A Genetic Carol – the Ghosts of Genetics Past, Present and Future

“Jacob called for his sons and said, "Gather together so I can tell you what will happen to you in the future.”  Gen 49:1 NET Bible 

In Charles Dickens’s A Christmas Carol, Ebenezer Scrooge is visited by the ghost of Jacob Marley. Marley tells Scrooge that he will be visited by three ghosts to better understand the man he has become and what the future will bring.  The first spirit, the Ghost of Christmas Past, shows Scrooge how his past, his youth has made him who he is.   The Ghost of Christmas Present shows him his present situation from an outsider’s point of view – giving him a new prospective.  Finally, The Ghost of Christmas Yet to Come, shows Scrooge “a” fate that awaits him.  

Ian Morris’s book Why the West Rules--for Now: The Patterns of History, and What They Reveal About the Future, he writes, “Scrooge’s Question At the climax of Charles Dickens’s A Christmas Carol, the Ghost of Christmas Yet to Come brings Ebenezer Scrooge to a weed-choked churchyard.  Silently, the Ghost points out an untended tombstone.  Scrooge knows his name will be on it; he knows that here, alone, unvisited, he will lie forever.  … Confronted with his own epitaph, Scrooge fell to his knees. “Good Spirit,” he begged, grabbing the specter’s hand, “assure me that I yet may change these shadows you have shown me, by an altered life!” Christmas Yet to Come said nothing, but Scrooge worked out the answer for himself.  He had been forced to spend an uncomfortable evening with the Ghosts of Christmas Past and Christmas Present because he needed to learn from both of them.  “I will not shut out the lessons that they teach,” Scrooge promised.  “Oh, tell me I may sponge away the writing on this stone!” 

Wellness and healthcare are about to become very personal as each one of us may be visited by the ghosts of Genetics Past, Present and Future.  In each one of your ~37 trillion cells (other than red blood cells) is a story about your past, your parents, and your ancestors and how they came to the United States.  For some, it is a story of what they have done – what crimes they or their relatives have committed.  There is also a story of you and your children’s current health and health future or at least a shadow of that health future.   In the past, these stories have been a mystery, but that is changing with low cost genetic sequencing of your DNA and even your baby’s DNA in the womb. 

Already 23andme has done over 1 million genotyping tests. https://www.23andme.com/more/genotyping/

 It is estimated that “as many as 1 billion people will have their full genomes sequenced over the course of the next decade and by 2025, genetics researchers will be producing somewhere between 2 and 40 exabytes (Billion Billon Bytes 10^18) of data every year.” https://www.sciencealert.com/genetic-data-storage-approaching-crisis-point-growing-faster-than-youtube

Let us consider the 3 Ghosts of Genetics:

Ghost of Genetics Past

In the book, Survival of the Sickest by Sharon Moalem, he write, “This is a book about mysteries and miracles. About medicine and myth…. it’s a book about life— yours, ours, and that of every little living thing under the sun.  About how we all got here, where we’re all going, and what we can do about it.”  

As outlined in the 3 books, DNA USA: A Genetic Portrait of America; Adam's Curse: A Future without Men and; The Seven Daughters of Eve: The Science That Reveals Our Genetic Ancestry by Bryan Sykes, the collection of DNA is telling a story of the start and migration of humanity through time.  There are a number of genetic ancestry companies that will let you know where you ancestors came from and who your biological relatives are.  For some, they learn a “new” history of their or their families past.  https://blogs.discovermagazine.com/gnxp/2010/06/the-paternity-myth-the-rarity-of-cuckoldry/#.VdtS6_lViko

One story I hope that we will better realize as a society by understanding our DNA is that we are all related and the only race is the human race.  Consider the words of Martin Luther King, Jr., “I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character. …  little black boys and black girls will be able to join hands with little white boys and white girls as sisters and brothers.”

Ghost of Genetics Present

A recent Economist article stated, “To date, medicine has recognised about 6,000 diseases that can be traced to a problem with one or another of those genes—a disorder in which a missing or garbled sequence of DNA leaves the body unable to make a particular protein, or causes it to be made in an abnormal form.” https://www.economist.com/news/briefing/21661799-it-now-easy-edit-genomes-plants-animals-and-humans-age-red-pen

Genetic testing will give us a new perspective on our health.  I am concern that without proper understanding of this information, some people will be more stressed out.  A medical joke goes: What the definition of a healthy person?  Answer: someone who has not been tested enough.  If you look hard enough at your DNA, you are sure to fine something to be concerned with. 

We need to understand genetic testing in the context of what maximizes our overall health.  I am a big believer in the best way to maximize health is to do what our mothers told us long ago: eat right, exercise, get plenty of rest, do not smoke or do drugs; drink in moderation (ok, my Mom did not say this to me when I was 10), do not do stupid things (i.e. do not play with matches and gasoline even if Jimmy B. is doing it - I have lots of Jimmy B. stories when I was young), make friends, go outside and play (but be careful - especially when playing with Jimmy B.) and do not stress out about life.  This advice will not solve all health problems but they could make a big difference.  In the end, we will all die.  Focus on the things you can control and do not stress about the things you cannot.  Remember stress can cause illness. “Can any one of you by worrying add a single hour to your life” Matt 6:27

So when the Ghost of Genetics Present shows you information about yourself, use the information to maximize the health you have been given and live your life to the fullest.

“Yesterday's the past, tomorrow's the future, but today is a gift.  That's why it's called the present.” - Bil Keane

Ghost of Genetics Future

In Matt Ridley book, Genome: The Autobiography of a Species in 23 Chapters, in the chapter on fate, he writes “Open any catalogue of the human genome and you will be confronted not with a list of human potentialities, but a list of diseases, mostly ones named after pairs of obscure central-European doctors. This gene causes Niemann— Pick disease; that one causes Wolf— Hirschhorn syndrome. The impression given is that genes are there to cause diseases....  Yet to define genes by the diseases they cause is about as absurd as defining organs of the body by the diseases they get: livers are there to cause cirrhosis, hearts to cause heart attacks and brains to cause strokes.  It is a measure, not of our knowledge but of our ignorance that this is the way the genome catalogues read.”

With genetic testing, not only are we confronted with our current health but we learn the probability of the risk of developing “future” diseases because of the information we find in our DNA testing.  As an example, “After hearing about film star Angelina Jolie's double mastectomy [because of the high probability of cancer because of her DNA] , a growing number of U.S. women now say they may ask their doctors whether the same preventive measure is right for them, according to a new Harris Interactive/HealthDay poll.

The survey of nearly 1,100 U.S. women, conducted in mid-July, found that almost all women (86 percent) had heard of Jolie's double mastectomy. And 5 percent of those women said they would seek medical advice on having a preventive mastectomy or ovary removal because of Jolie's decision.   That may seem like a small percentage, but it translates to about 6 million women nationwide, noted Harris Poll chairman Humphrey Taylor”.  https://consumer.healthday.com/cancer-information-5/breast-cancer-news-94/more-women-consider-gene-test-after-angelina-jolie-mastectomy-revelation-679159.html

But, with the possibility “to edit genetic information quickly and cheaply,” we “may sponge away the writing on this stone.”  In the Economist article, Editing humanity - A new technique for manipulating genes holds great promise—but rules are needed to govern its use, they write, “The genome is written in an alphabet of just four letters.  Being able to read, study and compare DNA sequences for humans, and thousands of other species, has become routine.  A new technology promises to make it possible to edit genetic information quickly and cheaply.  This could correct terrible genetic defects that blight lives.  It also heralds the distant prospect of parents building their children to order.

The technology is known as CRISPR-Cas9, or just CRISPR. It involves a piece of RNA, a chemical messenger, designed to target a section of DNA; and an enzyme, called a nuclease, that can snip unwanted genes out and paste new ones in. Other ways of editing DNA exist, but CRISPR holds the promise of doing so with unprecedented simplicity, speed and precision.”

https://www.economist.com/news/leaders/21661651-new-technique-manipulating-genes-holds-great-promisebut-rules-are-needed-govern-its

Some genes that could be targeted are listed in the following article:

“10 super-genes that scientists could someday program into your body

1. A variant that codes for extra-strong bones (LRP5 G171V/+).
2. A variant that codes for lean muscles (MSTN).
3. A variant that makes people less sensitive to pain — something that could be dangerous, as pain can be a useful warning signal, but may be helpful in some contexts (SCN9A).
4. A variant that's associated with low odor production (ABCC11).
5. A variant that makes people more resistant to viruses (CCR5, FUT2).
6. A variant that's connected to a low risk of coronary disease (PCSK9).
7. A variant that's associated with a low risk of Alzheimer's disease (APP A673T/+).
8. A variant that's associated with a low cancer risk (GHR, GH).
9. A variant that's associated with a low risk of type 2 diabetes (SLC30A8).
10. A variant that's associated with a low risk of type 1 diabetes (IFIH1 E627X/+).”

https://www.businessinsider.com/gene-edits-to-make-you-stronger-and-healthier-2015-4#ixzz3jko9ehuQ

I am excited about projects like the Cancer Genome Atlas project that is working to better understand and treat cancer.  “The deadly scourge of cancer has confounded doctors since ancient Egypt.  Now, The Cancer Genome Atlas (modeled after the Human Genome Project) promises a new and powerful approach in this age-old battle.”  https://www.youtube.com/watch?v=q4Z-RO6t1tU

Michio Kaku, in the book, The Future of the Mind: The Scientific Quest to Understand, Enhance, and Empower the Mind writes, “Humans are alone in the animal kingdom in understanding the concept of tomorrow. Unlike animals, we constantly ask ourselves “What if?” weeks, months, and even years into the future.”

Humans have thrived on the earth because they are good at forecasting the future.  We forecast the weather, the stock market (this week not so much), the path the cars on the road will take so there is not an accident.  We now have powerful tools to forecast our health.  In light of this wave of genetic information that is before us, how will we as an individual and a society respond as we are better understand our past, present and future based on our DNA?  Humanity has thrived in a world of constant change and new opportunities by creating new tools.   Genetic testing and editing will be another tool that can help to solve humanity's problems but it will create new challenges.  As Violet Crawley, Dowager Countess of Grantham in Downton Abbey stated “My dear, all of life is a series of problems that we must try and solve. First one, then the next, and then the next until at last we die.

 “Except for man, all creatures are immortal, for they are ignorant of death.”  Jorge Luis Borges

https://www.youtube.com/watch?v=u2cphuMbqfc

 PS

Links for further reading on the topic:

https://www.smithsonianmag.com/smart-news/there-are-372-trillion-cells-in-your-body-4941473/?no-ist

https://www.transpacificproject.com/index.php/transpacific-migrations/

Here is my reading list that has helped me in my understanding of genetics

• DNA USA: A Genetic Portrait of America; Adam's Curse: A Future without Men; The Seven Daughters of Eve: The Science That Reveals Our Genetic Ancestry by Bryan Sykes
• Bad Science; Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients by Ben Goldacre
• Genome: The Autobiography of a Species in 23 Chapters by Matt Ridley
• p53: The Gene that Cracked the Cancer Code by Sue Armstrong
• DNA: The Secret of Life Kindle Edition by James D. Watson
• The Emperor of All Maladies: A Biography of Cancer Paperback by Siddhartha Mukherjee
• Being Mortal: Medicine and What Matters in the End; The Checklist Manifesto: How to Get Things Right; Complications: A Surgeon's Notes on an Imperfect Science; Better: A Surgeon's Notes on Performance by Atul Gawande
• Genes, Chromosomes, and Disease: From Simple Traits, to Complex Traits, to Personalized Medicine by Nicholas Wright Gillham
• “Anticancer, A New Way of Life” by David Servan-Schreiber MD PhD
• The Philadelphia Chromosome: A Genetic Mystery, a Lethal Cancer, and the Improbable Invention of a Lifesaving Treatment by Jessica Wapner
• Survival of the Sickest by Sharon Moalem and Jonathan Prince
• The Immortal Life of Henrietta Lacks by Rebecca Skloot
• Survival of the Sickest: The Surprising Connections Between Disease ; Longevity and Inheritance: How Our Genes Change Our Lives--and Our Lives Change Our Genes by Sharon Moalem
• Biocode: The New Age of Genomics Kindle by Dawn Field --- What is Life?: How chemistry becomes biology by Addy Pross
• The Autistic Brain: Thinking Across the Spectrum by Temple Grandin , Richard Panek