20 April 2009

Predisposition to diseases by gene analysis: do not exaggerate!

Today in America. Farewell to gene illusionsRadio Liberty, 20.04.2009 13:28

The program is hosted by Yuri Zhigalkin. Professor of Medicine Daniil Golubev is taking part.Yuri Zhigalkin: Under the six years of great hopes associated with the decoding of the human genome in the two thousand and third year, most likely, a line has been drawn.

Scientists hoped that knowledge of the human gene structure would allow them to discover the causes of a wide variety of diseases at the cellular level. But, as in the case of another scientific sensation – stem cell experiments – euphoria is followed by disappointment.

The most prestigious American medical journal, The New England Journal of Medicine, has published a series of comments by leading American researchers in the field of the human genome, who admit that they managed to barely open the door to the boundless space of the human genome. And what they saw there convinced them that their hopes that they would be able to find the genes responsible for this or that disease were naive. The causes of most diseases are much more complex. Extremely expensive experiments comparing healthy and deformed genes have yielded almost no results. I asked Professor of Medicine Daniil Golubev to comment on these findings.

Daniil Golubev: I believe these disappointments are temporary. After the human genome was sequenced in 2003, a detailed and thorough study of the individual genetic structure of each person became possible. Naturally, the desire to predict the presence of a disease or the determinants that may cause it, there is a certain overlap in this regard. The expectations turned out to be greater than the results themselves. A number of diseases, such as Alzheimer's disease, mental illness for schizophrenia, diabetes do not have a single mutation that would determine their occurrence. There are a number of changes in the genome that lead to the occurrence of this disease. And there may also be so-called epigenomic factors, that is, the genome is normal, and the regulation of gene activity is disrupted. All these things reduce the possibility and probability of accurately predicting that this person will get sick with something.

Yuri Zhigalkin: So, Professor, are the proposals for conducting a genetic analysis of predisposition to certain diseases, let's say, not quite correct?

Daniil Golubev: In any case, the exaggeration of the possibility and commercialization of these services, as in any other business, is certainly evident. Information is sent out that it is possible to determine by a drop of saliva what and when you will get sick. This is, of course, an exaggeration, an exaggeration from a scientific point of view is inexcusable. Because, I repeat once again, a number of diseases do not have an exact genetic determination for their occurrence.

Yuri Zhigalkin: And what can genes tell us reliably?

Daniil Golubev: There are indisputable examples of the usefulness of this kind of approach. For example, certain racial groups have a clear genetic predisposition to certain diseases. For example, Ashkenazi Jews have a predisposition to breast cancer or skin cancer. Today it is possible to determine whether this woman has or does not have a predisposition to this type of disease. This is not a little. This is part of clinical practice. The individual mood of a given organism, for example, an African-American for sickle cell anemia, for prostate cancer can and should be determined, in particular, using genetic analysis. And then prevention and early treatment measures will be more perfect.

Yuri Zhigalkin: What do you think can be realistically expected as a result of these studies in the coming years?

Daniil Golubev: There is no need to be in captivity of illusions that it is possible to discover the gene for diabetes, schizophrenia, manic-depressive psychosis and, by acting on it, cure a person or prevent a disease. Each of these diseases is the result of a complex set of factors. I think that clarifying the connection between the genetic structure, which ultimately determines everything in the life of the organism, not only of a person, but also of any living being, and pathological processes, will eventually lead to the possibility of controlling these regulatory mechanisms and treatment and rational prevention. But this is not today's, and perhaps not tomorrow's solution to the issue.

Portal "Eternal youth" www.vechnayamolodost.ru20.04.2009

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