Major future leaps in longevity will most likely result from developments in molecular biology and genomics. And, on a practical level individual DNA testing will sooner or later play a major role simply because our genomes are different.
After several years of nothing much happening, individual DNA testing is slowly entering the mainstream. On the medical side, applications include diagnosis of disease susceptibilities, tissue typing for organ transplantation, prenatal genetic assessment, assessments in cardiology and oncology, and screening for infectious diseases. On the consumer side, popular applications include paternity testing and testing for HIV; such tests are sold via Internet. And of course there are niche markets such as in forensics. The cost-effectiveness of DNA testing is rapidly improving as is the range of applications, and within a five-year period. Individual DNA testing will probably have expanded by an order or two of magnitude. According to an article in GEN, “The Sky Could Be The Limit For DNA Testing.”
The traditional technology for DNA testing uses a technique called PCR standing for polymerase chain reaction. PCR is a technique used to multiply one or a few pieces of DNA in a couple of hours into millions or more copies. It works even when the source DNA is of relatively poor quality and it has become one of the most widely used laboratory techniques in molecular biology. Plain PCR is a labor-intensive multistep process that can be done for specific screening purpose in a lab but not in an ordinary kitchen. Some companies, Roche Molecular diagnostics in particular, have developed technological “platforms” which automate the major steps of PCR. For example “The COBAS® AMPLICOR Analyzer is the first benchtop system to fully automate the amplification and detection steps of the Polymerase Chain Reaction (PCR) testing process on a single instrument. It combines five instruments into one (thermal cycler, automatic pipettor, incubator, washer and reader).” A number of other platforms for DNA amplification and molecular testing are being developed. They include microarrays, beadarrays, and electrochemical arrays and may some day displace PCR. Their cost-effectiveness and user-friendliness continue to improve. But so far PCR remains the main technology with Roch Molecular Diagnostics enjoying by far the biggest slice of the market.
As time moves on and the diagnostic processes become simpler and less expensive, more and more medical labs are acquiring molecular diagnostic capabilities. Short-term driving forces include lower cost and simpler test units, units capable of doing multiple kinds of tests, and desire for faster turnaround time than possible if the tests have to be outsources. Today, in the infectious disease and oncology areas, traditional biochemical testing still is the dominant mode, with molecular testing representing only 20%-30% of the market, but the molecular/genetic testing continues to gain market share.
In the news and frequently reported in this Blog, there is a steady stream of research reports linking diseases to genes and gene polymorphisms and indicating new molecular therapy targets. There is an accelerating need for individual genetic testing if the fruits of such research are to be harvested. A longer-term driving force for widespread adoption of individual DNA testing is the slow emergence of personalized molecular-based medicine for assessing disease susceptibilities, disease detection, disease course prognosis, and prediction of patient drug response. I think this shift in paradigm may require 20 or more years before it is firmly in the forefront. Clearly this paradigm shift will have a major impact on protecting the health and extending the lives of those who will benefit from it.
Of course there are other segments of DNA analysis besides tests designed to helped individuals. There has been enormous progress in development of automated technologies for analyzing entire genomes. An example is Affymetrix’s microarray-based Gene Titan system.
Molecular laboratory testing is already a big business. The Gen article quotes a source (Kalorama) indicating estimating the 2007 worldwide market for molecular assays to be $3.7 billion. The market is projected to grow at an 11% annual rate, reaching $6.2 billion in 2012. Certain segments of this market are expected to grow at much higher rates. The highest-growth areas of DNA testing according to the GEN article are pharmacogenomics (35%), inherited disease testing (25%), oncology and infectious diseases.
In previous postings I have compared the rate of progress in the computer field in 1956 with the rate of progress in genomics and longevity science today. Personalized diagnostic testing today is playing a transformative role today in medicine as developments in computer memories did back then. Both then and today, scientific and commercial developments strongly supported each other. It will be a while before we have the analog of the PC revolution, however, when everyone does their own DNA testing in their homes using inexpensive kits. I fully expect this to happen within 20 years or so, however.