Therapy targeting mutated genes is starting to work wonders, but not for everyone. Growing up in Devon in the 1980s, brothers James* and Matt* had to be careful with their anticsa cut or bruise could land them in hospital.They have haemophilia, a genetic disease where the blood doesnt clot efficiently due to a lack of a clotting protein. Its plagued their family for generations. Their grannys brother died from it, and they, their uncle and a younger cousin have long managed it by injecting the missing protein to prevent bleeds.While haemophilia can now be managed effectivelyin high-income countries at least, where medication is readily availableit can severely limit freedom and quality of life and can even reduce life expectancy. Bleeds can be triggered by minor strains that healthy people barely notice, such as from walking or lifting boxes. Blood then seeps from the capillaries and pools in the joints, causing throbbing pain and lasting damage.

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