A DNA bank where genetic information about prisoners will be stored is just one of the ideas being discussed today. Prof. Michel Rebel talks about future research directions and controversial issues
Tali Tanner, Haaretz 29/6/03
The genes (above) from which proteins are produced that are inserted into the body as a drug to treat multiple sclerosis. Photo: Weizmann Institute
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Biotechnology - the use of living systems to produce products for medicine, food and the environment - is a field that carries a message of hope, says Prof. Michel Rebel from the department of molecular genetics at the Weizmann Institute, winner of the Israel Prize in the field of medical research in 1999 and chief scientist of the "Interfarm" company. The field, which combines mathematical and computer sciences with life sciences, enables great research progress.
Today, Prof. Rebel adds, we are beginning to reap the fruits of the first wave of research in biotechnology, which began in the 80s. These initial studies dealt with the isolation of genes and the production of a protein that is injected into the body and acts as a medicine. Today there are several drugs on the market that work according to these principles, for example a drug to treat multiple sclerosis.
The second wave of research began following the decoding of the human genome. There is an attempt to find the connection between a genetic change in a certain population and diseases. For example: it was found that genes with a certain shape increase the risk of schizophrenia, other genes that have changed increase the risk of breast cancer. An attempt was therefore made to develop drugs that would treat the genetic protein itself that causes the change, even before the development of the disease. Prof. Rebel says that it is possible that in the next decade people will be able to go to the doctor and undergo genetic mapping, and if it is found that they have a genetic tendency to suffer from a certain disease - they will be able to take a medicine that will change the problematic gene.
Another research direction that is still in its infancy is pharmacogenomics - matching the drug to the patient through genetic testing. Medicines bring different results in different people, notes Prof. Rebel; Among other things, side effects develop that can also cause death. The rate of patients dying due to side effects is high. In the future, through genetic mapping, it will be possible to diagnose in advance which populations of patients will respond well to the drug and which will not.
Another direction, which arouses a lot of interest and attention, is the use of embryonic stem cells. This technology is hoped to be used for corrective medicine. According to Prof. Rebel, the differentiation of embryonic stem cells into different tissues and their transplantation into patients will allow significant progress in curing diseases for which no cure has yet been found, such as transplanting cells into the brains of Alzheimer's patients, or as a replacement for damaged pancreatic cells in diabetic patients. So far they have succeeded in producing mouse embryonic stem cells, which produce insulin and can cure diabetes. In the future it will be possible to produce heart muscle cells, transplant them and prevent heart attacks.
The next step in this field will be a transition from simple tissue healing to organ healing. In an experiment done on mice, they succeeded in transplanting stem cells that differentiated and turned into kidney cells. There are also studies that try to test the possibility of restoring some of the nerve cells in the spinal cord in car accident victims.
Many ethical questions arise as a result of this research development, says Prof. Rebel, who also serves as chairman of the bioethics committee. Do not forget that genes indicate a tendency only and there is no genetic writing. Even a person who has a gene that may cause a certain disease will not necessarily develop it. The matter of the environment - such as lifestyle and diet - is also significant. There is a fear that genetic mapping of embryos will cause parents to choose the sex of the newborn or engage in the production of a genetically ideal baby. Using embryonic stem cells for research purposes is also problematic.
In addition to this, there is a question of civil rights and invasion of privacy - can a person's genetic information be taken without their consent? Prof. Rebel talks about a proposal that is being discussed these days, regarding the establishment of a DNA bank where genetic information about prisoners who have served a prison term of more than three years will be stored. If a crime is committed, they will contact the database to try to check if there is a genetic match. These and other issues become clear as the research progresses.
The example of Iceland
The use of small, isolated populations with a relatively homogeneous genetic structure is defined by geneticists as a convenient means of identifying genes. The two commercial ventures that stand out in this regard are those of "Decode", a company that took DNA samples from all of Iceland's 278 citizens, along with their genealogy and medical data, and sold the information to pharmaceutical companies. The second is "ID Gene", an Israeli genomics company that tries to extract information from the DNA of Ashkenazi Jews. After the project was published in "Haaretz", severe criticism arose against the company.
The only similarity between these two repositories and the repository at Ben Gurion University is in the DNA research of closed and small populations. However, the DNA samples in Ben Gurion were collected gradually, over about a decade. The samples were collected each time from one family with a hereditary disease, with the aim of finding the genes for the common diseases in it, and not to exploit them in advance for the benefit of the entire population. While the main goal of private companies is to generate profits, according to the researchers from Ben Gurion, the goal is first of all to benefit the patients. Currently there is no intention to trade the collected samples.
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