Schistosomiasis is one of the most important and widespread neglected tropical diseases (NTD), with over 200 million people infected in more than 70 countries; the disease has nearly 800 million people at risk in endemic areas. Although mass drug administration is a cost-effective approach to reduce occurrence, extent, and severity of the disease, it does not provide protection to subsequent reinfection. Interventions that target the parasites' intermediate snail hosts are a crucial part of the integrated strategy required to move toward disease elimination. The recent revolution in gene drive technology naturally leads to questions about whether gene drives could be used to efficiently spread schistosome resistance traits in a population of snails and whether gene drives have the potential to contribute to reduced disease transmission in the long run. Responsible implementation of gene drives will require solutions to complex challenges spanning multiple disciplines, from biology to policy. This Review Article presents collected perspectives from practitioners of global health, genome engineering, epidemiology, and snail/schistosome biology and outlines strategies for responsible gene drive technology development, impact measurements of gene drives for schistosomiasis control, and gene drive governance. Success in this arena is a function of many factors, including gene-editing specificity and efficiency, the level of resistance conferred by the gene drive, how fast gene drives may spread in a metapopulation over a complex landscape, ecological sustainability, social equity, and, ultimately, the reduction of infection prevalence in humans. With combined efforts from across the broad global health community, gene drives for schistosomiasis control could fortify our defenses against this devastating disease in the future.

中文翻译：

---

基因驱动器用于血吸虫病传播控制。

血吸虫病是最重要和最广泛被忽视的热带病之一，在70多个国家中有超过2亿人被感染；该病在流行地区有将近8亿人处于危险之中。尽管大规模给药是减少疾病发生，程度和严重程度的一种经济有效的方法，但它不能为后续的再感染提供保护。针对寄生虫的中间蜗牛宿主的干预是朝着消除疾病的方向发展的综合战略的关键部分。基因驱动技术的最新革命自然引发了这样的疑问：是否可以将基因驱动用于在蜗牛种群中有效传播血吸虫抗药性，以及从长远来看，基因驱动是否具有减少疾病传播的潜力。负责任地实施基因驱动将需要解决方案，以解决从生物学到政策等多个学科的复杂挑战。这篇综述文章从全球健康，基因组工程，流行病学和蜗牛/血吸虫生物学的实践者那里收集了观点，并概述了负责任的基因驱动技术发展，血吸虫病控制基因驱动的影响测量以及基因驱动治理的策略。在这个领域的成功取决于许多因素，包括基因编辑的特异性和效率，基因驱动力赋予的抗药性水平，基因驱动力如何在复杂环境中的种群中传播，生态可持续性，社会公平以及最终降低人类感染率。在整个全球卫生界的共同努力下，用于血吸虫病控制的基因驱动器将来可以加强我们对这种毁灭性疾病的防御能力。