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While the field of genetics may still sound foreign to some, an expert tells Syida Lizta Amirul Ihsan that its impact will be massive
IMAGINE being able to do genetic sequencing at 25 years old and knowing upfront that you have gene mutation which could develop into breast cancer and then, at 36, you notice a tiny lump and have it removed. It does not take you by surprise. You know it is coming.
The science of genetics has changed the idea of early detection. You can now know if you are susceptible to certain diseases and you can catch cancer, for example, even before it reaches stage one.
Medical geneticist Professor Dr Zilfalil Alwi from Universiti Sains Malaysia Kubang Kerian in Kelantan is one of only nine clinical genetic specialists in the country. He is passionate about the rapid development in genomics that will change the way we look at, well, everything.
“Health and diseases are just two aspects of the vast opportunities that the study of genome can offer mankind,”
There are mainly two types of genetic disease, he says. Some are caused by one gene, some by multiple genes.
“Diseases like diabetes, hypertension and heart disease are caused by multiple genes and we don’t yet know how many genes are involved.Maybe 20, 100 or 1,000. The more genes cause a certain disease, the more difficult it is to detect it early,” he says, adding that research is on-going to detect genes associated with them.
“The list for complex diseases is not completed yet,” he says.
SEQUENCING THE GENE
For about RM15,000, a person can sequence his or her genome, with a new technology that will yield results within weeks of a blood test. Genetically, you will then know what you are made of.
Bring the results to a clinical geneticist who then, with the help of other experts like bio-informatician and genomic scientist, translate the results so you know what you are susceptible to, and what you are protected from, so you can make necessary lifestyle changes.
“Every week, I read of new genes linked to a disease and if we collect all this data, we will one day know, definitively, how many genes are involved in diabetes, for example,”
“More Chinese suffer from throat cancer than Indians and Malays, and I think one of the reasons is that their genes may make them susceptible to it,” says Dr Zilfalil, who is also president of the Malaysian Society of Human Genetics (MSHG).
What makes the field even more difficult is that the process is far from linear. The gene in a certain race that makes it susceptible to a disease may not have the same explanation in another.
Dr Zilfalil’s research reveals that Kelantanese Malays have a genetic variation that protects them from the bacteria h.pylori which causes gastritis.
“Initially, scientists thought that genetic variations don’t cause anything but now we know that even small changes in the gene may protect or make you susceptible to certain conditions, which make the field so interesting. The possibilities are endless,” he says.
MORE THAN MEDICINE
But the study of the human genome is not limited to health alone.
Social behaviour, according to Dr Zilfalil, can also be attributed to certain genes.
“How do you explain why some people are risk-takers while others are happier in their comfort zones? There may be interplay between a set of genes that make them behave that way,” he says.
“There are different ways in which a certain ethnic group behaves and we believe it is not just the surroundings that shape their behaviour. Genes have something to do with it too.
“This means social engineering will take longer because behaviour may not be just about your environment.”
Dr Zilfalil and his team are in the midst of sequencing the genome of two Kelantanese Malays since they are, according to his research, the most basal and most ancestral of all Malays in the country.
A senior consultant paediatrician, Pahang-born Zilfalil, who has made Kelantan his home, says his interest in genomics began when he wanted to know more about children’s diseases.
“Treating children was good, but it had become routine and I wanted something beyond that. This field shows me those diseases even before they are manifested in patients.”
NO EASY WAY OUT
Having knowledge about our genes, he says, is not a way for us to “blame” them when things don’t go our way. Understanding what we are made of allows us to counter defects to be on par with others.
“If a child is born a slow learner and parents know that it is in the genes and therefore, not modifiable, they can take necessary steps so the child can grow up with the same learning ability as his peers.”
Doctors will face ethical considerations when the technology becomes widely available. “Parents may want their children to have their desired features — blue eyes, curly hair — but I don’t think manipulating science that way is right,” he says.
“Educating the public on the importance and future of genetics in healthcare and the ethical considerations that come with advancements in this field are some of the MSHG agenda,” says Dr Zilfalil.
“A well-informed society will be more ready to accept these advancements and our country will benefit in the long run.”
Meanwhile, he looks forward to the day when an accident victim is taken to the hospital and the first thing doctors do is sequence the patient’s genome to see what he or she is susceptible to and doctors can tailor treatment accordingly.
“I hope I can see that in my lifetime,” he says.