[HN Gopher] 30 years since the Human Genome Project began - what...
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       30 years since the Human Genome Project began - what's next?
        
       Author : oedmarap
       Score  : 67 points
       Date   : 2021-01-04 12:12 UTC (10 hours ago)
        
 (HTM) web link (www.wired.com)
 (TXT) w3m dump (www.wired.com)
        
       | suc_syn wrote:
       | We need to leverage our current knowledge to deliver actionable
       | results to regular people. Data generation is pretty reasonable
       | from the standpoint of time and costs, data storage who owns it,
       | has rights to it, and how to deliver incites from that data to
       | regular providers (see family practitioners) that aren't deeply
       | knowledgeable about genomics and their interpretation.
        
         | bitwize wrote:
         | > We need to leverage our current knowledge to deliver
         | actionable results to regular people.
         | 
         | Sure, Gavin Belson, what are our OKRs for that?
        
       | cogman10 wrote:
       | The problem to tackle, IMO, is medical privacy and intellectual
       | property.
       | 
       | We've created a system where the only sane way for a biomedical
       | company to behave is to patent, copyright, and hide as much
       | medical information as possible. Further, we've made it REALLY
       | hard to share such medical data in the first place.
       | 
       | Now, I get WHY we do this. There are a lot of good reasons
       | (privacy and insurance issues come to the top of my mind).
       | However, we should be working to eliminate those reasons as much
       | as possible.
       | 
       | What we need to advance human understanding of medicine is a
       | national database of medical data that's publicly available.
       | 
       | Ideally, We'd record every measurable aspect about a person in
       | this database and update it throughout their lives (when did they
       | get vaccinated? What allergies do they have? Did they get any
       | cancers?)
       | 
       | That sort of a database would make it really easy to start mining
       | for treatments, correlations, etc. It'd even have some positive
       | benefits like removing the need for every doctors visit giving
       | you a form with 50000 questions you've answered a million times
       | before.
       | 
       | But I get why we don't do this. We don't do this for fear of
       | police overly relying on genetic information to "prove" someone
       | committed a crime (We found your DNA at the scene, you must be
       | guilty). We don't do this out of fear of Insurance companies
       | exploding their rates when any sort of marker comes up (Oh,
       | you've got Gene XYZ that means you'll probably die sooner, so you
       | get a higher rate or we won't insure you). We don't do this
       | because of issues around discrimination (Oh, you have (had?) HIV?
       | You must be gay and we hate gay people here).
       | 
       | But, man, do I wish we could somehow shape society so some day we
       | could do it. It'd have the potential for so much good.
        
         | tejtm wrote:
         | a glimmer.
         | 
         | https://ncats.nih.gov/n3c/about
         | 
         | As an optimist I like to think that this could be a wedge in a
         | crack Covid exposed in our (US) collective medical/insurance
         | dis-function.
         | 
         | With dissimilar records harmonized across many institutions
         | under the same roof and levels of access to the datasets for
         | partners who did not "provide" records to the pool (you)
         | 
         | we are testing the theory, my hope is before Covid is over the
         | genie is out of the bottle and cant be stuffed back in for the
         | profit of a few at the expense of many.
         | 
         | But you folks reading this who are able to apply disparate
         | strategies to reasoning over large complicated data sets...
         | PLEASE DO !!!
        
         | TedDoesntTalk wrote:
         | Nice post, but what does that have to do with the Human Genome
         | Project?
        
           | tejtm wrote:
           | The GP post highlights a "blocker" on where to go with the
           | Human Genome Project ... integrating existing traditional
           | data and "personalized medicine" i.e your genome at the scale
           | of global statistical significance v.s entrenched interests
           | and a history of bad behaviour by a few bad apples.
           | 
           | fantastic rewards, fantastic risks, inevitable whether you
           | work on it or not.
        
       | cabaalis wrote:
       | I know very little about this. Is it possible to get my sequence
       | from one of the commercial groups doing this, and then "look it
       | up" in a genome reference to verify my brown eyes, for example?
       | 
       | I acknowledge the lack of knowledge leading to the question. But
       | it would be neat if possible.
        
       | emcq wrote:
       | Shockingly the human genome itself has not been fully sequenced,
       | despite the human genome project completing years ago [0]. There
       | are difficult to map regions of the genome, some of which are
       | interesting. Only recent advances in long read sequencers have
       | helped to solve some of these issues [1].
       | 
       | For the future to truly be amazing with one sequencing the lab
       | prep, chemistry, and equipment required needs to advance. Oxford
       | Nanopore has some advancements here [2] but it's still a ways to
       | go before you could have a sample prepared as easily as an
       | ultrasound or x-ray.
       | 
       | [0] https://www.statnews.com/2017/06/20/human-genome-not-
       | fully-s... [1] https://www.ecseq.com/support/ngs/are-there-
       | regions-in-the-g... [2] http://nanoporetech.com/products/voltrax
        
         | aroch wrote:
         | The Telomere-to-Telomere consortium has made fantastic progress
         | on this in the last year or two:
         | https://genomeinformatics.github.io/CHM13v1/
         | 
         | Thanks to them we now have a nearly completed genome, only
         | missing the deconvoluted rDNA array segments (~12mb or so, we
         | know the sequences since they're basically identical but no one
         | has accurately placed the individual array variants yet).
        
       | cma wrote:
       | No mention of computed protein folding?
        
         | patall wrote:
         | That is because the article is about genomics. Not molecular
         | biology in general.
        
       | alextheparrot wrote:
       | There was an interesting comment made on the recent "Bio Eats
       | World" episode [0] that genetic tests are not aligned with health
       | care reimbursement cycles.
       | 
       | Jorge Conda [0] cited two reasons that genome sequencing
       | (Different from 23andMe's GWAS, for example). First he cited the
       | high upfront cost to buy the machines (Usually meaning you need
       | to be a big hospital). The second fact was a bit more
       | interesting, which is that doing one expensive test (Genome
       | sequencing) which then your health care provider could do cheap
       | queries against ("Which other users have your symptoms and
       | similar mutations in key genes" for example) does not align with
       | the current billing model.
       | 
       | I think that's the "What's next". Finding a way to effectively
       | bring genomic care to the general population, to allow for better
       | research into genetic conditions. If you're interested in how
       | "big" this can be, here's a case where "This American Life"
       | covered how just a few genetic differences was the difference
       | between an olympic athlete and a muscular dystrophy patient [2].
       | 
       | There's also the bio-terrorism and pandemic response angle, which
       | is why the DoD is investing in third-generation sequencing
       | systems where portability has finally become more of a priority.
       | 
       | [0] https://en.wikipedia.org/wiki/Knome [1] https://a16z.com/bio-
       | eats-world-podcast/ (About 13 minutes in) [2]
       | https://www.propublica.org/article/muscular-dystrophy-patien...
        
         | jdale27 wrote:
         | There are a handful of sequencing-based genetic tests that have
         | achieved fairly wide penetration; NIPT and cancer panels are
         | probably the best examples.
         | 
         | However, if the question is why whole-genome sequencing has not
         | gained wider clinical usage, I think the answer is less about
         | reimbursement, and more the fact that there are just very few
         | clinically compelling reasons to sequence a whole human genome.
         | 
         | Then there is the fact that although we have ostensibly
         | achieved the fabled "$1000 whole genome" that was touted as the
         | tipping point for clinical acceptance, that was really more of
         | a publicity stunt by Illumina. In reality a clinical-grade WGS
         | still costs a multiple of $1000 (see, e.g., https://bmchealthse
         | rvres.biomedcentral.com/articles/10.1186/...). The Moore's Law-
         | like cost reductions of genome sequencing are a bit of a myth
         | at the present time; in practice Illumina has a monopoly on the
         | technology used for clinical WGS, and therefore they have a
         | great deal of influence over the effective cost of sequencing.
        
           | ramraj07 wrote:
           | If I want to sequence my own genome are there any services
           | that do it already today with any reliability?
        
       | dekhn wrote:
       | It's really unclear what's next for the HGP. While HGP and many
       | other sequencing projects have been invaluable to academic
       | research, and it's truly useful for a number of diseases, the
       | main result of the HGP, in my mind, is that it made clear to
       | everybody how much harder the genotype->phenotype problem was
       | than what the geneticists who set up the HGP anticipated.
       | 
       | Medically speaking, there isn't enough evidence to support the
       | cost of doing WGS for individuals in most circumstances, or even
       | storing large amounts of WGSs to do large-scale population-level
       | analysis.
        
       | hardtke wrote:
       | One thing that surprisingly hasn't happened in the 30 years since
       | the Human Genome Project is a Nobel Prize for the work. There are
       | examples from large physics projects where the leaders were
       | awarded the prize. Surely Francis Collins and perhaps Craig
       | Venter are deserving.
        
         | jdale27 wrote:
         | Francis Collins and Craig Venter certainly got a lot of the
         | publicity, but arguably there are others who were more
         | influential. E.g. Leroy Hood who developed the first automated
         | DNA sequencer, and Mike Hunkapiller who led the commercial
         | development of the technology at Applied Biosystems to the
         | point where it was practical to sequence the whole genome.
         | Hunkapiller was also the impetus behind the formation of
         | Celera, though Venter was its leader.
        
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       (page generated 2021-01-04 23:00 UTC)