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Maryam Nazir Personal Genomics: Branch of genomics concerned with the sequencing and analysis of the genome of an individual  Once sequenced, it can be compared with published literature to determine likelihood of disease risk or trait expression  Main aim: to inform preventative action  Techniques SNP arrays  Partial sequencing  Whole genome sequencing   Can be used to evaluate: ○ SNPs ○ Indels ○ Large SVs ○ New sequences ○ Haplotypes Cost of Sequencing  Continual development of new sequencing technologies, next-generation sequencing  Increased speed and reduced cost of sequencing  Now possible to offer genetic testing to consumers Personal Genome Project Large, long-term study  Aim: To sequence and publicize the complete genomes and medical records of 100,000 volunteers  All data will be available in the public domain  Purpose: To enable research in personal genomics and personalized medicine   Each participant:  Full DNA sequence  Extensive phenotype information ○ Medical records ○ MRI images ○ Other measurements  Volunteer criteria:     Permanent residents of the US, Canada, UK Able to submit tissue and/or genetic samples Informed consent “no promise of anonymity and data return” Personalized Medicine    A model of medicine which proposes the customization of healthcare with medical decisions being tailored to the individual patient Goal: To individualize prevention, diagnosis, and treatment--by use of genetic differences as markers Disease risk  >2500 diseases have predictive medical value ○ Can be recommended for genetic tests for single genes or whole genome sequencing  Gene signatures  Gene expression pattern in a cell can be uniquely characteristic of a condition  Risk assessment, diagnostic & prognostic applications  Match patients and treatments Pharmacogenomics Field that analyzes how genetic makeup affects an individual’s response to drugs  Want to tailor treatments for patients based on their genetics  Cancer genomics Main goal: to identify genes, or gene signatures, that may provide insights into cancer diagnosis, predicting clinical outcomes or targets for cancer therapies  Tumour sequence is compared to a matched normal tissue  Personalized cancer treatments  Genetic profiles of tumours part of recommended evaluation for certain cancers (colon, breast, lung...)  Nutrigenomics Study of how individual genetic variation affects a person’s response to nutrients and impacts their risk of nutrition-related chronic diseases  People respond differently to certain foods  Human Ancestry Looks at a person’s DNA at specific locations compares results to defined groups  Mitochondrial DNA   Traces direct maternal line  Y-Chromosome DNA  Traces a male’s direct paternal line  Autosomal DNA  Tests all ancestry, shows how closely a person is related to others Commercial Services  Gentle  most comprehensive genetic test currently on the market  screens for >1700 genetic conditions  predicts response to certain medications  HelloGenome (Korea)  genotyping (SNP chips) and full genome sequencing (Solexa machines)  Illumina, Sequenom, Oxford Nanopore Technologies, Pacific Biosciences, Complete Genomics, 454 Life Sciences  commercializing full genome sequencing  do not provide any genetic analysis or counselling component  Positive Bioscience (Mumbai)  Next-generation sequencing  To determine most beneficial cancer treatment for patients  Nutrigenomix  SNP genotyping  Each gene tested is involved in the way the body processes a certain dietary component  With information obtained, can tailor the diet to prevent chronic diseases (cancer, heart disease, type 2 diabetes) -ex. Caffeine  Only available through registered dieticians  $385 23andMe Mail order “spit kits”  SNP genotyping (DNA array)  Assessment of:   inherited traits  ancestry  genetic risk for >240 diseases and common conditions Information presented in user profile  $99  Ethical Issues  Personal privacy & misuse of information  Whose responsibility?  Who owns the genomic info?  Genetic discrimination  Discrimination based on information obtained from an individual’s genome  Genetic Information Nondiscrimination Act (U.S.) ○ Prevents discrimination by health insurers and employers, but does not apply to life insurance or long-term care insurance  Psychosocial stress  Consequence of knowing one’s predisposition to disease  Know risk, have no cure Other Issues How relevant are the results of commercial services? Clinical utility?  Education needed in interpreting results and communicating genetic information   For the average person/patient  For doctors  For the public & media  genetic counselling Conclusions  A fairly large number of loci that are known to be predictive of disease have been identified  Many of these can be clinically targeted Immediate applications are limited at present  The promise of personal genomics lies in the future   Must first build a database of personal genomes  Many people envision a future where personal genomic information is one of the essential tools used to tailor one’s medical care References  Offit, Kenneth. "Personalized medicine: new genomics, old lessons." Hum Genet. 130. (2011): 3-14.  Snyder, Michael, Jiang Du, and Mark Gerstein. "Personal genome sequencing: current approaches and challenges." Genes Dev. 24. (2010): 423-431.  Werner, Thomas. "Next generation sequencing in functional genomics." Briefings in Bioinformatics. 2.5 (2010): 499-511.  Cooper, David N., et al. "Genes, Mutations, and Human Inherited Disease at the Dawn of the Age of Personalized Genomics." Human Mutation. 31.6 (2010): 631–655.  Chin, Lynda, Jannick N Andersen1, and P Andrew Futreal. "Cancer genomics: from discovery science to personalized medicine." Nature Medicine. 17.3 (2011): 297-303.