This article was published in the U-T San Diego on December 2, 2013.  To view the article on that site, click here.

GENETIC TESTING POISED TO SHAPE LIFE DECISIONS

Greater availability of DNA analysis could play into whom to marry, whether to have children

By Gary Robbins12:01 a.m.Dec. 2, 2013

As if love weren’t complicated enough, there’s an emerging wrinkle that could make you rethink marriage, child-bearing or even flirting with someone you have a crush on.

The New Yorker magazine pithily summed it up in a recent cartoon that shows a couple happily exchanging wedding vows. The caption reads: “Do you, Ashley, accept Nesbitt and his genome to be your husband?”

A society-shaking convergence is underway, and it’s being stoked in part by San Diego’s huge science industry.

Big leaps in technology are making it quicker and easier for people to get a look at their DNA. There’s more and more of such data becoming available — and at cheaper and cheaper prices. Schools like the University of California San Diego are drowning in genetic information as they explore which genes might hurt us and why.

Companies such as 23andMe and Ancestry.com have been simplifying the genetic information they sell to the mass consumer.

And celebrities like Angelina Jolie are making things personal. In May, the actress announced that genetic testing had revealed that she has a high risk of breast cancer, leading her to get a double mastectomy.

The “personal genomics” movement stumbled a bit last week when the U.S. Food and Drug Administration told 23andMe to stop selling its $99, consumer-oriented DNA analysis kits because of concerns about the accuracy of those tests.

The FDA action could be a blip for the industry, which continues to see new companies entering the market. This month, GenePeeks plans to launch a commercial service that checks whether a particular woman is a good genetic match with a particular sperm donor. The service is already generating chatter on dating websites, which give rise to one-third of the marriages in the U.S.

“I can see a future where people who use online dating services like Match.com say, ‘I want to see your genetic screening profile,’” said Val Catanzarite, chief of maternal fetal medicine at the San Diego Perinatal Center. “Some people say this isn’t how love works. But when you use an online service, you’re already screening for characteristics. People are going to begin asking about genes, and that’s not far away.”

Cinnamon Bloss strikes a cautionary note.

“We are a ways from seeing low- and middle-income people having easy, routine access to their genomic information, especially if they are not educated or savvy enough to seek it out,” said Bloss, director of social sciences and bioethics at the Scripps Translational Science Institute in La Jolla.

“But I agree with the sentiment that genome testing will become ubiquitous in health care eventually, and genetics will definitely play a large role in how couples think about planning a family,” she added.

The potential implications are getting plenty of attention at places such as the University of San Diego, where professor Larry Hinman raises the issue in his bioethics class.

Among the questions: Is genetic testing a romantic buzzkill?

Melissa Georgi, a senior, said during a recent class: “I think it is important to understand each other’s genome going into a marriage. But if (my boyfriend) had a predisposition toward some disease, I would look at every option for helping him. I believe in love more than I believe in giving up on someone based on genetics.”

Couples are just as concerned about the health of any children they might have.

For example, the Jewish community has been especially active in urging people of Jewish heritage to undergo screening for the defective gene that causes Tay-Sachs disease, a neurological disorder. If both parents have the gene, there’s a one in four chance their child will develop Tay-Sachs.

The idea of deeper genetic screening across all levels of society is occurring partly because of advances in the technology used to examine all or part of a person’s genetic makeup. Those advances have driven down prices: In 2007, it cost $9 million to sequence a person’s entire genome. Today, the figure is about $5,000.

The market is dominated by Illumina of San Diego and Life Technologies of Carlsbad, which are developing gene-sequencing machines that are increasingly fast and accurate, as well as less expensive.

Such innovation has made direct-to-consumer genomics possible.

Until the new FDA order, the Mountain View-based 23andMe had broken through a key price barrier by charging $99 for each consumer test kit. The company examined a saliva sample from each customer for genes related to about 250 health conditions and traits. The analysis also revealed how well that individual might respond to certain medications, including the blood thinner warfarin.

“I’m sure that (23andMe) will be replaced by a similar product that is validated regarding accuracy,” Catanzarite said.

In Cambridge, Mass., GenePeeks hopes to form a niche by screening potential sperm donors for about 600 genes associated with childhood diseases. The service, which costs about $2,000, would help women find someone whose genome meshes well with theirs.

Bloss said some people have accused GenePeeks of trying to create designer babies. But she noted, “They’re not trying to screen for hair color or height or IQ. This screening is for things that could cause severely debilitating, life-threatening genetic diseases. This isn’t ‘Gattaca.’”

Bloss was referring to the 1997 sci-fi film that portrays a world in which people can improve their genetic makeup. Those who don’t are consigned to an underclass.

Such tinkering isn’t expected to become routine in the short term; scientists are just beginning to understand human genetics. But change is coming.

Almost all of the 4 million babies born in this country each year are screened for 30 to 40 worrisome genes. The federal government is considering whether to expand that list to hundreds of genes, possibly by the end of this decade.

The testing is likely to spur the kind of conversation that Yasmine Hachimi, a junior at the University of San Diego, recently had with her boyfriend.

“He just openly asked me, ‘Hey, what diseases run in your family?’ I think he was concerned because my grandmother had Alzheimer’s,” Hachimi said. “I don’t know whether this sort of thing will affect whether people decide to terminate their relationships, but it is a good idea to educate yourself.”

Life Technologies is working to develop better sequencing machines so everyone — from scientists to consumers — has a better understanding of genetics. But Dr. Paul Billings, the company’s chief medical officer, urges people to keep things in perspective.

“There’s no such thing as a perfect baby or a perfect wife or a perfect husband,” he said. “The idea that you can better choose a mate based on their genetic fitness is mythological and fanciful. Hanging out with a person is better than checking their genome.”

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