November 20, 2024

Zombies in our genes

Zombies in our genes helped us evolve, and could help battle cancers




Viruses are ubiquitous entities that have long plagued humans, often presenting in pesky, self-limiting infections, like a bout of the common cold. While most viral encounters are transient and merely inconvenient, some can have devastating or chronic consequences, leading to severe disease or even death. The recent COVID-19 pandemic and other emerging infectious diseases around us are good examples.

However, this battle between host and pathogen churns up a fascinating question: could viral infections have reshaped the human genome in the process?
Endogenous retroviruses (ERVs)
These remnants of ancient viral infections are embedded in the human genome and are often called "zombie" regions. ERVs were previously thought to be inactive, but recent studies suggest they can play a role in cancer. For example, the LTR10 retroelement in humans is thought to affect the formation of colorectal cancer tumors.

The LIF6 gene

This gene may have helped elephants evolve into their current size by suppressing or eliminating cancerous cells. It's thought that the TP53 gene and the LIF6 gene work together to stop cancer growth by suppressing damaged DNA.

Evolutionary tricks

Researchers can use evolutionary tricks to learn how defunct genes became functional again. For example, researchers can learn how the LIF6 gene was turned back on in elephants.

Here's some more information about ERVs and retroviruses:
Retroviruses are a group of viruses that can integrate and reshape the genomes of the hosts they infect.

ERVs are important for the existence of mammals because they helped the placenta evolve.

Cancer cells express many genes that shouldn't be on, and many of the switches that turn them on come from ancient viruses.

retroviruses, endogenous retroviruses, human evolution, ancient viruses, viral DNA, genetic material, immune system, cancer research, tumor suppression, gene regulation, antiviral defense, molecular biology, genome integration, epigenetics, cancer therapy, immunotherapy, genomic innovation, cellular mechanisms, human genome, evolutionary biology

#ZombiesInOurGenes, #HumanEvolution, #EndogenousRetroviruses, #AncientViruses, #GeneticInnovation, #ImmuneDefense, #CancerResearch, #TumorSuppression, #GeneRegulation, #AntiviralMechanisms, #Epigenetics, #ViralDNA, #GenomeIntegration, #CancerTherapy, #Immunotherapy, #MolecularBiology, #GenomicInnovation, #EvolutionaryBiology, #CellularMechanisms, #HumanGenome

November 19, 2024

Optogenetics

How Optogenetics Can Put the Brakes on Epilepsy Seizures


In what could one day become a new treatment for epilepsy, researchers at UC San Francisco, UC Santa Cruz and UC Berkeley have used pulses of light to prevent seizure-like activity in neurons in brain tissue taken from epilepsy patients as part of their treatment.

Eventually, they hope the technique will replace surgery to remove the brain tissue where seizures originate, providing a less invasive option for patients whose symptoms cannot be controlled with medication.

The team used a method known as optogenetics, which employs a harmless virus to deliver light-sensitive genes from microorganisms to a particular set of neurons in the brain. Those neurons can then be switched on or off with pulses of light.

When the brain is acting normally, neurons send signals at different times and frequencies in a predictable, low-level chatter. But during a seizure, the chatter synchronizes into loud bursts of electrical activity that overwhelm the brain’s casual conversation.

The team used the light pulses to prevent the bursts by switching off neurons that contained light-sensitive proteins.

It is the first demonstration that optogenetics can be used to control seizure-like activity in living human brain tissue, and it opens the door to new treatments for other neurological diseases and conditions.

“This represents a giant step toward a powerful new way of treating epilepsy and likely other conditions,” said Tomasz Nowakowski, PhD, an assistant professor of neurological surgery and a co-senior author of the study, which appears Nov. 15 in Nature Neuroscience.


Subduing epilepsy’s spikes

To keep the surgically removed tissue alive long enough to complete the study, which took several weeks, the researchers created an environment that mimics conditions inside the skull.

John Andrews, MD, a resident in neurosurgery, placed the tissue on a nutrient medium that resembles the cerebrospinal fluid that bathes the brain.

David Schaffer, PhD, a biomolecular engineer at UC Berkeley found the best virus to deliver the genes, so they would work in the specific neurons the team was targeting.

Andrews then placed the tissue on a bed of electrodes small enough to detect the electrical discharges of neurons communicating with each other.
Remote-control experimentation

First, the team needed to find a way to run their experiments without disturbing the tissue. The tiny electrodes were only 17 microns apart – less than half the width of a human hair – and the smallest movement of the brain slices could skew their results.

Mircea Teodorescu, PhD, an associate professor of electrical and computer engineering at UCSC and co-senior author of the study, designed a remote-control system to record the neurons’ electrical activity and deliver light pulses to the tissue.

Teodorescu’s lab wrote software that enabled the scientists to control the apparatus, so the group could direct experiments from Santa Cruz on the tissue in Nowakowski’s San Francisco lab.

That way, no one needed to be in the room where the tissue was being kept.

“This was a very unique collaboration to solve an incredibly complex research problem,” Teodorescu said. “The fact that we actually accomplished this feat shows how much farther we can reach when we bring the strengths of our institutions together.”
New insight into seizures

The technology allowed the team to see that they could stop the seizure-like activity by stimulating a surprisingly small number of neurons as well as determine the lowest intensity of light needed to change the electrical activity.

They were also able to observe how neurons interact while inhibiting a seizure.

These insights provide a deeper understanding of how the approach might be used to tightly regulate brain activity that leads to seizures and could spare patients the invasiveness and side effects of having brain tissue removed, said Edward Chang, MD, the chair of Neurological Surgery at UCSF.

“This kind of approach could really improve care for people with epilepsy,” said Chang, who, along with Nowakowski, is a member of the UCSF Weill Institute for Neurosciences. “We’ll be able to give people much more subtle, effective control over their seizures while saving them from such an invasive surgery.”

neural modulation, light-sensitive proteins, channelrhodopsin, halorhodopsin, optogenetic tools, neuronal circuits, brain mapping, optogenetic stimulation, optical fibers, genetically encoded actuators, neural network dynamics, synaptic plasticity, photocontrol, optogenetic therapy, microbial opsins, optogenetic gene delivery, behavioral neuroscience, functional connectivity, optical neurobiology, neuroengineering,

#Optogenetics, #Neuroscience, #BrainResearch, #NeuralModulation, #LightActivated, #Channelrhodopsin, #BrainMapping, #OpticalNeurobiology, #SynapticPlasticity, #Neurotechnology, #NeuralCircuits, #BrainHealth, #Photocontrol, #GeneDelivery, #OptogeneticTools, #Neuroengineering, #BehavioralNeuroscience, #FunctionalConnectivity, #NeuroscienceResearch, #BrainScience

November 18, 2024

The Great Biologist’s Swansong

The Genetic Book of the Dead by Richard Dawkins review – the great biologist’s swansong



ll things must pass, but some leave legacies. That is the story of life on Earth. Fossilised remains of organisms represent just one of the various treasure troves of information about how life used to be, one set of clues to why it is the way it is today. In the early 20th century, genes entered the storehouse of evidence for evolution, first as theoretical particles, later as the unit of selection, and today with molecular precision. Some 165 years after Darwin’s Origin of Species, evolution by natural selection is incontrovertible, the proof of it irrefutable and bounteous.

Richard Dawkins has done the lord’s work in sharing this radical idea for more than a third of that time, partly through research, but with wider impact in his general writing. This book, one of nearly a dozen he has written about evolution, looks set to be his last (he has called a tour to support it The Final Bow).

The “dead” of the title refers not to our long departed ancestors, whose ancient DNA scientists like me now scrutinise. Instead, it’s a metaphor for genes as artefacts of past organisms and their environments. As ever, Dawkins shines his light on the gene-centric view of evolution – it is not the individual, the population or even species that are the subject of selection, but these units of inheritance composed of DNA. He showcases the effects of nature’s genetic choices in mimicry, camouflage, predation, mating – all areas that have been very well covered elsewhere (not least by Dawkins himself). He does do it well, albeit with the tone of a Victorian gentleman naturalist. All life is in these pages, and by all, I mean almost exclusively cute animals, which make up a vanishingly tiny proportion of life on Earth, but have given us so many of the vital clues to the puzzle of evolution. Bower birds, horned lizards, naked mole rats, cuckoos, mossy frogs, owls and Tasmanian tigers and bears, oh my!

It’s rich throughout and even has pretty pictures. There is, however, an incongruous, score-settling chapter about the debate around the gene-centric view, which I think will be of interest to historians of science, but sits uncomfortably here – like a sore thumb, or in Dawkins’s crabby neologism in response to the fact that sore thumbs don’t stick out, “like a Golden Delicious in a bowl of genuinely delicious apples”. When the gene-centric view emerged, complexities followed, as they always do in biology, to the extent that we don’t all even agree on the definition of a gene. Dawkins plants himself like a tree and gives no quarter. This kind of discussion is highly typical of academia, but it’s a footnote in the story of evolution, and probably should be here too. At least the irascible atheist preacher is absent in these pages. Instead the author is in his element, celebrating the wonder of evolution. The style is Dawkins through and through: professorial, elegant bordering on pompous, reverential to the grandees of evolution.

It would be a lie to say I wasn’t profoundly influenced by his work from the 1980s: I consider The Blind Watchmaker to be his masterpiece, and The Extended Phenotype his best for a more specialised audience. These days, I tell students not to put Dawkins’s work on their personal statements, because if you want to study evolution, you ought to have read him – it is not impressive, it is necessary. But it was the more joyful work of Peter Medawar, Olivia Judson and most of all Steve Jones that compelled me to write about evolution myself – gritty and funny stories about people and families, where the ideas emerge from the bottom up – rather than Dawkins’s shtick: the inspirational public-school teacher for whom the British poetic canon is as important as Darwin (there is plenty of actual poetry in this book). It’s hard not to be aware of the differing backgrounds that gave rise to these two approaches, Jones working class and Welsh, Dawkins the Oxford don, a son of privilege.

This is a wonderful book in so many ways, but I didn’t love it, I think because my tastes in prose have evolved. It feels like the last instalment from a bygone era of grandiloquent science writing, one of which Dawkins was the doyen, the raconteur. It’s a greatest hits, or Dawkins by numbers, depending on your point of view.

If this is indeed Dawkins’s “swansong”, as he has hinted, then I don’t think many of us would mind too much if it was a Status Quo-style final tour that rolled on for a while yet, faithful to his obstinate advocacy for Darwin’s momentous idea. Ultimately, the fate of all organisms, according to the fixed laws of evolution, is extinction. But future scientists will surely study the words of Richard Dawkins long after he has succumbed to the forces he has done so much to celebrate.

Richard Dawkins, The Genetic Book of the Dead, evolutionary biology, natural selection, genetic legacy, evolutionary theory, biologist swansong, adaptation, genetic blueprint, evolutionary innovation, science writing, evolutionary dynamics, genetic heritage, biological diversity, Darwinian principles, genetics and evolution, species survival, evolutionary mechanisms, population genetics, evolutionary adaptation, evolutionary storytelling

#RichardDawkins, #TheGeneticBookOfTheDead, #EvolutionaryBiology, #NaturalSelection, #Genetics, #Adaptation, #BiologicalDiversity, #ScienceWriting, #EvolutionaryMechanisms, #PopulationGenetics, #DarwinianTheory, #EvolutionaryScience, #GeneticLegacy, #EvolutionaryTheory, #EvolutionaryStorytelling, #SpeciesSurvival, #GeneticBlueprint, #EvolutionaryAdaptation, #BiologistSwansong, #EvolutionaryDynamics

November 16, 2024

Genetic Lung Diseases

Transformative treatments for children with fatal genetic lung diseases


Inherited SP-B deficiency is a genetic disorder affecting approximately 1 in 1 million newborns in the US and Europe. It results from mutations in the SP-B gene, which is essential for lung function and survival.

Current interventions only provide temporary relief, and once genetic diagnosis of SP-B deficiency is confirmed, treatment is usually withdrawn and patients die. The only definitive treatment, lung transplantation, is often not accessible owing to the scarcity of donor organs for newborns and the risks involved. This leaves few if any viable options for long-term survival.

Professor Deborah Gill says: 'It must be devastating to be told that your newborn baby has a fatal disease for which there is no treatment. Surfactant protein B (SPB) deficiency is a rare disease where a baby is born with severe breathing difficulties. The babies cannot keep their lungs inflated and need mechanical ventilation to help keep them alive. Currently, there is no cure or treatment for this disease, but we think gene therapy could help. We aim to deliver a functional copy of the gene responsible for SPB deficiency deep into the babies' lungs to help them make normal lung surfactant so they can breathe independently.'

AlveoGene, co-founded in 2023 by Professor Deborah Gill and Professor Steve Hyde, is developing a gene therapy known as AVG-002 using its InGenuiTy® platform. This uses a unique lentiviral vector to deliver a functional SP-B gene directly to the neonatal deep lung alveolar region with high efficiency and efficacy via respiratory instillation.

AlveoGene has now been awarded a Rare Pediatric Disease Designation (RPDD) by the US Food & Drug Administration (FDA) for AVG-002. This means that it will receive a rare paediatric disease Priority Review Voucher (PRV) when the designated drug is approved for the associated indication in the paediatric population.

The voucher will reduce the product's review time and accelerate any granted approval and subsequent market entry by at least four months. The PRV may be used by the original recipient, or it can be sold to another company for the purchaser's use, with PRVs recently achieving sales prices of $100-$150 million.

Preclinical data in SP-B gene knock-out mouse models demonstrate that a single dose of AVG-002 extends survival substantially longer when compared with reported data of other SP-B deficiency candidates in development. This offers the possibility of a lifelong treatment from a single administration.

These data are further reinforced by findings that confirm the restoration of normal lung histology and function following AVG-002 treatment in disease-induced lung tissues. AlveoGene is therefore advancing its preparations for the clinical development of AVG-002 in lethal neonatal SP-B deficiency with the possibility of filing for marketing authorisation by 2028.

genetic lung diseases, hereditary pulmonary disorders, cystic fibrosis, alpha-1 antitrypsin deficiency, primary ciliary dyskinesia, idiopathic pulmonary fibrosis, pulmonary surfactant metabolism dysfunction, hereditary hemorrhagic telangiectasia, lung cancer genetics, rare lung diseases, congenital lung malformations, pulmonary hypertension genetics, bronchiectasis genetics, connective tissue disease-related ILD, familial pulmonary fibrosis, interstitial lung disease, lung developmental disorders, genetic testing for lung disease, monogenic lung diseases, genomic medicine in pulmonology,

#GeneticLungDiseases, #PulmonaryGenetics, #CysticFibrosis, #Alpha1AntitrypsinDeficiency, #PrimaryCiliaryDyskinesia, #IdiopathicPulmonaryFibrosis, #SurfactantMetabolism, #HereditaryHemorrhagicTelangiectasia, #LungCancerGenetics, #RareLungDiseases, #CongenitalLungMalformations, #PulmonaryHypertension, #BronchiectasisGenetics, #ILD, #FamilialPulmonaryFibrosis, #InterstitialLungDisease, #LungGenetics, #GeneticTesting, #MonogenicLungDiseases, #GenomicMedicine.


International Conference on Genetics and Genomics of Diseases 

November 15, 2024

X Chromosome loss in older women

Inherited genetic factors may predict the pattern of X chromosome loss in older women


What

Researchers have identified inherited genetic variants that may predict the loss of one copy of a woman’s two X chromosomes as she agesExit Disclaimer, a phenomenon known as mosaic loss of chromosome X, or mLOX. These genetic variants may play a role in promoting abnormal blood cells (that have only a single copy of chromosome X) to multiply, which may lead to several health conditions, including cancer. The study, co-led by researchers at the National Cancer Institute, part of the National Institutes of Health, was published June 12, 2024, in Nature.

To better understand the causes and effects of mLOX, researchers analyzed circulating white blood cells from nearly 900,000 women across eight biobanks, of whom 12% had the condition. The researchers identified 56 common genetic variants—located near genes associated with autoimmune diseases and cancer susceptibility—that influenced whether mLOX developed. In addition, rare variants in a gene known as FBXO10 were associated with a doubling in the risk of mLOX.

In women with mLOX, the investigators also identified a set of inherited genetic variants on the X chromosome that were more frequently observed on the retained X chromosome than on the one that was lost. These variants could one day be used to predict which copy of the X chromosome is retained when mLOX occurs. This is important because the copy of the X chromosome with these variants may have a growth advantage that could elevate the woman’s risk for blood cancer.

The researchers also looked for associations of mLOX with more than 1,200 diseases and confirmed previous findings of an association with increased risk of leukemia and susceptibility to infections that cause pneumonia.

The scientists suggest that future research should focus on how mLOX interacts with other types of genetic variation and age-related changes to potentially alter disease risk.

Who

Mitchell Machiela, Sc.D., M.P.H., Division of Cancer Epidemiology and Genetics, National Cancer Institute

The Study

“Population analyses of mosaic X chromosome loss identify genetic drivers and widespread signatures of cellular selection” appears June 12, 2024, in Nature.

About the National Cancer Institute (NCI): NCI leads the National Cancer Program and NIH’s efforts to dramatically reduce the prevalence of cancer and improve the lives of people with cancer. NCI supports a wide range of cancer research and training extramurally through grants and contracts. NCI’s intramural research program conducts innovative, transdisciplinary basic, translational, clinical, and epidemiological research on the causes of cancer, avenues for prevention, risk prediction, early detection, and treatment, including research at the NIH Clinical Center—the world’s largest research hospital. Learn more about the intramural research done in NCI’s Division of Cancer Epidemiology and Genetics. For more information about cancer, please visit the NCI website at cancer.gov or call NCI’s contact center at 1-800-4-CANCER (1-800-422-6237).

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit nih.gov.

gene editing, genetic markers, genome sequencing, CRISPR technology, genetic mapping, molecular breeding, quantitative trait loci (QTL), genetic diversity, gene expression profiling, functional genomics, genome-wide association studies (GWAS), transgenic crops, epigenetics, genetic resistance, hybrid vigor, molecular markers, phenotypic variation, DNA barcoding, polygenic traits, marker-assisted selection,

#Genetics, #GenomicBreeding, #GeneEditing, #GenomeMapping, #CRISPR, #GWAS, #MolecularBreeding, #Epigenetics, #GenomicSelection, #GeneticDiversity, #MarkerAssistedSelection, #FunctionalGenomics, #Phenotyping, #TransgenicCrops, #QTLMapping, #DNASequencing, #HybridVigor, #GeneExpression, #PlantBreeding, #GeneticImprovement

November 14, 2024

B chromosomes in rye

Genetic study solves the mystery of 'selfish' B chromosomes in rye


Some chromosomes, such as B chromosomes, can increase their inheritance rate to their own advantage. These extra chromosomes are found in many plants, animals, and fungi and rely upon various strategies to avoid being eliminated over time, as most organisms tend to remove non-essential genetic elements.

However, the genetic mechanisms by which B chromosomes avoid elimination are poorly understood. An international research team led by IPK Leibniz Institute identified genes on the rye B chromosome, that are likely responsible for regulating this process. The results were published in Nature Communications.

Supernumerary B chromosomes, unlike A (standard) chromosomes, are not required for the normal growth and development of organisms and as of 2024, B chromosomes have been discovered in almost 3,000 species from all eukaryotic phyla. Most B chromosomes confer no detectable selective consequences at low numbers, but increased numbers can result in phenotypic aberrations and reduced fertility.

To avoid elimination, many B chromosomes influence cell division in their favor and increase their copy number in the process. This phenomenon is called chromosome drive. The "selfish" B chromosomes, therefore, only become active when their existence is at stake and not for the benefit of the plant.

Drive mechanisms in B chromosome systems have been studied in many species and contexts using various technologies, from classical genetics to cytogenetics.

But despite being an ideal test case to study the underlying mechanisms of the chromosome drive, B chromosome research has only slowly been able to capitalize on the data explosion of the DNA sequencing boom. B chromosomes are highly structurally complex, repetitive, and multitudinous, all of which make them resistant to pseudomolecule-level chromosome assembly, especially before recent developments in the area of long-read sequencing.

As such, gene-level insight into the specific mechanisms that control chromosome drive is severely limited, and specific gene candidates implicated in this phenomenon have not been identified so far.

To identify drive-controlling factor(s) on the rye B chromosome, an international research team led by the IPK Leibniz Institute first narrowed down the size of the drive-control region.

Next, the researchers used long DNA reads and assembled the rye B chromosome into a single ~430 Mb-long pseudomolecule and performed a detailed transcriptome analysis.

"Using a newly-assembled B chromosome pseudomolecule, we identified five candidate genes whose role as moderators of chromosome drive is supported by additional studies," explains Jianyong Chen, first author of the study.

"The DCR28 gene, which is presumably responsible for regulating this process, stood out," emphasizes Prof. Andreas Houben, head of IPK's research group "Chromosome Structure and Function." Furthermore, it was shown that the B chromosome originated from fragments of all seven rye standard A chromosomes.

These findings could also be helpful for research into genetic diseases that are based on the unequal distribution of chromosomes.

genetic diversity, chromosomal variation, rye genome, B chromosomes, supernumerary chromosomes, gene expression, genome instability, chromosomal inheritance, non-Mendelian inheritance, chromosomal drive, adaptive evolution, chromatin structure, cytogenetics, nucleolar organizing regions, gene silencing, molecular markers, DNA amplification, heterochromatin, karyotype evolution, plant genetics,

#Genetics #BChromosomes #ChromosomeVariation #RyeGenomics #SupernumeraryChromosomes #GeneExpression #GenomeInstability #NonMendelian #ChromosomalInheritance #EvolutionaryBiology #PlantGenetics #Cytogenetics #GeneSilencing #AdaptiveEvolution #MolecularMarkers #ChromatinStructure #Heterochromatin #Karyotype #NucleolarOrganization #Rye

November 13, 2024

Genetic Discrimination

Genetic Discrimination Is Coming for Us All


Insurers are refusing to cover Americans whose DNA reveals health risks. It’s perfectly legal.
By Kristen V. Brown

The news came four years ago, at the end of a casual phone call. Bill’s family had always thought it was a freak coincidence that his father and grandfather both had ALS. But at the end of a catch-up, Bill’s brother revealed that he had a diagnosis too. The familial trend, it turned out, was linked to a genetic mutation. That meant Bill might also be at risk for the disease.

An ALS specialist ordered Bill a DNA test. While he waited for results, he applied for long-term-care insurance. If he ever developed ALS, Bill told me, he wanted to ensure that the care he would need as his nerve cells died and muscles atrophied wouldn’t strain the family finances. When Bill found out he had the mutation, he shared the news with his insurance agent, who dealt him another blow: “I don’t expect you to be approved,” he remembers her saying.

Bill doesn’t have ALS. He’s a healthy 60-year-old man who spends his weekends building his dream home by hand. A recent study of mutations like his suggests that his genetics increase his chances of developing ALS by about 25 percent, on average. Most ALS cases aren’t genetic at all. And yet, Bill felt like he was being treated as if he was already sick. (Bill asked to be identified by his first name only, because he hasn’t disclosed his situation to his employer and worried about facing blowback at work too.)

What happened to Bill, and to dozens of other people whose experiences have been documented by disease advocates and on social media, is perfectly legal. Gaps in the United States’ genetic-nondiscrimination law mean that life, long-term-care, and disability insurers can obligate their customers to disclose genetic risk factors for disease and deny them coverage (or hike prices) based on the resulting information. It doesn’t matter whether those customers found out about their mutations from a doctor-ordered test or a 23andMe kit.

For decades, researchers have feared that people might be targeted over their DNA, but they weren’t sure how often it was happening. Now at least a handful of Americans are experiencing what they argue is a form of discrimination. And as more people get their genomes sequenced—and researchers learn to glean even more information from the results—a growing number of people may find themselves similarly targeted.

When scientists were mapping the immense complexity of the human genome around the turn of the 21st century, many thought that most diseases would eventually be traced to individual genes. Consequently, researchers worried that people might, for example, get fired because of their genetics; around the same time, a federal research lab was sued by its employees for conducting genetic tests for sickle-cell disease on prospective hires without their explicit consent. In 2008, the Genetic Information Nondiscrimination Act (GINA) was signed into law, ensuring that employers couldn’t decide to hire or fire you, and health insurers couldn’t decide whether to issue a policy, based on DNA. But lawmakers carved out a host of exceptions. Insurers offering life, long-term-care, or disability insurance could take DNA into account. Too many high-risk people in an insurance pool, they argued, could raise prices for everyone. Those exceptions are why an insurer was able to deny Bill a long-term-care policy.

Cases like Bill’s are exactly what critics of the consumer-genetic-testing industry feared when millions of people began spitting into test tubes. These cases have never been tallied up or well documented. But I found plenty of examples by canvassing disease-advocacy organizations and social-media communities for ALS, breast cancer, and Huntington’s disease. Lisa Schlager, the vice president of public policy at the hereditary-cancer advocacy group FORCE, told me she is collecting accounts of discrimination in life, long-term-care, and disability insurance to assess the extent of the problem; so far, she has about 40. A man Schlager connected me with, whose genetic condition, Lynch syndrome, increases the risk for several cancers, had his life-insurance premium increased and coverage decreased; several other providers denied him a policy altogether. Kelly Kashmer, a 42-year-old South Carolina resident, told me she was denied life insurance in 2013 after learning that she had a harmful version of the BRCA2 gene. One woman I found via Reddit told me she had never tested her own DNA, but showed me documents that demonstrate she was still denied policies—because, she said, her mom had a concerning gene. (Some of the people I spoke with, like Bill, requested not to be identified in order to protect their medical privacy.)

Studies have shown that people seek out additional insurance when they have increased genetic odds of becoming ill or dying. “Life insurers carefully evaluate each applicant’s health, determining premiums and coverage based on life expectancy,” Jan Graeber, a senior health actuary for the American Council of Life Insurers, said in a statement. “This process ensures fairness for both current and future policyholders while supporting the company’s long-term financial stability.” But it also means people might avoid seeking out potentially lifesaving health information. Research has consistently found that concerns about discrimination are one of the most cited reasons that people avoid taking DNA tests.

For some genetically linked diseases, such as ALS and Huntington’s disease, knowing you have a harmful mutation does not enable you to prevent the potential onset of disease. Sometimes, though, knowing about a mutation can decrease odds of severe illness or death. BRCA mutations, for example, give someone as much as an 85 percent chance of developing breast cancer, but evidence shows that testing women for the mutations has helped reduce the rate of cancer deaths by encouraging screenings and prophylactic surgeries that could catch or prevent disease. Kashmer told me that her first screening after she discovered her BRCA2 mutation revealed that she already had breast cancer; had she not sought a genetic test, she may have gotten a policy, but would have been a much worse bet for the insurer. She’s now been cancer-free for 11 years, but she said she hasn’t bothered to apply for a policy again.

Read: Remember that DNA you gave 23andMe?

Even employers, which must adhere to GINA, might soon be able to hire or fire based on certain genetic risk factors. Laura Hercher, a genetic counselor and director of research at the Sarah Lawrence College Human Genetics Program, told me that some researchers are now arguing that having two copies of the APOE4 mutation, which gives people about a 60 percent chance of developing Alzheimer’s, is equivalent to a Stage Zero of the disease. If having a gene is considered equivalent to a diagnosis, do GINA’s protections still apply? The Affordable Care Act prevents health insurers from discriminating based on preexisting conditions, but not employers and other types of insurers. (The ACA may change dramatically under the coming Trump presidency anyway.) And the Americans With Disabilities Act might not apply to the gray area between what might be viewed as an early manifestation of a disease and the stage when it’s considered a disability. FORCE and other advocacy groups—including the ALS Association and the Michael J. Fox Foundation—as well as members of the National Society of Genetic Counselors, are working in a few states to pass laws that close gaps left by GINA, as Florida did in 2020, but so far they have been mostly unsuccessful.

Genetic testing has only just become common enough in the U.S. that insurers might bother asking about it, Hercher said. Recently, groups like Schlager’s have been hearing more and more anecdotes. “People are so worried about genetic discrimination that they are failing to sign up for research studies or declining medically recommended care because of the concerns of what could happen to their insurance,” Anya Prince, a professor at the University of Iowa College of Law, told me. Carolyn Applegate, a genetic counselor in Maryland, told me that when patients come to her worried about a hereditary disease, she typically advises them to line up all the extra coverage they might need first—then hand over their DNA to a lab.

So far, these unintended consequences of genetic testing seem to be manifesting for people with risk for rare diseases linked to single genes, which, combined, affect about 6 percent of the global population, according to one estimate. But the leading killers—heart disease, diabetes, and the like—are influenced by a yet unknown number of genes, along with lifestyle and environmental factors, such as diet, stress, and air quality. Researchers have tried to make sense of this complex interplay of genes through polygenic risk scores, which use statistical modeling to predict that someone has, say, a slightly elevated chance of developing Alzeheimer’s. Many experts think these scores have limited predictive power, but “in the future, genetic tests will be even more predictive and even more helpful and even more out there,” Prince said. Already, if you look deep enough, almost everyone’s genome registers some risk.

In aggregate, such information can be valuable to companies, Nicholas Papageorge, a professor of economics at Johns Hopkins University, told me. Insurers want to sell policies at as high a price as possible while also reducing their exposure; knowing even a little bit more about someone’s odds of one day developing a debilitating or deadly disease might help one company win out over the competition. As long as the predictions embedded in polygenic risk scores come true at least a small percentage of the time, they could help insurers make more targeted decisions about who to cover and what to charge them. As we learn more about what genes mean for everyone’s health, insurance companies could use that information to dictate coverage for ever more people.

Bill still doesn’t know whether he will ever develop ALS. The average age of onset is 40 to 60, but many people don’t show symptoms until well into their 70s. Without long-term-care insurance, Bill might not be able to afford full-time nursing care if he someday needs it. People who do develop ALS become unable to walk or talk or chew as the disease progresses. “Moving people to the bathroom, changing the sheets, changing the bedpans,” Bill said—“I dread the thought of burdening my wife with all of those things.”

Cases like Bill’s could soon become more common. Because scientists’ understanding of the human genome is still evolving, no one can predict all of the potential consequences of decoding it. As more information is mined from the genome, interest in its secrets is sure to grow beyond risk-averse insurers. If consumer-facing DNA-testing companies such as 23andMe change their long-standing privacy policies, go bankrupt, or are sold to unscrupulous buyers, more companies could have access to individuals’ genetic risk profiles too. (23andMe told me that it does not share customer data with insurance companies and its CEO has said she is not currently open to third-party acquisition offers.) Papageorge told me he could imagine, say, scammers targeting people at risk for Alzheimer’s, just as they often target older people who may fall for a ploy out of confusion. All of us have glitches somewhere in our genome—the question is who will take advantage of that information.

Genetic information, Genetic privacy, Employment discrimination, Insurance discrimination, Genetic testing, Genomic data, Personal genomics, Genetic counseling, Health disparities, DNA profiling, Bioethics, Medical privacy, Hereditary conditions, Genetic risk, Data protection, Genomic research, Health equity, Predictive genetics, Ethical guidelines, Patient rights,

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