review · Gene Therapy
Genetic modification offers an alternative approach to mosquito control for vector-borne diseases, building on non-insecticidal successes seen with sterile or incompatible insect methods against arboviruses. While techniques to suppress mosquito numbers or make them resistant to pathogens are less developed, the emergence of CRISPR-Cas9-mediated gene drives has accelerated progress. Research focuses on two main strategies: population suppression and population replacement. Replacement approaches include genetically modifying mosquitoes to boost immune responses or express anti-parasite effector molecules, which could form part of a broader combined strategy to fight malaria. Despite substantial advances over the past decade, technical limitations and ethical considerations remain critical challenges that influence how these genetic tools fit into the wider scope of mosquito control.
Malaria remains a major public health challenge, and traditional insecticidal approaches face growing challenges. Understanding how gene drive technologies can suppress vector populations or render mosquitoes resistant to disease provides public health planners with potential new tools, while highlighting the necessary ethical and technical balances required before deployment.
The technology represents early-stage to development-stage interventions aimed at public health authorities and disease control programmes. Potential applications include genetically modified mosquito strains engineered for population suppression or malaria resistance. However, commercialisation pathways remain constrained by technological limitations and complex ethical considerations that must be resolved before field adoption.
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Genetic modification for the control of mosquitoes is frequently touted as a solution for a variety of vector-borne diseases. There has been some success using non-insecticidal methods like sterile or incompatible insect techniques to control arbovirus diseases. However, control by genetic modifications to reduce mosquito populations or create mosquitoes that are refractory to infection with pathogens are less developed. The advent of CRISPR-Cas9-mediated gene drives may advance this mechanism of control. In this review, use and progress of gene drives for vector control, particularly for malaria, is discussed. A brief history of population suppression and replacement gene drives in mosquitoes, rapid advancement of the field over the last decade and how genetic modification fits into the current scope of vector control are described. Mechanisms of alternative vector control by genetic modification to modulate mosquitoes' immune responses and anti-parasite effector molecules as part of a combinational strategy to combat malaria are considered. Finally, the limitations and ethics of using gene drives for mosquito control are discussed.
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DOI: 10.1038/s41434-024-00468-8
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