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genomictestingformentalillness.harishsager.pptxBy Harish Sager
Genomic Testing for Mental Illness
DNA
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DNA (deoxyribonucleic acid) is the hereditary material located in the cell nucleus and mitochondria of most organisms. DNA provides the information necessary for cells of an organism to be built. This information is stored as code consisting of four chemical bases: adenine (A), guanine (G), cytosine (C) and thymine (T). The order of these bases provides the information needed for building an organism
https ://ghr.nlm.nih.gov/primer/basics/dna
-DNA – -The blueprint for organisms
-DNA – -The blueprint for organisms
The bases A and T pair together and the bases C and G pair together, forming base pairs. These pairs are attached with sugar and phosphate molecule together, forming a nucleotide. Nucleotides are arranged in two long strands that form the double helix spiral. DNA strands can make identical copies of itself (NIH, 2016).
https://ghr.nlm.nih.gov/primer/basics/dna
The difference between Genomics and Genetics
Genomics is not to be confused with genetics. Genetics is the study of heredity and the composition of DNA, whereas genomics is the study of the complete set of genetic material in an organism (OxfordDictionary, n.d.), this is referred to as the genome. The genome is analyzed by using math techniques and powerful computing to analyze a staggering amount of DNA sequences. These patterns provide data to determine variations that affect health, disease or drug response.
Approximately 61.5 million Americans, one fourth of the U.S. population, suffer from mental illness at some point in their lives. About 13.6 million Americans have a chronic mental illness such as schizophrenia, bipolar disorder and clinial depression.
http://www2.nami.org/factsheets/mentalillness_factsheet.pdf
The are various causes of mental illness. Family genetics can be a contributing factor, however, experiential factors in life, such as psychological trauma, stress, abuse and drug use. It is due to these various factors that mental illness can be very challenging to treat. At times, many of these factors overlap. Counseling and medications can address different aspects of mental illness.
Image source: (Image Source: Debby Tsuang, M.D., M.Sc., University of Washington/VAPSHCS)
For many people with psychological challenges, talk therapy can resolve a significant issues. However, with more serious illnesses, medication along with counseling is necessary.
Germline GeneTherapy
Somatic Gene Therapy
Germline gene therapy enables disease-causing gene variants to be corrected. It is carried out by transferring DNA into cells that produce reproductive cells in the body.
This therapy focuses on body (somatic) cells, that affect only an individual and cannot be passed to an offspring
Two Types of Gene Therapy
http://www.angelfire.com/hi3/germline/
http://www.open.edu/openlearn/science-maths-technology/science/biology/gene-therapy/content-section-3
Genomics strives to have a comprehensive understanding of the genome (an organisms entire genetic makeup) interacts with environmental, non-genetic factors. These factors can include a person’s lifestyle, diet, exposure to hazardous conditions and other conditions. Since mental illness, like cancer and diabetes, is not monogenic, that is, it has multiple potential causes; testing for such illness can be challenging but genomics can help in comprehension.
http://depts.washington.edu/cgph/GenomicsGenetics.htm
Genomics
In 1990, the U.S. Department of Energy and the National Institutes of Health initiated the Human Genome Project, which was completed in 2003. The goals of the project were to “identify all the approximately 20,000-25,000 genes in human DNA; determine the sequences of the 3 billion chemical base pairs that make up human DNA; store this information in databases; improve tools for data analysis; transfer related technologies to the private sector, and address the ethical, legal, and social issues (ELSI) that may arise from the project” (University of Washington, n.d.).
http://depts.washington.edu/cgph/GeneticTestingGlossary.htm#Humangenome
Human Genome Project
Trial and error with medication can be a harrowing procedure for patients.
In the past, the efficacy of psychiatric drugs was greatly a matter of trial and error. This method may eventually find a suitable prescription for the patent, but sometimes no drug may alleviate the symptoms. Even in the case that a effective medication is found, the paitent often has to go through a harrowing process of dealing with symptoms such as psychosis, severe depression and suicidal thoughts. Often the medication changes have to be done while the patient is in a psychiatric ward, greatly disturbing their life.
Pharmacogenomics determines how a person’s genetic makeup affects their reaction to specific drugs. This information is very useful since it provides an alternative to the trial and error method of the past. Pharmacogenomics combines “biochemistry with annotated knowledge of genes, proteins and single nucleotide polymorphisms” (University of Washington, n.d.). In many cases, an appropriate medication is found for a patient through this information, greatly decreasing the length of the process and sparing the patient from symptoms of the illness.
http://depts.washington.edu/cgph/GeneticTestingGlossary.htm#Humangenome
Pharmacogenomics
Matching patients to medications
Finding the effective medication for psychiatric symptoms can be a tedious process of trial and error. Many medications may not be effective for patients of certain genetic makeup. Genomic testing can help make this process much more efficient.
How tests and treatments work together
DNA is collected for testing by rubbing a swab inside the cheek od a patient. The DNA is analyzed for different variations of genes that affect the overall responses to different medications. This test allows for better prescribed medications, unique for each patient.
Using gene testing to prescribe effective medications is an increasing tread recently. Over 600,000 such tests have been administered between the years 2012 and 2015 (Daley, 2015). Due to the increasing popularity of this testing and the approval from the medical community, Medicare has started to agree with payment for gene testing in some situations. Genomic testing also liberates patients from the stigma of mental illness, because it helps isolate biological sources for the illness. However, psychiatric genetics is a new field and therefore a lack of regulation has caused concern regarding the ethics of testing. Such testing is expensive is a potential area of exploitation of insurance. The Food and Drug Administration (FDA) plans to regulate gene testing in the future (Daley, 2015).
The Indiana University School of Medicine has done research that devised a test that will allow the determination of the likelihood of a person developing schizophrenia.
The National Human Genome Research Institute (NHGRI) has a future goal of incorporating genomic medicine with mainstream healthcare to address disease on individual levels.
https://www.genome.gov/17516574/the-future-of-genomic-medicine-policy-implications-for-research-and-medicine/
http://www.csmonitor.com/USA/Justice/2012/0724/Colorado-shooting-No-cameras-for-suspect-s-next-appearance-judge-rules-video
Mental illness is a very significant issue that has been neglected in our society due to various reasons. In recent times, many acts of violence have been committed by individuals that have untreated mental illness. It is extremely important to no longer sweep such things under the rug.
With the modern day’s improved attitude towards mental illness and the hope of genomic testing assisting in the proper use of medication, there is hope for mentally ill individuals to live happy healthy lives in the future.
Resources
Daley, Beth. ( October 3, 2015). Are genetic mental health test causing ,more harm than good? The EYE. Retrieved April 2, 2016 from http://eye.necir.org/2015/10/03/are-genetic-mental-health-tests-causing-more-harm-than-good-documentation/
Duckworth, Ken. ( March 2013). Mental Illness: Facts and Numbers. NAMI. Retrieved April 1, 2016 fromhttp ://www2.nami.org/factsheets/mentalillness_factsheet.pdf
Rattue, Grace. (May 19, 2012). Genetic Test May Predict Risk of Schizophrenia. MNT. Retrieved April 2, 2016 from http://www.medicalnewstoday.com/articles/245591.php
Goodale, Gloria. ( July 24, 2012). Colorado shooting: No cameras for suspect's next appearance, judge rules. Christian Science Monitor. Retrieved April 1, 2016 from http://www.csmonitor.com/USA/Justice/2012/0724/Colorado-shooting-No-cameras-for-suspect-s-next-appearance-judge-rules-video
U.S. National Library of Medicine. (April 20, 2016). What is DNA? NIH. Retrieved April 20, 2016 from https://ghr.nlm.nih.gov/primer/basics/dna
University of Washington. (N.D.). Genomics vs. Genetics: What’s the Difference? Center for Genomics and Public Health. University of Washington. Retrieved April 1, 2016 from http://depts.washington.edu/cgph/GenomicsGenetics.htm
University of Washington. (N.D.). Glossary of Acronyms and Terms. University of Washington. Retrieved April 1, 2016 from http://depts.washington.edu/cgph/GenomicsGenetics.htm
(N.A.). (November 16, 2005). The Future of Genomic Medicine: Policy Implications for Research and Medicine. National Human Genome Research Institute. Retrieved April 1, 2016 from https://www.genome.gov/17516574/the-future-of-genomic-medicine-policy-implications-for-research-and-medicine/
