Dennis Lo, molecular biologist: “There is an exchange of genetic information between the baby and the mother” | Health & Wellness | EUROtoday

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“Conventional thinking said that the blood circulation of the mother and that of the baby are separate and that the exchange of materials is limited to the nutrients that the mother provides to the baby,” remembers Dennis Lo (Hong Kong, 60 years previous). The researcher explains that his findings confirmed that the trade is rather more intimate. “There is an exchange of genetic information between the baby and the mother,” he factors out.

Since the late 1997s, Lo looked for fetal DNA within the pregnant girl's blood and developed methods to investigate it and detect ailments earlier than start. Her work allowed the event of a non-invasive take a look at to determine Down syndrome, a dysfunction that till then might solely be detected with methods that might endanger the lifetime of the fetus. The expertise was launched in 2011 and has modified the observe of prenatal diagnostics, decreasing the necessity for invasive testing.

This week, Lo visited Madrid to obtain the Commemorative Lecture Award from the Conchita Rábago de Jiménez Díaz Foundation in recognition of his analysis work. The professor on the Chinese University of Hong Kong can be one of many world leaders within the improvement of liquid biopsy, a method that enables tumors to be identified by way of a blood take a look at.

Ask. In addition to detecting alterations in a chromosome, comparable to Down syndrome, prenatal diagnostic methods can receive DNA to sequence the infant's whole genome. Can this be helpful to stop ailments?

Answer. There is figure displaying that it’s doable to acquire the whole genome, however individuals use this system for extra selective functions. If you’ve quite a lot of genetic ailments that you simply wish to take a look at, this expertise can be utilized. In the UK NHS they’ve a service like this. But in case you discuss the entire genome, there’s something that we have now to debate and debate. Personally, I consider that in being pregnant, a lady already has many issues to fret about, so we should always not burden her with data that she doesn’t want. The data she wants is to know if the infant could undergo from any critical sickness that threatens her life at the moment, through the being pregnant or instantly afterward.

If you discuss full sequencing of the infant's genome, you’ll be able to be taught issues about his well being within the distant future. I don't suppose the mom must know that her baby has a excessive likelihood of growing diabetes in 40 years. Furthermore, our information of the implications of that data shouldn’t be full. You may even see the entire genome and never know what it means, and that may fear the mom too. So I feel for now it’s best to restrict this data to on the lookout for vital and early ailments.

P. Will or not it’s attention-grabbing to mix the data supplied by prenatal analysis to determine genetic issues with genetic enhancing methods that enable them to be corrected?

R. Currently, moral and authorized pointers say that you simply can’t change a child in such a manner that that change shall be heritable. You have in all probability learn concerning the case of a Chinese scientist who modified the genome of infants to make them immune to HIV. That case has been condemned globally and the query stays whether or not these adjustments that confer resistance to HIV can have different results later within the lives of those infants, making them, for instance, extra prone to different viral infections. That mentioned, when this scientist did gene enhancing on him, he used Non-Invasive Prenatal Diagnosis (NPD) to test if enhancing him had labored.

Dennis Lo, in Madrid
Dennis Lo, in MadridINMA FLORES

P. Now, there are nonetheless tumors, comparable to lung or pancreas, which are usually detected too late. Is it doable that liquid biopsies will change that state of affairs?

R. There are checks for a single kind of most cancers and others for a number of sorts. In these of a kind of most cancers, I’ve developed one for head and neck most cancers. For one kind of tumor it’s simpler to do scientific trials since you solely have one most cancers and one threat group. In that case, the outcomes could be spectacular. In Hong Kong, I’ve centered on nasopharyngeal most cancers, which is quite common in southern China. A Cantonese like me has a lifetime threat of getting any such most cancers of 1 in 39. We have used liquid biopsy for any such most cancers and we have now seen that, if you don’t do the take a look at, round 75% of circumstances are detected in stage three or 4 [muy avanzados], however in case you do the take a look at, 70% are found in part one or two, and could be handled earlier. Survival elevated tenfold, in order that's an enormous enchancment. We printed the article in 2017, within the New England Journal of Medicineand now we’re implementing this expertise in Hong Kong.

For evaluation of many kinds of most cancers, as every most cancers has completely different genomic adjustments, it’s tough to do a take a look at for all sorts of tumor, which have their very own mutations. What we have now performed is develop a take a look at that appears at epigenetic change. Epigenetics is when the DNA sequence doesn’t change, however the formatting of the sequence does. The attention-grabbing factor is that completely different organs within the physique have a special format, so [por el formateo] you’ll find out the place the most cancers is. A couple of years in the past, we developed this expertise, which has now been licensed to Grail, [una compañía] of which I used to be a scientific co-founder. Grail now has a take a look at for 50 kinds of most cancers. According to the most recent knowledge printed by them, if the take a look at is optimistic, the chance that that individual has most cancers at that second is 75%. If it’s detrimental, the chance is 2.5%. And they’ll inform the place the most cancers is with 86% accuracy. The present weak point of this take a look at is that for stage one most cancers, the sensitivity is 25% and for stage two, round 57%. So we have now to enhance.

P. Can't a lot data generate stress, make us really feel that we’re all the time preventive sufferers ready for most cancers to be detected?

R. I feel well being training and the power of well being techniques to comply with individuals and deal with them appropriately is vital to eradicate stress. If you’ve a expertise that factors out a threat, however you’ll be able to't deal with it, it's ineffective, however we will see what occurs with blood clots and ldl cholesterol management. Many individuals, particularly over a sure age, take drugs to manage this drawback and don’t dwell with a lot fear. They take their statins and are monitored usually. With most cancers it might be one thing comparable.

P. Can liquid biopsies even be used to raised comply with the remedy of the illness?

R. The concept of ​​liquid biopsy is that blood absorbs DNA from completely different elements of the physique, in it there’s a combination that provides an outline of what’s occurring within the physique at a second. And it permits us to have a look at a number of clones of a tumor on the similar time and see the way it evolves and adapt remedies. In lung most cancers there’s a gene referred to as EGFR (epidermal progress issue receptor) and you probably have an EGFR mutation, you’ll be able to deal with the tumor with medicine referred to as tyrosine kinase inhibitors. Afterwards, the tumor can evolve and develop resistance and develop metastasis, and there additionally, you will see extra DNA circulating within the blood.

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