Whatever your complaints against today’s drug and medical systems, don’t worry. They will soon all be changed beyond recognition, predicts Michael Christman, president and CEO of Coriell Institute for Medical Research in Camden. “Our recently enhanced ability to profile the individual human genome is an advancement that will prove more disruptive to medicine than anything we have seen in years,” Christman says.
Mapping out a person’s genetic information and determining specifically all his inherited tendencies toward disease and drug tolerances could prove a revolutionary aid in medical treatment. It also has the potential of spreading fear among patients and being used as a manipulative tool by governments and employers. But whether we’re ready or not, the technology is here, says Christman.
This latest advancement by the Coriell Institute (www.coriell.org) is just one of several breakthrough technologies to be discussed at the New Jersey Technology Council’s annual meeting: “Future of Innovation: Let’s Chart our Own Course,” on Thursday, July 17, at 11:30 a.m. at the Forsgate Country Club in Monroe. Cost: $55 and NJTC membership. Visit www.njtc.org. Maxine Ballen, CEO of NJTC, opens the conference, presenting an overview of the Garden State’s areas of strongest technological potential.
Moderating the panel on New Jersey’s innovation economy are Les Browne, NJTC chairman, and Catherine Franzini, CEO of the New Jersey Economic Development Authority. Panelists include Don Newsome, president of Sarnoff Corporation on Washington Road; Gary Butler, president of Automatic Data Processing; Mike Robinson, CEO of Broadview Networks; Biege Doruk, CEO of Gaia Power Technologies; and Stephen Morgan, president of Jersey Central Power and Light.
Though the CEO at Coriell for only a year, Christman has been working with the human genome for most of his professional career. His interest in the mechanics of the natural world was first fired while growing up in Seattle by his father, an environmental scientist. Christman studied chemistry at the University of North Carolina Chapel Hill, earning a bachelors in l981. He then earned his Ph.D. in biochemistry at University of California Berkeley, followed by postdoctoral work at MIT. “It was at MIT that I really saw the power of genetics and gained my fascination for the field,” says Christman.
The genome of an individual is that which holds the full history of his hereditary information, encoded on the DNA. It has been likened to a billion-word library printed in 5,000 volumes, with each volume being 300 pages long. The size of a pinpoint, a copy of this entire library fits into the nucleus of almost every cell.
Researchers have had lots to read in very small type. But as of six months ago the genome translation technique is up, rolling, and ready for clinical trials.
Getting genotyped. Visit Coriell’s website and you can join the other 2,200 people who have had their individual genome information typed. It costs approximately $1,000 and lasts a lifetime. Just a few drops of the donor’s blood or saliva are mixed with a fluorescent dye, and loaded onto a microchip cassette. After a little warming in an oven, and various other techno translations, more than a million points of individual variations are made plain. A donor can discover biological tendencies ranging from his proclivity toward heart disease to his sensitivity toward Lipitor.
The information is unchanging. At a later time, if an individual is considering a new medical procedure or new drug, he may reference the inherited risks through his chart. “The trouble is, at this point, technology has outpaced medical knowledge,” says Christman. “We are not yet using the profiled genome information anywhere near its fullest potential.”
But there have been some starts. The FDA has noted that Coumadin, the popular blood thinner, is not a one-size-fits-all drug. Common genetic differences can make one individual 10 times as sensitive as another. One person’s cure might be another’s toxic overload. Genetic assessment of the tolerance has allowed for much more accurate and effective doses to be prescribed.
Also, few doctors can read a genotype chart, though Christman assures that is on the verge of changing. “In 10 years this will all be part of all the best practices. Everyone will have a comprehensive genome profile that will be referred to regularly,” he says. Is your risk of breast cancer worth the radiation from repeated mammograms? Which part of the cancer cluster does your body need to watch out for?
Genetic privacy. Humankind holds an illusion of free will. We do not greet silently some lab-coated scientist’s report that we are mentally limited, will never be able to be play in the NBA, or that we are destined to die after 47.2 years. Nor do we want anyone making decisions based on this genetic tally of our fate.
Leonardo Favio’s 1993 movie, “Gatica,” details one man’s rebellion against a society that pre-categorizes its members based on the genetic abilities parents are able to purchase for their offspring. Could it happen in our government? Perhaps, but much closer at hand is the fear that employers or insurance companies will reject individuals based on their genetic picture. New Jerseyans have been safe from this for the past decade by a statute forbidding any genetic-based decisions regarding employment, medical insurance acceptance, or the setting of premiums. A similar federal law, signed by President Bush, will take effect in 18 months.
Even with these external safeguards, there comes the question of how much of your genome do you really want to know yourself. Having a genetic proclivity toward heart disease does not mean you will drop dead at 35. But the haunting fear that you stand teetering on the edge of a dozen life-threatening diseases just might do the trick. Such anxiety can not totally be done away with, although Christman does note that information concerning untreatable diseases, such as Alzheimer’s, is never revealed.
Double edge for pharma. “Definitely, one of the industries receiving the greatest shakeup is pharmaceuticals,” says Christman. The good news is that genetic profiling may provide a new life for drugs previously rejected. If a substance was found in trials to produce a toxic side effect in 40 percent of the cases, the tests may be resurrected and restudied. It may be determined that those 40 percent held a certain common genetic factor. The drug might work on the remaining 60 percent and may be profitably brought to the market.
At the same time, many currently popular drugs may prove, under genetic scrutiny, to be totally ineffective for 40 percent of the people taking them. It is possible that the $12 billion annual revenues made from Lipitor would be cut by 40 percent.
As with any new information resource, the key will be in the handling. It could lead the way toward enormous medical healing or open the door to horrific cultural control and government- ordered predestination. —