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Experts Discuss the Latest Precision Medicine Research

Susan Bernstein  |  Issue: February 2018  |  February 18, 2018

Big data, already a fixture of big business, is also now in use in large-scale disease research. California-based 23andMe conducts huge genotyping analyses to identify disease risks and potentially preventive interventions. 23andMe has nearly 3 million customers in its database now, according to Robert Gentleman, PhD, vice president of computational biology at the company. The company sells its genetic testing services directly to consumers, who send saliva samples through the mail for analysis.

23andMe conducts genotyping (but not sequencing) and has generated a panel of 23 million SNPs so far. These data reveal variability in the human genome that may drive development of new therapies for rheumatic diseases and others.

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Customers join online to receive a saliva-based DNA kit in the mail. 23andMe analyzes the sample and sends the customer detailed data about their health risks. Customers may opt out anytime, and all the data are aggregated and de-identified for privacy.

23andMe says it has collected more than 800 million data points, and it divides its findings into disease-specific cohorts that may prove useful for rheumatology research, such as one cohort of nearly 50,000 psoriasis patients. Self-reported data aren’t always reliably accurate, he said.

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Researchers use next-generation sequencing to develop more effective tests. A new blood test measures IgG4/IgG mRNA ratio in patients, which may show active disease in patients with granulomatosis with polyangiitis (GPA). Researchers in the Netherlands developed this IgG4 qPCR test to identify a key protein that correlates to high disease activity in GPA patients. GPA can lead to irreversible organ damage and has a 75% five-year survival rate, said Niek de Vries, MD, PhD, a researcher at Amsterdam Rheumatology and Immunology Center in the Netherlands.

A lack of sensitive, specific disease activity markers for GPA may lead to delayed treatment, undertreatment or overtreatment, said Dr. de Vries. Evidence points to a clear role for B cells, and results from this new blood test may help differentiate patients with active disease from those in remission.


Susan Bernstein is a freelance journalist based in Atlanta.

References

  1. Ermann J, Rao DA, Teslovich NC, et al. Immune cell profiling to guide therapeutic decisions in rheumatic diseases. Nat Rev Rheumatol. 2015 Sep;11(9):541–551.
  2. Zhou Q, Yang D, Ombrello AK, et al. Early-onset stroke and vasculopathy associated with mutations in ADA2. N Engl J Med. 2014 Mar 6;370(10):911–920.
  3. The International FMF Consortium. Ancient missense mutations in a new member of the RoRet gene family are likely to cause familial Mediterranean fever. Cell. 1997 Aug 22;90(4):797–807.
  4. Zhou Q, Wang H, Chae J, et al. A dominantly-inherited Behçet-like disorder caused by haploinsufficiency of the TNFAIP3/A20 protein. Pediatr Rheumatol Online J. 2015;13(Suppl 1): O71.
  5. Langefeld CD, Ainsworth HC, Cunninghame Graham DS, et al. Transancestral mapping and genetic load in systemic lupus erythematosus. Nat Commun. 2017 Jul 17;8:16021.
  6. Banchereau R, Hong S, Canterel B, et al. Personalized immunomonitoring uncovers molecular networks that stratify lupus patients. Cell. 2016 Apr 21;165(3):551–565.
  7. Munroe ME, Vista ES, Merrill JT, et al. Pathways of impending disease flare in African-American systemic lupus erythematosus patients. J Autoimmun. 2017 Mar;78:70–78.
  8. Hinks A, Bowes J, Cobb J, et al. Fine-mapping the MHC locus in juvenile idiopathic arthritis (JIA) reveals genetic heterogeneity corresponding to distinct adult inflammatory arthritic diseases. Ann Rheum Dis. 2017 Apr;76(4):765–772.
  9. Li G, Martínez-Bonet M, Wu D, et al. High throughput identification of non-coding functional SNPs via Type IIS enzyme restriction. Nature Genet. 2018 [in press].
  10. Li G, Cunin P, Wu D, et al. The rheumatoid arthritis risk variant CCR6DNP regulates CCR6 via PARP-1. PLoS Genet. 2016 Sep 14;12(9):e1006292.
  11. Nigrovic PA, Raychaudhuri S, Thompson SD. Review: Genetics and the classification of arthritis in adults and children. Arthritis Rheumatol. 2018 Jan;70(1):7–17.
  12. Hoadley KA, Yau C, Wolf DM, et al. Multiplatform analysis of 12 cancer types reveals molecular classification within and across tissues of origin. Cell. 2014 Aug 14;158(4):929–944.
  13. Drake JM, Paull EO, Graham NA, et al. Phosphoproteome integration reveals patient-specific networks in prostate cancer. Cell. 2016 Aug 11;166(4):1041–1054.
  14. Hernandez W, Gamazon ER, Smithberger E, et al. Novel genetic predictors of venous thromboembolism risk in African-Americans. Blood. 2016 Apr 14;127(15):1923–1929.

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Filed under:Meeting ReportsRheumatoid ArthritisSystemic Lupus Erythematosus Tagged with:ACR/ARHP Annual MeetingArthritisbig dataGenetic researchgenomicsLupusPrecision MedicineRheumatoid arthritis

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