Monday, June 15, 2009
A Renowned Geneticist Analyzes Consumer Tests
Francis Collins shares his thoughts on the present and future of consumer genetic medicine.
| Francis Collins (right), the former head of the National Human Genome Research Institute, was named one of GQ magazine's rock stars of science. He is now working on a book on personalized medicine. Credit: Ben Watts |
Just exactly how accurate are direct-to-consumer genetic
tests? Francis Collins, the former head of the National Human Genome Research
Institute, decided to find out for himself while researching a new book on personalized
medicine. (Collins published
the book The Language of God: A Scientist
Presents Evidence for Belief in 2006.)
Collins, who played a central role in the Human Genome Project and is rumored to be the next head of the National Institutes of
Health, announced at the Consumer Genetics Conference in Boston last week that
he had had his genome analyzed by the big three of direct-to-consumer genetic
testing: 23andMe, Navigenics, and DecodeMe. He ordered the tests under a fake
name, lest the genomics superstar get special treatment. His speech at the
conference was the first time the companies heard that they had had Collins's DNA in
hand.
Collins said that sequence-wise, the tests "appear to be
highly accurate": there were almost no differences in the genotype information generated
in the three different analyses. But there were significant differences in the
numbers of genetic variations used to calculate disease risk, as well as the final
risk score. For example, one company used 5 single nucleotide polymorphisms,
or SNPs, to calculate risk for a particular disease, pronouncing Collins at low
risk. Another used 10 SNPs, placing him at high risk, and the third used 15, concluding
that he is at average risk. Collins also said that the analyses provided little information
on his "carrier status," meaning whether he carried genetic risk factors that didn't
influence his own risk of disease but could be passed down to future
generations.
Collins's speech last week was more upbeat than one he gave at
the Personal Genomes Conference in Cold Spring Harbor last fall. In that
lecture, he emphasized the potential difficulty in finding the as yet remaining
genetic variations underlying the heritability of disease. In the latest
speech, he instead emphasized what could come out of genome-wide association
studies: new targets for drugs.
"We have undervalued these studies," he said at the
Consumer Genetics Conference. "Even if a variant has a small impact on disease risk, that doesn't
mean it's not a good risk target." In type 2 diabetes, for example, two of the
nine common genetic variants that have so far been linked to the disease are
involved in the pathway targeted by two major diabetes drugs. "[Pharma
companies and others] have not jumped on this as rigorously as they could,"
said Collins. "Perhaps because it's a bit overwhelming--there are so many of
them."
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