Alex Kelleher’s Blog

So I’ve got my results from 23andme – having sent off my sample some weeks ago.  (Thankfully, nothing too shocking in there!)

So, here’s a taster of what you get:

1. Clinical Reports:  The screenshot table below is a snapshot of my risk for various conditions, such as:

• Type 1/2 Diabetes
• Certain forms of cancer
• Crohn’s disease, etc. 

They are the data that clinically 23andme are sure enough of to actually lay them out this formally.  I’ve blanked the particular conditions, but you get the gist.  Also included in this section is information on:

• Traits (such as the ability to taste certain bitter flavours, lactose intolerance)
• Carrier status of certain conditions such as Bloom’s syndrome and Canavan disease
• Drug response to such drugs as Plavix (a blockbuster heart drug)

2. Research Reports – this is analysis that “has not yet gained enough scientific consensus to be included” in the Risks section as above.  It includes things such as:

• Blood pressure
• Dependencies and addictions
• Asthma
• Headaches

3. Ancestry- this shows you a map of your maternal and paternal ancestry, as below – along with (as in all other sections of the site) a healthy dose of background and eductional material

4.  Surveys – the site has a lot of surveys, mainly health/psychological, and the results of those are both interesting to see, and obviously are fuelling 23andme’s knowledge of how genes influence all kinds of health conditions.

5. Sharing – a fascinating part of the site, and one I haven’t yet had time to dig into.   You can select to share your genome with anyone else on the site, at a basic or full level – which enables a bunch of functionality. 

The somewhat obvious extention of this is to work out what the combination of your genetic makeup and a potential partner’s will put your potential children at risk of, with the Inheritance Calculator

Now that adds something to the mate-selection process, huh. 

Actually of all the features and content on the site (and there’s a lot of it), the two elements that raise most people’s eyebrows when I tell them about the service are the disease risks, and the inheritance calculator.   As odd as it seems, I think both represent something really pretty important: the ability to help guard against future risk. 

If I know I’m at a slightly higher risk of some disease because of my particular genetics, AND I know something that I can do about it (eat more broccoli or whatever), why wouldn’t I do that?  Or prepare my kids for it?

I spend my waking hours looking at ways to work out how people behave online and use that information, and to me the analysis of genetic profile is a (long) extension of this – it’s part of the mix of technologies that will enable us to understand US better.

Overall I’m highly impressed with the site – there’s a ton of information there, and obviously by submitting surveys and detailed further information the site will improve.  Over time, they’ll add the ability to analyze and risk-profile more health conditions. 

On a lighter note (but the same topic area!), I’m about to try out facionic.com – results when I get them…

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Tonight, in about 1/2 hour, I’m going to take a saliva sample and ship it off to the States. 

A company called 23andme is then going to analyze that DNA, and tell me my risks for 118 diseases, my ancestral path and allow me to navigate other people with similar DNA…

This is mainly thanks to Esther Dyson’s persuasion, who has always been enthusiastic about the service (she’s also any advisor to my Company, Cognitive Match).  And, in fact, the moment the service was proposed (which from memory was still a year starting with 19) I knew I’d be signing up at some point.  The thing is, it’s at least 50% of what defines ME, it’s my DNA.  (Although note that researchers are finding other features of our DNA, including how it is folded, could be just as important - thanks to @christophebacon for that one).

So Bill Moorier’s app (http://abstractnonsense.com/mri/), “Inside my head” caught my eye for the same reason.  If you fancy, you can use this app to navigate around Bill’s head, presented in a full set of MRI scans… No, I’m not totally sure either why you would want to see inside Bill’s head – but I wouldn’t mind seeing inside my own.  Especially if it was labelled up with facts about brain areas, comparisons with other people’s brains and so on. 

That’s only the start, of course.  Twin this data with eHRs (electronic health records) which we’ll all be getting access to within 3-5 years  (Google Health is already delivering this, and Microsoft and others are working on int), and you have an electronic record of YOU.   Then what? Suddenly, you’ll be in control of your health – all in one place, at one time. 

And the combination of that data will make some amazing things happen in medicine – your genes, combined with your medical history, your travel plans, what you eat every day… Not only will it enable huge advances in personalized medicine, but connections between your health and your life will pour out of this thing.  And ultimately, we will all be a bit healthier.

So, getting 23andme to analyze my DNA, and considering buying the recently buzzed-up FitBit is the first step along that road.  I realise many people wouldn’t find all of this healthy, and it might even be more stressful/worrying than not knowing anything.  But for now, my curiosity is outweighing all that.

I’ll let you know if it changes once 23andme is done analyzing…

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So the whole world is going personalized.  Even in medicine, which I guess most people would think is personalized anyway, it’s the Next Big Thing.  Of course, it’s personalized to a degree in that your doctor will use their judgement in what you might have, but if you have the same disease as someone else, you’re likely to get the same drug and treatment.

That’s changing.  In fact, Pfizer’s DX Division Head says that personalized programs are “happening in the development and commercial stages right now”.  And that’s from the world’s largest pharmaceutical company.  There’s $110bn of company valuation they have to protect in the future, so you can bet they’re spending some good money in this area.

In the UK, the government last month released a note on personalised medicine, covering the current movement away from the “One size fits all” approach.  This note suggests that genetic differences between us can account for up to 95% of the variation in how we each respond to drugs. 

Really what we’re talking about here is a more granular approach.  Your medical, family and life history is combined with an ever greater number of lab test to build up a picture of you as different from another person with the same condition.  Strictly speaking, this isn’t “personal”.  It doesn’t mean that as an individual, you are unique, and will get a treatment no-one else will get. As the UK government report says, “Personalised medicine tailors treatment to patient subgroups“.

Of course it just isn’t possible to test new or existing drugs against every single person who could take them.  So the best that can be expected right now is to know that a drug works for “someone like you“.  One day, computer modelling of the effects of a drug on me as an individual (which would be my DNA plus my current health state, and changes that the environment and life have made – in fact a digital capture of the biology of me right now) will of course be possible – delivering truly personalised medicine. I’ll then pop a pill that would work for no-one else, and bingo – cured.  Until then, I plan to avoid all germs, and eat only aloe vera.

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