Comments on: How important are genetic risks really?

By: Mailund on the Internet » In all honesty, I pulled those numbers out of a hat

Mailund on the Internet » In all honesty, I pulled those numbers out of a hat — Sun, 23 Mar 2008 05:16:23 +0000

[...] my blog received a lot of traffic about this post from yesterday about the relative risk of disease genes. I wrote that the relative risk (RR) of the [...]

By: Thomas Mailund

Thomas Mailund — Mon, 03 Mar 2008 17:38:01 +0000

I think this is a very good point, Owen. The environmental factors are often much more important for disease development than any genetic factor (at least as far as we currently understand). Really, we need to understand both the genetic causes as well as the environmental causes, and of course the interaction between the two. This, however, is probably much harder than it sounds.

I think we need to turn to systems biology to really understand any complex disease, but at this point we hardly know which components make up the system.

By: Owen Robertson

Owen Robertson — Mon, 03 Mar 2008 15:35:29 +0000

I think that this post brings up a very interesting discussion point. The focus of the personalized medicine push has been on genetics. But what we are finding, is that genetics is only a small part of the picture, and is very complicated. For example: The differences in risk for developing lung cancer show a genetic risk factor -- but, when you look at smoking data, smoking trumps genetics, and now there are no specific risk factors that predispose you to smoke-induced lung cancer (accounting for about 90% of lung cancers, btw). What this all means, is that the influence of the environment is quite strong, and can often trump genetic predispositions (at least on a population level). When are we going to start focusing on the importance of environment (and our biological reaction to it) as the key to personalized medicine? What I really want to know is... what diseases am I *NOW* in the early stages of, while I can still reverse the process? This can only be done by assessing the state of my system, and following it over time. Does anyone hear a "Systems Biology may be the key to Personalized Medicine" theme to this? That is where I think we need to focus.

Just my $0.02....

Owen

By: Mailund on the Internet » In all honesty, I pulled those numbers out of a hat

Mailund on the Internet » In all honesty, I pulled those numbers out of a hat — Thu, 28 Feb 2008 17:25:25 +0000

[...] How important are genetic risks really? [...]

By: ring worm blogger » Blog Archive » How important are genetic risk really?

Wed, 27 Feb 2008 22:03:43 +0000

[...] important are genetic risk really? December 31, 1969 4:00 pm ring worm medication diabetes Thomas Mailund had a pretty good blog post. Definitely worth your time. Here is a small excerpt:With the validated [...]

By: Thomas Mailund

Thomas Mailund — Wed, 27 Feb 2008 15:46:26 +0000

Just to be absolutely clear, I think I should add another comment here. I think that personal genome services like deCODEme and 23andMe are very cool and I think we at some point in the future will be able to use it for medical purposes, but we need to be realistic about what they can provide with our current level of technology and knowledge. The variation we tag with the current SNP chips are all (relatively) high frequency variants, and for those, as a genral rule, we don't expect major risks! Knowing your markers can still give you some interesting information, though. You can track your genomic ancestry, for example. Again, be realistic here, it won't tell you exactly where your ancestors came from or anything like that, but it will tell you a bit about the general area different parts of your chromosomes came from, and that is pretty neat in any case.

By: Thomas Mailund

Thomas Mailund — Wed, 27 Feb 2008 15:24:39 +0000

Exactly, and I fear that misunderstanding this can do a lot of harm to serious research...

People who buy the hype about personalised medicin based on our new genetic findings will at some point figure out that we are not delivering what the thought they were promised, and that could reduce funding for our research. Not because the research is not important, but because it did not deliver what we never promised it would...

By: David Bradley

David Bradley — Wed, 27 Feb 2008 15:13:11 +0000

Thanks for picking up on my latest post. Interesting comment. The kind of shift in risk you and I allude to (e.g. of the order of 0.1% to 0.2% risk) is important to the scientists, but it's nothing, like you say compared to the change in risk of lung cancer between not smoking and taking up smoking.

It irritates the heck out of me to see headlines proclaiming a doubling of risk with such and such an activity (contraceptive pill and hormone replacement therapy, being the cases in point) when that doubling is actually of a low risk activity in the first place. Buying two lottery tickets may double your chances of winning, but when your chances are 1 in 14 billion to start with, that's not a great shortening of the odds.