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Amazing Samples: From DNA Sequencing to Therapy

Posted by Richard Tsai on Jul 1, 2014 11:45:00 AM

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Sometimes, large scale research projects make it easy to lose track of the significance of the individual and a single sample. A single biobank freezer can store more than 45,000 vials and the even value of the contents of only one freezer is difficult to fully comprehend. Imagine that worth, magnified by hundreds or thousands of freezers! But it's important to remember the importance of each vial. A single sample, when used in a specific way, can literally save a life - to that person, that sample is all that matters. To that end, we’re kicking off the Amazing Samples series, where each post will discuss examples of how various sample/biosample types (DNA, RNA, stem cells, viruses, etc) contribute towards saving lives and changing the world.


Genome Sequencing and Rare Diseases

In 2003, almost 20 years after the Human Genome Project began, first proposed by Dr. Alvin Trivelpiece and led by experts like Dr. James Watson and Dr. Francis Collins (now the Director at NIH, and yes, you can follow his tweets @NIHDirector), they finally completed mapping the human genome. Barely more than a decade later, the cost of such genomic sequencing has dropped exponentially, allowing an individual’s genetic code to be analyzed in a relatively quick and affordable manner. As you’ll read in the examples below, this has opened up a universe of new diagnostic possibilities, and can save a person’s life. These stories appeared in "Diagnosing Rare Diseases", by Dr. Jimmy Lin and Ana Sanfilippo. Checkout their amazing video below!

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First Patient Cured 
Nicholas Santiago Volker is the first patient to have been cured as a result of genomic sequencing. When he was only two years old, he started exhibiting various bizarre symptoms that confused doctors; wounds that couldn’t heal, holes forming on his skin and going to his intestines. After four years and well over a hundred surgeries, they decided to sequence his genome, and the results showed a single change in his DNA, on the XIAP gene, that had destroyed his immune system, resulting in a rare inflammatory condition. Nicholas was given a cord blood transplant, and within a few weeks he was fully active and eating normal food again.


Life Changing Diagnosis for the Twins
Twins Alexis and Noah Beery shared a genetic illness that, again, doctors could not correctly identify. The initial (and regrettably incorrect) diagnosis was cerebral palsy, but the corresponding treatment was ineffective and the twins’ condition continued to worsen. Years later, their mother, Retta Beery, took it upon herself to research other potential causes. She discovered a genetic disorder, Segawa’s Dystonia, which resembles cerebral palsy in its symptoms, but requires a very different treatment. The new medicine seemed to work, and allowed the twins to develop to a more typical level of coordination for children their age. However, Alexis started experiencing severe respiratory issues, and was repeatedly rushed to the emergency room; again, the reason could not be diagnosed, partially because Segawa's Dystonia was not completely understood. It was around this time that their father, Joe Beery, swapped a successful career in the airline industry for a new career at Life Technologies (part of Thermo Fisher Scientific), which specializes in genomic solutions with tools like the Ion PGMTM (Personal Genome Machine - see it in action here). This career change pointedly led to genetic sequencing of not just the twins, but the entire family. Two mutations were identified that were ultimately treatable with a simple serotonin precursor. Now, only a few years later, the twins now show no symptoms of their genetic condition and are living normal lives.

Identifying Super Ultra Rare Diseases
Dr._Jimmy_Lin_and_Sequencing_ChipRobert Stone didn’t start exhibiting any symptoms until after his first birthday, when his health quickly went downhill. From being a normal, healthy baby, he lost control of his limbs, all functional mobility, and any capacity for communication. Doctors were baffled, and for fourteen long years, the Stones took him to doctor after doctor, performing test after test, without a even a single positive result. Beyond the inability to treat their child, there was considerable psychological strain on the Stone family, as they didn't have any idea what the nature of his condition was. Finally, his parents connected with the Rare Genomics Institute (www.raregenomics.org), a non-profit organization that “crowdfunds” genomic sequencing, allowing families to collect the necessary funds for the procedure from generous contributors around the world. Within a year of sequencing Robert’s DNA, researchers discovered that he has an incredibly rare condition called Dystonia 16—Robert is only the ninth case ever reported. With the correct diagnosis, made possible by genetic sequencing, Robert is now being treated for the correct condition, and the Stone family's long, frustrating years of uncertainty are over, their hope renewed.

Maya_-_Crowdfunded_gene_discoveryFor the 4-year-old Maya Nieder, the power of sequencing her DNA samples enabled scientists at RGI and its research partners at Yale University to discover a completely new gene variant for her disease. "She could have seen all the doctors in the world. They would not have solved this without genomic sequencing. The disease was previously not described," said Dr. Jimmy Lin. "It's not in any medical books. Now they are actively studying it at a top medical institution". Learn more about Maya's story here (http://raregenomics.org/rare-disease-maya-nieder-first-crowdfunded-gene-discovery/)

These are just a handful of rare disease patients whose health conditions have been correctly diagnosed and are receiving the correct treatment as a result of genomic sequencing. For each of them, that one small vial containing their DNA literally changed their lives. Beyond rare diseases, DNA samples have also helped revert a court decision, supported the development of personalized medicine, and even finding genetically-related family members. A single sample of DNA can be truly amazing.

Do you have any experiences or stories that illustrate how amazing DNA samples are? Please feel free to share them in the comment section below!

 

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