In the news

  • Newsletter Edition
The PHG Foundation monthly newsletter features news and views about genetics and genetics research, from a public health perspective. The newsletter is written by staff of the PHG Foundation.

In the news

News story   |   Published 28 September 2006

The Council of the European Union has adopted, by a qualified majority, a common position on the draft 7th Research Framework Programme and forwarded it to the EU Parliament for next stage in the codecision process. In a press release the Council states that the document “…reflects to a great extent both the Commission’s proposal and the Parliament’s opinion as regards structure, scientific and technological content, means of implementation and budgetary resources.” Some changes have been suggested, according the Council’s statement explaining their reasoning, such as increasing the number of priority areas from 9 to 10 by splitting security research and space research to create separate thematic areas. Their stance on ethical issues remains consistent with previous versions of the draft legislation. Research on adult or embryonic human stem cells may be funded, depending on both the contents of the scientific proposal and the legal framework of the Member State(s) involved. Research into human reproductive cloning, research that will alter the human germ-line and creating embryos solely for research purposes will not be funded.

The draft legislation now moves back to the European Parliament for its second reading, tentatively scheduled on 29 November 2006. It is hoped that it will be approved at this time in order to allow the 7th Framework Programme to begin its work. If so, the first calls for proposals could be published in December 2006 (see news story).


News story   |   Published 22 September 2006

Prof. Graeme Laurie has been appointed as the new chairman of UK Biobank’s Ethics and Governance Council. He replaces Prof. Alistair Campbell, former professor of ethics in medicine at the University of Bristol. Prof. Laurie is currently Chair of Medical Jurisprudence at the University of Edinburgh and is co-director of the Arts and Humanities Research Council Research Centre for Studies in Intellectual Property and Technology Law. In 1991, a World Health Organisation working group he convened produced international guidelines on genetic databases, Genetic Databases: Assessing the benefits and the impact on human & patient rights. He has authored the monograph Genetic Privacy: A Challenge to Medico-legal Norms, published by Cambridge University Press in 2002, as well as other numerous publications.

The Ethics and Governance Council is an independent committee funded by two of the UK Biobank funders, the Medical Research Council and the Wellcome Trust . The Council has the role of acting “…as an independent guardian of UK Biobank’s Ethics and Governance Framework (EGF), to advise the board on the conformance of UK Biobank's activities with this framework and to safeguard the interests of participants and the public.” It is advisory only, with no regulatory functions.

UK Biobank recently received approval to extend its operations nationally, after the successful completion of the pilot phase of the project (see related story ). Over the next four years, researchers will collect samples, measurements and lifestyle data from 500,000 adults across the UK between the ages of 40 to 69, building an information resource “…to develop new and better ways of preventing, diagnosing and treating common illnesses such as cancer, heart disease, diabetes and Alzheimer’s disease.”

Keywords : Genetic Databases

News story   |   Published 21 September 2006

The Department of Health has announced that the Genetics White Paper Our inheritance, our future - realising the potential of genetics in the NHS of June 2003 is to be reviewed. The White Paper itself contained a commitment to a three-year review, saying: “The exact timing for different genetic advances is uncertain and it is too early to accurately predict all our requirements for the next decade. …To make a reality of our vision this White Paper sets out a detailed plan of action and investment for the next three years. We will review progress at the end of that time to see what more needs to be done”. A progress summary on the implementation of commitments set out in the Genetics White Paper has also been released; most have been implemented, with many projects ongoing. A total of £52.4m has reportedly been invested to the end of financial year 2005-6.

The review is to be led by Dr David Harper, Chief Scientist and Director General for Health Protection, International Health and Scientific Development at the Department of Health. It will include information on new and forthcoming developments in genetic science relevant to healthcare, and consultation with a range of stakeholders including professional bodies, patient groups, research and academic organisations on their activities, opinions and recommendations for future policy. Individuals and organisations that have not been directly approached are also invited to submit their views via forms available from the progress review website.

Publication of the review outcomes is expected to be in early 2007.

Keywords : uk

News story   |   Published 19 September 2006

Research presented at the British Society of Human Genetics annual conference in York this week supports previous work on non-invasive antenatal gender testing. The test, which examines foetal DNA present in the maternal blood, has been used on more than 70 pregnant women whose babies were at high risk of gender-related genetic disorders; the Institute of Child Health team report that it could be used to identify the gender of foetuses from as early as seven weeks, several weeks before routine ultrasound analysis or the invasive techniques chorionic villus sampling (CVS) or amniocentesis can be used to determine the sex of the foetus (see BBC news report). These latter techniques are associated with an approximately 1% risk of miscarriage.

Certain types of genetic disease affect only males, or only females, and in these instances determining the gender of the foetus reveals whether or not it is at risk of the disease. For example, the X-linked chromosomal disorder Duchenne muscular dystrophy affects male children; if the foetus is female then it will be healthy and no further testing is required; if male, then the parents may wish to opt for invasive diagnostic testing to determine whether or not the foetus is affected.

The ICH researchers also used the test on women whose babies were at risk of an inherited condition called congenital adrenal hyperplasia (CAH), which causes excessive production of the male hormone androgen. Girls affected by this condition can be successfully treated in the womb with steroids; the new test allowed the prompt identification of these female foetuses without the need for invasive testing.

Further research by the ICH team and other groups seeks to improve the extraction and enrichment of free foetal DNA from the maternal blood to widen the applications of the technique to actual diagnostic testing for genetic diseases.


News story   |   Published 18 September 2006

The Council for International Organizations of Medical Sciences (CIOMS) has drafted new guidance entitled, Special Ethical Considerations for Epidemiological Research. The document is intended as a supplement to the 2002 CIOMS International Ethical Guidelines for Biomedical Research Involving Human Subjects. When approved it will supersede the 1991 CIOMS International Guidelines for Ethical Review of Epidemiological Studies.

The supplement “…focuses on the distinctive aspects of epidemiological research.” The authors note that, traditionally, the majority of epidemiological studies were ‘observational’, rather than interventional, and therefore were believed to not raise significant ethical issues and were commonly carried out without ethics review. However, there is now increased attention being paid to the ethical conduct of research and, for epidemiologists, new issues have arisen such as the potential for harm in the disclosure of health-related information and the need to protect the confidentiality of data. Therefore updated guidance for epidemiologists was needed. For example, the supplement extends Guideline 4 on informed consent (from the 2002 document) to include guidance on using personally identifiable materials in research and using non-identifiable materials in studies that are exempt from ethical review. The supplement also adds Guidelines on research involving the internet and on issues of conflict of interest.

CIOMS has been working to update its 1991 guidance since 2003. It was decided that instead of replacing it, a supplement to the broader 2002 Guidelines document would be preferable. Presenting the documents together “…should ease the process of ethical review because many of those using the supplement…will have experience with using the Guidelines in the context of biomedical research projects.” The supplement is open for comment until 15 December 2006. It is planned that a final draft will be submitted for final approval to the CIOMS Executive Committee in June 2007. After this a new version of the 2002 Guidelines, to include the supplement, will be published.


News story   |   Published 13 September 2006

An international consortium of researchers, BloodGen, is developing a new form of genetic blood test that will provide much closer matching between blood samples and transfusion recipients. BloodGen, which includes experts from Germany, Sweden, Spain, the Czech Republic and the Netherlands, as well as the UK, seeks tovalidate and standardise molecular genotyping approaches to large-scale blood group diagnosis and to prove its superiority over currently applied serological testing”. Normal serological testing of blood checks for the major blood group antigens, or cell surface markers, to determine whether blood is type A, B, AB or O, and whether it is Rhesus positive or negative. Transfusion recipients must be given blood that matches their own blood group, otherwise dangerous complications will arise as their immune systems will attack the apparently ‘foreign’ blood cells (alloimmunisation).However, even with the normally safe blood typing process, recipients of multiple blood transfusions (such as people with leukaemia or haemophilia) can over time develop dangerous immune responses against the donated blood cells, due to mismatch between other, less important, blood cells markers.

The new Bloodchip test will use DNA microarray (gene chip) technology to allow the rapid identification of a much larger number of minor blood cell markers. This would make it possible to make much more accurate matches between donated blood and recipients, reducing the number of cases of alloimmunisation. The Bloodchip could detect up to 116 distinct DNA signatures or profiles associated with blood groups. Currently in a large-scale EU pre-clinical trial, the developers hope that the Bloodchip test will lead to the routine use of molecular genotyping of blood groups across the EU.

UK National Blood Service Research Director Professor Marion Scott commented: "The Bloodchip test will literally be a lifesaver for those who suffer from illnesses that require multiple blood transfusions such as haemophilia, sickle cell disease and thalassaemias…The Bloodchip test will be of enormous benefit in ensuring those with these disorders receive perfectly matched blood to enable them to better manage their conditions" (see BBC news report).


News story   |   Published 11 September 2006

The US Food and Drug Administration (FDA) has published new draft guidance on regulating a new category of complex diagnostic test (see NY Times news report). These tests, termed In Vitro Diagnostic Multivariate Index Asseys (IVDMIAs), are expected to show growth in market over the near term and the FDA has decided it needed to seek comments on new guidance in this area.

Currently, the FDA considers diagnostic test kits sold to laboratories, doctors and hospitals to be medical devices and therefore they need to receive appropriate approvals before they can be sold. However, tests developed and performed within a single laboratory, so-called ‘home-brew’ tests, are not regulated as they are considered laboratory services using established reagents. But the FDA has realised that these new IVDMIAs are different, as they do not use the same common elements as in-house tests. IVDMIAs use clinical data, sometimes from more than one in vitro assay, that are analysed by an algorithm that integrates the variables in the assays to calculate a patient-specific risk. An example of an IVDMIA is Genomic Health’s Oncotype DX test which analyses 21 genes in a breast tumour sample and calculates whether the patient’s cancer will recur and whether they will benefit from chemotherapy. The reason IVDMIAs need to be regulated, according to the NY Times, is that the algorithms that are used are different for each IVDMIA and this makes it difficult for doctors to interpret the test results consistently. As the algorithms are not standard, they must be tested for effectiveness and as the algorithm cannot be separated from the assays, because both are needed to enable the test to work, the entire test must be regulated.

Commentators believe that this move indicates that the FDA is willing to take on further regulation of laboratory tests. There have been calls from policy groups, such as the Genetics & Public Policy Center, for the FDA to regulate genetic tests. However, even the policy groups recognise that additional regulation may hinder innovative research and slow new products entering the market. It should be noted that the FDA guidance, even when finalised, will not be legally enforceable. These guidelines will only indicate the FDA’s thinking on this matter. The consultation is open for 90 days and comments can be submitted to the FDA ecomment website.


News story   |   Published 8 September 2006

HFEA consults on donating eggs for research

The Human Fertilisation and Embryology Authority (HFEA) has released a consultation document, Donating eggs for research: safeguarding donors, seeking comments on whether egg donation for research should take place and if so, what safeguards should be put into place to ensure the donor’s well-being. Specifically the consultation asks for views on the appropriateness of non-patient (altruistic) donation, egg sharing for research (as has been licensed), what safeguards should be in place to protect donors if these forms of donation are allowed and any other comments on donating eggs specifically for research purposes.

Historically, women have been able to donate their surplus eggs for the treatment of others as well as for research, such as into fertility treatment. Eggs can be harvested while a woman is undergoing various treatments, such as sterilisation and IVF treatment. Egg-sharing programmes allow women to donate surplus eggs to other women in exchange for a reduction in the cost of their IVF treatment. However, with the rise in embryo research, more focus has been placed on allowing women to donate their eggs specifically for research purposes. UK researchers currently use surplus eggs from other treatments for research, but contend that fresh eggs are necessary in order to facilitate embryo research (see BBC news story). The HFEA has already issued a licence to the North East England Stem Cell Institute allowing them to approach women to donate eggs to research, as opposed to another infertile woman, in exchange for reduced IVF costs (see related news story). However, while the HFEA favours allowing this kind of donation (see related news story), it has been a controversial decision, as it could be seen as a coercive tactic being used on vulnerable women.

Another issue is one of non-patient donation. Woman have been interested in donating their eggs simply for altruistic reasons, perhaps because they know someone who has a condition that might be helped through stem cell therapies. Unfortunately, the procedures and drugs used to stimulate ovulation could result in women suffering from ovarian hyperstimulation syndrome (OHSS). The HFEA notes in the consultation that mild OHSS is relatively common (between 1-10% of cases) while severe OHSS is rare (~1% of cases). However, severe OHSS can be fatal, raising the question of whether women should be allowed to risk potentially serious complications to donate to research that will not help them directly.

There are many safeguards currently in place to protect women donors, including informed consent procedures that ensure that the person taking the consent is not involved in the research project. In this way, a woman will not be pressured into donating by someone with a vested interest in the success of the research. Another possible safeguard suggested by the HFEA is not allowing women to donate eggs to a research project on which they are employed. This reflects the concern the international community had following allegations that South Korean research staff had been pressured into donating their eggs to support Prof Hwang Woo-Suk’s experiments (see previous news story). The HFEA welcomes comments on whether these and other safeguards would be sufficient to protect women donating for research purposes, or if the practice in general should be prohibited or limited in some way. The consultation closes 8 December 2006.


News story   |   Published 6 September 2006

The US National Institutes of Health (NIH) is seeking comments on its proposed plans regarding data sharing and tracking of NIH-funded genome-wide association studies (GWAS). The NIH defines a GWAS as “…any study of genetic variation across the entire human genome that is designed to identify genetic associations with observable traits (such as blood pressure or weight), or the presence or absence of a disease or condition.” GWAS data, in combination with clinical and other data, offers the opportunity to study the basic biological processes that affect human health. In the future, the NIH states, this could lead to improvements in disease prediction and patient care, leading potentially to the goal of personalised medicine. As GWAS advance, the NIH decided it was time to update their policies regarding tracking of these studies, data sharing, publication and intellectual property.

The NIH intends to create a central repository at the National Center for Biotechnology Information, National Library of Medicine. NIH-funded researchers conducting GWAS will be expected to submit to the repository descriptive information regarding their study, including the protocol, questionnaires used, variables measured, etc. Further, the NIH will encourage researchers to submit curated and coded phenotype, exposure, genotype and pedigree data. The data will be submitted using a coded system, without identifiable information. Researchers will retain the key to the codes; the identities of the participants in the study will not be disclosed to the GWAS repository or any secondary source unless appropriate measures are taken and approvals gained. This should protect the confidentiality of the participants in studies. As a result, participants in GWAS should not expect to be given any individual results that may come from any studies using their data. The GWAS must have received ethics and institutional approval before being submitted to the repository.

The descriptive information from the GWAS will be available in an open-access database. Researchers who wish to access more detailed information, such as genotype and phenotype datasets, will need to apply through a NIH Data Access Committee. They must certify that they will: only use the data for the approved research purpose, protect data confidentiality, follow all applicable laws and policies for handling the data, not attempt to identify study participants from the data, not sell the data and provide annual progress reports.

Those submitting GWAS data will, for a limited amount of time (expected to be nine months), retain the exclusive right to publish their findings. This may change if requested by the NIH Institute or Center funding the GWAS. Investigators using GWAS will be asked to acknowledge those who conducted the original study. Finally, the NIH “…discourages premature claims on pre-competitive information that might impede research” while recognising that patents are necessary to encourage downstream private investment. The NIH expects that the GWAS data and conclusions drawn from it will remain freely available and will work to ensure this happens. They hope to “…discourage patents that would prevent the use of or block access to any genotype-phenotype data developed with NIH support,” while supporting “…a responsible approach to intellectual property derived from downstream discoveries…” The closing date for comments on these proposed policies is 31 October 2006; responses can be sent to a NIH comment site.


News story   |   By Dr Philippa Brice   |   Published 6 September 2006

A recent publication has revealed encouraging results for the use of gene therapy as a treatment for cancer [Morgan RA et al. (2006) Science Aug 31; Epub ahead of print]. Researchers from the US National Cancer Institute have used a retrovirus vector to introduce receptors into T-lymphocytes taken from seventeen patients with advanced metastatic melanoma, an aggressive form of skin cancer associated with very poor survival; the life expectancy of the patients at the time of treatment was reportedly 3-6 months (see BBC news report). The modified T-cells carried surface receptors designed to recognise and bind to the cancer cells via a surface molecule called MART-1, thereby enhancing immune destruction of these cells by the body. They were re-introduced into the patients and showed good persistence, or engraftment in fifteen patients; the tumour-specific T-cells comprised at least 10% of the total lymphocyte blood content for at least two months after treatment. In two of the seventeen patients, the modified anti-tumour cells showed long-term persistence in excess of one year, and in these patients the treatment led to total regression of the cancers. They have remained cancer-free for 18 months.

Experts agree that considerable improvements to the process will be required to make it suitable for greater numbers of patients and cancers the treatment failed to cure the majority of subjects in the trial - but the authors correctly observe that their results suggest the therapeuticpotential of genetically engineered cells as a treatment for cancer. Research team leader Dr Steven Rosenberg said that they would be seeking ways to enhance survival and persistence of the modified, tumour-specific T-cells, and also noted that they had successfully expressed lymphocyte receptors that specifically recognise multiple other forms of cancer, including breast and lung tumours. Of note, the therapy was not associated with any significant toxicity or side-effects, in contrast with aggressive forms of chemotherapy.

Although as with many gene-therapy approaches, considerable barriers will need to be overcome to make the technique more reliable and widely applicable - achieving long-term expression of therapeutic genes is a particular problem - these results are nevertheless a heartening 'proof-of-principle' demonstration of the potential power of gene therapy to combat cancers.


Research articles

Research article   |   Published 25 September 2006

A new paper in the American Journal of Medical Genetics reports the results of an investigation into how BRCA1/2 genetic testing alters the perception of breast and ovarian cancer risk in high-risk families [McInerney-Leo A et al. (2006) Am J Med Genet A. 140A, 2198-2206]. Individuals with a strong family history of cancer tend to overestimate personal risk; genetics education and counselling is intended to improve the accuracy of this risk perception (and hence create a reduction in anxiety and psychological distress along with appropriate health behaviours, such as increased adherence to screening programmes for those at genuinely high risk). However, the authors say that less is known about the effect of genetic testing on risk perception, particularly among members of high-risk breast and ovarian cancer families. They therefore recruited a total of 138 women from thirteen families, of which 87% chose to be tested for a known familial mutation.

Risk perceptions were assessed using a questionnaire before and after receiving genetic test results. The initial (baseline) risk perception was generally high, with 75% of women appropriately considering themselves to be a higher risk of developing breast cancer and ovarian cancer than other women their age. There was no difference in risk perception between those choosing testing and those declining testing. Following testing, 24% of participants were identified as mutation carriers; this did not affect their breast cancer risk perception but did increased their perception of ovarian cancer risk. Those testing negative had a significant decrease in all dimensions of risk perception. Interestingly, women who declined genetic testing showed significant reductions in their perceived risk of ovarian cancer and of carrying a mutation, although their breast cancer risk perception was not affected. It was found that seven out of eighteen of these women had had a parent who tested negative for the familial mutation, and in these cases the reduction in perceived risk was consistent with a decrease in actual risk.

The authors assert that their findings “demonstrate the significant impact genetic test results can have on perceived risk”, and contrast their observed modification of risk perception created by genetic testing with less successful attempts to improve accuracy of risk perception in similar high-risk populations through education and counselling. They propose that genetic tests may have an additional value for high-risk patients than information based upon family history alone, and suggest further research to determine whether this might apply to different forms of familial cancer and other diseases.

Comment: The finding that women can “successfully understand and integrate their genetic test results” is a positive one, but unsurprising given that the study population was highly educated and had significant prior interest in genetic testing. The study failed to demonstrate significant associations between perceived risk and follow-up screening practices, although as all the study participants had family histories of breast and ovarian cancer, it is probable that their adherence to screening programmes was already high. The effect of mutation testing on measures of psychological and emotional distress is not discussed. The study is therefore of limited utility, since in addition to the issue of whether genetic testing accurately modifies risk perception, the key question that remains is: does this alteration in risk perception as a result of genetic testing have health benefits for the individual, in terms of improved compliance with appropriate screening and/or emotional well-being?


New reviews and commentaries

New reviews and commentaries, 25 September 2006

Reviews & commentaries

Pharmacogenetics of warfarin: current status and future challenges. Wadelius M and Pirmohamed M (2006) Pharmacogenomics J. Sep 19; Epub ahead of print. Review on the key genes involved in warfarin metabolism, and prospects for pre-prescription genotyping and individualized therapy to avoid dangerous side-effects (PubMed).

Pharmacogenetics, drug-metabolizing enzymes, and clinical practice. Gardiner SJ and Begg EJ (2006) Pharmacol Rev. 58, 521-90. Review of current evidence base for genetic testing as a guide to therapeutic drug type and dose, in terms of drug-metabolizing enzymes (PubMed).

The October edition of Nature Reviews Genetics includes a special focus section of reviews on statistical analysis:

 

Computer programs for population genetics data analysis: a survival guide. Excoffier L and Heckel G (2006) Nat Rev Genet. 7, 745-58 (PubMed).

 

Modern computational approaches for analysing molecular genetic variation data. Marjoram P and Tavare S (2006) Nat Rev Genet. 7, 759-70 (PubMed).

 

Genetic relatedness analysis: modern data and new challenges. Weir BS, Anderson AD and Hepler AB (2006) Nat Rev Genet. 7, 771-80 (PubMed).

 

A tutorial on statistical methods for population association studies. Balding DJ (2006) Nat Rev Genet. 7, 781-91 (PubMed).

 

Spreading of silent chromatin: inaction at a distance. Talbert PB and Henikoff S (2006) Nat Rev Genet. 7, 793-803. Review of proposed models for heterochromatin formation as a mechanism of gene silencing (PubMed).

 

Genes, environment and the value of prospective cohort studies. Manolio TA, Bailey-Wilson JE and Collins FS (2006) Nat Rev Genet. 7, 812-20. Perspectives article on the importance of prospective cohort studies as a complement to case-control studies in the hunt for gene-environment interactions (PubMed).

The following letter to the editor is a rebuttal of an earlier article dismissing “genetic epidemiology as a misguided and hopeless quest for the philosopher’s stone” [Dissecting complex disease: the quest for the Philosopher's Stone? Buchanan AV et al. (2006) Int J Epidemiol. 35, 562-71]; see also the authors’ response.

Genomics, epidemiology, and common complex diseases: let's not throw out the baby with the bathwater! Khoury MJ and Gwinn M (2006) Int J Epidemiol. Sep 19; Epub ahead of print (PubMed).

 


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New reviews and commentaries, 18 September 2006

Reviews & commentaries

Predictive genetic testing for type 2 diabetes. Janssens AC, Gwinn M, Valdez R, Narayan KM and Khoury MJ (2006) BMJ 333, 509-10. Cautionary editorial article warning of how reports of newly identified genetic associations can raise unrealistic expectations of imminent medical benefits, and how scientists and the media must avoid this pitfall (PubMed).

 

The human tissue act. Furness PN (2006) BMJ 333(7567):512. Editorial on the HTA and how confusion over the precise terms of the Act may yet stifle research (PubMed).

 

Molecular biology: sticky end in protein synthesis. Roy H and Ibba M (2006) Nature 443, 41-2. News and views piece on the discovery of a new genetic defect underlying pathological protein aggregation (PubMed).

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New reviews and commentaries, 14 September 2006

Reviews & commentaries

RNA interference as potential therapy - not so fast. Marsden PA (2006) N Engl J Med. 355, 953-4. Commentary on the clinical implications of current research into RNAi as a therapeutic intervention (PubMed).

Reconstructing human origins in the genomic era. Garrigan D and Hammer MF (2006) Nat Rev Genet. 7, 669-80. Review of genetic and statistical methods for analysis of the evolution of human populations (PubMed).

Insulators: exploiting transcriptional and epigenetic mechanisms. Gaszner M and Felsenfeld G (2006) Nat Rev Genet. 7, 703-13. Review of DNA insulators, sequence elements that separate regions of chromatin (PubMed). 

Public health and human values. Hayry M (2006) J Med Ethics 32, 519-21. Ethical discussion on whether the aims of public health are at odds with the values of individuals and communities (PubMed).

Chromosome instability leaves its mark. Pollack JR (2006) Nat Genet. 38, 973-4. News and views article on genomic instability as a hallmark of cancer, accompanying the report of a new gene expression signature of aneuploidy with clinical predictive value (PubMed).

Genome structural variation and sporadic disease traits. Lupski JR (2006) Nat Genet. 38, 974-6. News and views piece on how genomic rearrangements can lead to sporadic disease, and prospects for identification of the genetic causes of certain disease traits (PubMed).

Reversal of fortune. Timchenko L (2006) Nat Genet. 38, 976-7. News and views articles on how reducing the numbers of CUG-repeat transcripts reverses symptoms in a mouse model of myotonic dystrophy (PubMed).

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New reviews and commentaries, 13 September 2006

Reviews & commentaries

Preimplantation diagnosis for genetic susceptibility. Braude P (2006) N Engl J Med. 355, 541-3. Perspective article following the recent HFEA decision to widen the approved conditions for which PGD is permissible to include lower genetic disease susceptibilities (PubMed).

 

Genes on the Web--direct-to-consumer marketing of genetic testing. Wolfberg AJ (2006) N Engl J Med. 355, 543-5. Perspective article (PubMed).

 

DNA testing, banking, and genetic privacy. Roche PA and Annas GJ (2006) N Engl J Med. 355, 545-6. Perspective article (PubMed).

 

Ethicists and biologists ponder the price of eggs. Check E (2006) Nature 442, 606-7. Special report on the pros and cons of paying women to provide human eggs for stem-cell research (PubMed).

Gene silencing in wet age-related macular degeneration. Arjamaa O (2006) Lancet 368, 630-1. Commentary (PubMed).

Balancing potential risks and benefits of using confidential data. Davies C and Collins R (2006) BMJ 333, 349-51. Analysis of how far patient protections should be allowed to detract from the public health benefits of medical research (PubMed).

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