &rpar;&semi;&NewLine; &rpar;&semi;<&sol;script><&excl;-- End DFP &colon; &sol;22390678&sol;TH&lowbar;Mweb&lowbar;Inarticle&lowbar;1x1&comma; publisher&colon; The Hindu --><script data-cfasync&equals;"false">&NewLine; totalPcount &equals; totalPcount &vert;&vert; &lbrack;&rsqb;&semi;if &lpar;totalPcount&period;length > 0 && isDeviceEnabled&lpar;"small"&rpar; && Number&period;isInteger&lpar;6&rpar; && totalPcount&period;length >&equals; &lpar;5 &plus; 3&rpar;&rpar; var container &equals; document&period;createElement&lpar;"div"&rpar;&semi;&NewLine; container&period;className &equals; "article-ad"&semi;container&period;appendChild&lpar;createElementScript&lpar;"div"&comma; "dfp-ad articleinlinead"&comma; "MWeb&lowbar;AT&lowbar;Middle02"&comma; minHeight&colon; '280px'&rpar;&rpar;&semi;&NewLine; insertElementEnd&lpar;totalPcount&lbrack;6 - 1&rsqb;&comma; container&rpar;&NewLine; <&sol;script><&excl;-- Begin DFP &colon; &sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle02&comma; publisher&colon; The Hindu --><script type&equals;"ac29f62f1f2a6de36468058b-text&sol;javascript">if &lpar;totalPcount&period;length > 0 && Number&period;isInteger&lpar;6&rpar; && totalPcount&period;length >&equals; &lpar;5 &plus; 3&rpar;&rpar; if &lpar;isDeviceEnabled&lpar;"small"&rpar;&rpar; &NewLine; googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &NewLine; googletag&period;defineSlot&lpar;'&sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle02'&comma; &lbrack;&lbrack;300&comma; 250&rsqb;&comma; &lbrack;336&comma; 280&rsqb;&rsqb;&comma; 'MWeb&lowbar;AT&lowbar;Middle02'&rpar;&period;addService&lpar;googletag&period;pubads&lpar;&rpar;&rpar;&semi;&NewLine; &rpar;&semi;&NewLine; userIdentify&period;then&lpar;function&lpar;&rpar; if &lpar;isDeviceEnabled&lpar;"small"&rpar; && isNonSubcribedUser&lpar;&rpar; && totalPcount&period;length > 0 && Number&period;isInteger&lpar;6&rpar; && totalPcount&period;length >&equals; &lpar;5 &plus; 3&rpar;&rpar; googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &NewLine; googletag&period;display&lpar;'MWeb&lowbar;AT&lowbar;Middle02'&rpar;&semi;&NewLine; &rpar;&semi;&NewLine; &rpar;&semi;<&sol;script><&excl;-- End DFP &colon; &sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle02&comma; publisher&colon; The Hindu --><script data-cfasync&equals;"false">&NewLine; totalPcount &equals; totalPcount &vert;&vert; &lbrack;&rsqb;&semi;if &lpar;totalPcount&period;length > 0 && isDeviceEnabled&lpar;"small"&rpar; && Number&period;isInteger&lpar;9&rpar; && totalPcount&period;length >&equals; &lpar;8 &plus; 3&rpar;&rpar; var container &equals; document&period;createElement&lpar;"div"&rpar;&semi;&NewLine; container&period;className &equals; "article-ad"&semi;container&period;appendChild&lpar;createElementScript&lpar;"div"&comma; "dfp-ad articleinlinead"&comma; "MWeb&lowbar;AT&lowbar;Middle03"&comma; minHeight&colon; '280px'&rpar;&rpar;&semi;&NewLine; insertElementEnd&lpar;totalPcount&lbrack;9 - 1&rsqb;&comma; container&rpar;&NewLine; <&sol;script><&excl;-- Begin DFP &colon; &sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle03&comma; publisher&colon; The Hindu --><script type&equals;"ac29f62f1f2a6de36468058b-text&sol;javascript">if &lpar;totalPcount&period;length > 0 && Number&period;isInteger&lpar;9&rpar; && totalPcount&period;length >&equals; &lpar;8 &plus; 3&rpar;&rpar; if &lpar;isDeviceEnabled&lpar;"small"&rpar;&rpar; &NewLine; googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &NewLine; googletag&period;defineSlot&lpar;'&sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle03'&comma; &lbrack;&lbrack;300&comma; 250&rsqb;&comma; &lbrack;336&comma; 280&rsqb;&rsqb;&comma; 'MWeb&lowbar;AT&lowbar;Middle03'&rpar;&period;addService&lpar;googletag&period;pubads&lpar;&rpar;&rpar;&semi;&NewLine; &rpar;&semi;&NewLine; userIdentify&period;then&lpar;function&lpar;&rpar; if &lpar;isDeviceEnabled&lpar;"small"&rpar; && isNonSubcribedUser&lpar;&rpar; && totalPcount&period;length > 0 && Number&period;isInteger&lpar;9&rpar; && totalPcount&period;length >&equals; &lpar;8 &plus; 3&rpar;&rpar; googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &NewLine; googletag&period;display&lpar;'MWeb&lowbar;AT&lowbar;Middle03'&rpar;&semi;&NewLine; &rpar;&semi;&NewLine; &rpar;&semi;<&sol;script><&excl;-- End DFP &colon; &sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle03&comma; publisher&colon; The Hindu --><script data-cfasync&equals;"false">&NewLine; totalPcount &equals; totalPcount &vert;&vert; &lbrack;&rsqb;&semi;if &lpar;totalPcount&period;length > 0 && isDeviceEnabled&lpar;"small"&rpar; && Number&period;isInteger&lpar;12&rpar; && totalPcount&period;length >&equals; &lpar;11 &plus; 3&rpar;&rpar; var container &equals; document&period;createElement&lpar;"div"&rpar;&semi;&NewLine; container&period;className &equals; "article-ad"&semi;container&period;appendChild&lpar;createElementScript&lpar;"div"&comma; "dfp-ad articleinlinead"&comma; "MWeb&lowbar;AT&lowbar;Middle04"&comma; minHeight&colon; '280px'&rpar;&rpar;&semi;&NewLine; insertElementEnd&lpar;totalPcount&lbrack;12 - 1&rsqb;&comma; container&rpar;&NewLine; <&sol;script><&excl;-- Begin DFP &colon; &sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle04&comma; publisher&colon; The Hindu --><script type&equals;"ac29f62f1f2a6de36468058b-text&sol;javascript">if &lpar;totalPcount&period;length > 0 && Number&period;isInteger&lpar;12&rpar; && totalPcount&period;length >&equals; &lpar;11 &plus; 3&rpar;&rpar; if &lpar;isDeviceEnabled&lpar;"small"&rpar;&rpar; &NewLine; googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &NewLine; googletag&period;defineSlot&lpar;'&sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle04'&comma; &lbrack;&lbrack;300&comma; 250&rsqb;&comma; &lbrack;336&comma; 280&rsqb;&rsqb;&comma; 'MWeb&lowbar;AT&lowbar;Middle04'&rpar;&period;addService&lpar;googletag&period;pubads&lpar;&rpar;&rpar;&semi;&NewLine; &rpar;&semi;&NewLine; userIdentify&period;then&lpar;function&lpar;&rpar; if &lpar;isDeviceEnabled&lpar;"small"&rpar; && isNonSubcribedUser&lpar;&rpar; && totalPcount&period;length > 0 && Number&period;isInteger&lpar;12&rpar; && totalPcount&period;length >&equals; &lpar;11 &plus; 3&rpar;&rpar; googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &NewLine; googletag&period;display&lpar;'MWeb&lowbar;AT&lowbar;Middle04'&rpar;&semi;&NewLine; &rpar;&semi;&NewLine; &rpar;&semi;<&sol;script><&excl;-- End DFP &colon; &sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle04&comma; publisher&colon; The Hindu --><script data-cfasync&equals;"false">&NewLine; totalPcount &equals; totalPcount &vert;&vert; &lbrack;&rsqb;&semi;if &lpar;totalPcount&period;length > 0 && isDeviceEnabled&lpar;"small"&rpar; && Number&period;isInteger&lpar;15&rpar; && totalPcount&period;length >&equals; &lpar;14 &plus; 3&rpar;&rpar; var container &equals; document&period;createElement&lpar;"div"&rpar;&semi;&NewLine; container&period;className &equals; "article-ad"&semi;container&period;appendChild&lpar;createElementScript&lpar;"div"&comma; "dfp-ad articleinlinead"&comma; "MWeb&lowbar;AT&lowbar;Middle05"&comma; minHeight&colon; '280px'&rpar;&rpar;&semi;&NewLine; insertElementEnd&lpar;totalPcount&lbrack;15 - 1&rsqb;&comma; container&rpar;&NewLine; <&sol;script><&excl;-- Begin DFP &colon; &sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle05&comma; publisher&colon; The Hindu --><script type&equals;"ac29f62f1f2a6de36468058b-text&sol;javascript">if &lpar;totalPcount&period;length > 0 && Number&period;isInteger&lpar;15&rpar; && totalPcount&period;length >&equals; &lpar;14 &plus; 3&rpar;&rpar; if &lpar;isDeviceEnabled&lpar;"small"&rpar;&rpar; &NewLine; googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &NewLine; googletag&period;defineSlot&lpar;'&sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle05'&comma; &lbrack;&lbrack;300&comma; 250&rsqb;&comma; &lbrack;336&comma; 280&rsqb;&rsqb;&comma; 'MWeb&lowbar;AT&lowbar;Middle05'&rpar;&period;addService&lpar;googletag&period;pubads&lpar;&rpar;&rpar;&semi;&NewLine; &rpar;&semi;&NewLine; userIdentify&period;then&lpar;function&lpar;&rpar; if &lpar;isDeviceEnabled&lpar;"small"&rpar; && isNonSubcribedUser&lpar;&rpar; && totalPcount&period;length > 0 && Number&period;isInteger&lpar;15&rpar; && totalPcount&period;length >&equals; &lpar;14 &plus; 3&rpar;&rpar; googletag&period;cmd&period;push&lpar;function&lpar;&rpar; &NewLine; googletag&period;display&lpar;'MWeb&lowbar;AT&lowbar;Middle05'&rpar;&semi;&NewLine; &rpar;&semi;&NewLine; &rpar;&semi;<&sol;script><&excl;-- End DFP &colon; &sol;22390678&sol;TH&lowbar;MWeb&lowbar;AT&lowbar;Middle05&comma; publisher&colon; The Hindu --><&sol;div>&NewLine;<&sol;div>&NewLine;<p><script async src&equals;"https&colon;&sol;&sol;platform&period;twitter&period;com&sol;widgets&period;js" charset&equals;"utf-8"><&sol;script><&sol;p>&NewLine;

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