If the idea of having everyone's genome sequenced at birth brings to mind images from "Blade Runner" or "Gattaca", you're not alone. The tremendous potential of understanding and using genomic information from birth to death suggests motives both beneficent and nefarious. This path is quite realistic, given the galloping state of modern genomic science. That's one reason genomics will loom large at our upcoming Techonomy Bio conference in Mountain View, Calif., on June 17. In this article we conduct a Techonomy thought exercise: envisioning a world in which everyone has his or her genome sequenced at birth (or, in some cases, even earlier). Here's how it might look.
Start with what it might mean for disease prediction, prevention, and treatment. A genetic roadmap from birth will indicate which hereditary diseases a person may be at highest risk of developing, so steps can be taken from the start to prevent or delay onset of those illnesses. As the genetic causes of more diseases are uncovered, all available genomes could be screened immediately and people with the newly discovered variant could be notified right away.
Down the road, as our genome information is supplemented with data about our microbiome (the populations of microbes living on and in our bodies), scientists might be able to find those of us who are more susceptible to even non-genetic diseases. For example: There is some evidence that people with certain microbes on their skin are more attractive to mosquitoes, so this group would be at higher risk of contracting a mosquito-borne disease such as malaria or dengue fever. As epidemiology progresses to the point of being able to show real-time outbreak information--just as we watch storms come our way on a weather map -- these people with heightened risk could take additional precautions during periods when these diseases are on the rise.
Experts might also be able to pinpoint genetic factors in more complex conditions, so that people who are, say, more susceptible to addictions could be better safeguarded from or at least forewarned about the dangers of smoking, drinking, or taking drugs.
Genomic information will offer important guidelines about drug response and dosage tolerance, so doctors can tailor treatments by knowing which medications to prescribe and in what doses so they are most likely to be effective with minimal side effects. The time and expense currently spent randomly trying medications until one works properly, plus all the adverse events that result from such trial and error, would be avoided.
Of course, genetic information has considerable relevance beyond medicine. Some scientists have found DNA variants that may be linked to athletic aptitude-- genetically-gifted people in one group are known as "marathoners" because of their capacity for endurance, and people with another variant are called "sprinters" because they do best with high-intensity bursts of activity. The presence of certain genes can even reveal which types of food you are prone to like best. At a minimum, kids with the so-called bitter gene would never have to confront Brussels sprouts again. As this field takes off, restaurants might even prepare whole meals customized to each person's genetic code.
Ultimately, it won't be enough to read each person's genome; we'll want to make changes as well, for better or for worse. Genome editing is a rapidly growing research field and could offer the opportunity to change someone's DNA long before the onset of a disease. For a woman who carries the breast cancer risk gene, instead of having to undergo a prophylactic mastectomy, her parents would be able to choose genome editing to remove the risk genes at birth -- or possibly even before. Naturally, this brings up a host of ethical issues around which genetic elements will be acceptable for editing. If we can prevent disease, is it also OK to make sure our kids are more likely to be thin? And as long as we're doing that, how about giving them the genes for blue eyes instead of brown?
Here at Techonomy, we don't have the answers, but we are glad to be helping to kick off the conversation at our upcoming half-day conference. If you can be in California on June 17, please join us.
Our first-ever Techonomy Bio event is June 17th in Mountain View, Calif. Learn more here.