Raymond McCauley forewarned, forearmed: in-house DNA kits

This special Podcast is brought to you by Barclays Africa, and Raymond McCauley, an expert in biotechnology, bioinformatics with Singularity University is with us, grabbing a few minutes after your presentation. That kind of blew people away because I think in South Africa we aren’t as up-to-date on developments in DNA, and the human genome and how that is transforming, potentially medicine and all kinds of other things. Just, from your own background, how long have you been in this field?

Since about 1999, and I switched over from computer science, as a lot of people, I think, have done, so I’ve been here for a while but it’s actually, fairly common. Most folks I can present things that happened ten years ago, and they’re like ‘that’s mind blowing are we doing that today’? I say, “No, that’s a decade old,” so it’s a new, almost kind of stealth technology that people just aren’t up to speed with.

One area where they are up to speed, it seems, is the investors because anything to do with Biotech has had a fantastic run.  Is it overdone or only just starting?

A little bit of both, you know, and I’ll hedge by saying that but I think, sometimes, the field blows up and people invest, sometimes foolishly. A lot of times there are people who are still finding their ways. We’re sort of seeing a new class of Biotech investors who, very sadly, enter the field, learn more about it. They’d made some mistakes. They made some good bets, and they’re getting better and better.

I heard it being described earlier that the whole drone area is like the Wild West. Would biotech be in the same position?

Maybe even, it’s almost like the West before the cowboys showed up, I think. That we’ve just got the Native Americans there, and people are still making it up as they go along. We have a total absence of regulation in some of these pieces.

So the TENX Company is very easy or rather, there will be a number of them, in this field?

Oh, definitely, I think we’re kind of…  One of the analogies that I really like, and this kind of goes back to where I live now, in the Bay Area, there’s the Computer History Museum. They’ve got a great display where they have the Honeywell ‘computer of the future’, and it’s a kitchen computer, a $10,000 computer that was invented back in the 70’s. It has this beautiful fibreglass exterior and it’s got a keyboard and a display screen, and it was to store recipes. They said, “This is what people will use computers for in their homes and we can sell a few $10,000 computers.”

We’re kind of, I think, at that same stage. There are whole consumer markets, sort of being invented (being come up with). Some of those are going to look like that kitchen recipe computer for $10,000, and then they’re going to be other things that will just be commonplace and credibly useful and change the way we live.

The whole Human Genome Project has also been an indication of how exponentiality can be at work.

Definitely, and one of the interesting things about that was they were making it up as they go along, but in a good way, so they…

How did it all start?

Interestingly enough, the U.S. Government, wanted to go ahead and do a project and it was backed not by the National Institute of Health, or some of the other places you would think it would come from, but the Department of Energy. They were very foresight for they knew that these biological machines that make us up and that make up all of nature. That there was a way to harness those and do something about producing energy, and new industrial processes, so they really wanted to look at that. It’s an interesting sort of orthogonal start, and a lot of people don’t realise that’s where it came from.

And lots of money went into it, in the early stages. In fact, that again listening to some of your colleagues, the suggestion early on was that it was a failure.

Because everybody thought, it was off to such a slow start but, in many ways, because they were developing the technologies, they went… Whenever they hit the point, halfway through the project, where they had actually sequenced one percent of the human genome, people thought ‘oh, we’ll never get the whole thing done’. That was a really good example of an exponential at work. That meant that we were on track and that we had really picked up steam, and that we were going to be able to double and redouble, and redouble from there. It was amazing.

The Government Project, for the Human Genome Project, actually was first and going for quite a while. Then there was a commercial project that joined later on, because they joined later and took advantage of some of the new technology, their whole projects ran, not for several billion Dollars, but for 100 million Dollars, so it gives you an idea, kind of how the technology compressed in the time that was available.

And today? 

Today we know we can get all in human genome sequenced and get, at least, the raw data for under $1,000, sometimes much under a $1,000. One of the new bottlenecks though, so now that you’ve got the data, you really want the information, so how can you interpret those AC’s, G’s, and T’s, and tell something about somebody’s health or something about something that’s good for cancer research, etcetera. Something that’s good for industrial biology, some of this energy production, so those are the parts we are still feeling our way on that.

Have there been any successes or is it still too early?

No, tremendous successes, especially with human health, we’re finding new things about how disease works, discovering new, whole mechanisms we didn’t even know happened in the body that, basically turn off and on the switches for all of the chemical pathways, metabolism that goes on. Learning more and more of where, we’ve always hypothesised how bacteria interact with humans. How different systems work for inflammation, the immune system. We now can get really, sort of get it under a DNA microscope and get it right down to first principles.

Just bringing science to medicine.

Oh, definitely, and sometimes in a disturbing way to medicine, people are used to practising medicine as sort of an artisanal. You know, this is how we’ve done it. This is what works. A good doctor is somebody who has a feel and an instinct for things. Now, we’re seeing a whole wave of evidence based medicine and translational medicine. Taking it right from the research labs, in to the clinic.

So the doctor, your GP.

Whatever it is, and the same thing, I think is happening with the doctors.  There’s so much complexity now, as far as facts known and treatment options and everything else.  That you need someone who can, sort of, ride on top of that and call in the specialists.  We’ve already seen some of that. What I think is interesting is that there is not really a direct analogy and therefore, who the patient is or they’re the star of the show. They kind of need their own, little personal assistant or handler, who will go ahead and help them coordinate some of that too.

Raymond, you’ve got Obama Care in the United States. Here in South Africa we’re looking at something called the National Health Insurance, which is going to be an incredibly expensive investment. The population needs to be uplifted in that field, but knowing what you know, which seems to be on a completely different trajectory. How would you approach improving the health of a country?  Is it possible to leapfrog?

I think it is, partly because a lot of the problems in the system seem to be political, and process problems, and how we do things, some of these new technologies offer a chance to leapfrog. Not insurance companies, some of the big healthcare systems, look very suspiciously at the new technology saying, “Do we really want this?  Is this just a new call centre?” What’s going to happen is, in the short run, the costs will go up, as we come up with new diagnostics and new modes of care, but in the medium term (we hope), and definitely in the long run. We’re going to see the cost plummet dramatically because we’re going to have people coming up with new ways to prevent disease or delay it, so far into the future. That you’re not fixing something that went wrong. You’re preventing something from going wrong.

A bit like the story of CureVac?

CureVac being a great example and the fact that what they’re looking at. We’ve sort of reduced the problem of vaccinations to principle. Instead of the old-fashioned smallpox vaccination. We take dead and dying disease, inject it under the skin, and get the immune system inured that way, or you recreate particles of the disease and use that. You were not really doing that. You were taking the information from the disease, the information that the virus itself uses, to make copies of itself, and feeding that into the bodies, so the body makes its own copies, and gets sensitised to both the RNA, the information and to the particles that can be made, and then knows how to defend against the disease.

And it’s been well supported by the Gates’ Foundation, making lots of investments into Africa, so I guess we could see CureVac being applied on this Continent.

And I think that that’s one of their big foundational plays there. They’ve put $57m in, and not as a grant but as an actual equity investment but they’re hoping that this will have a wide range of vaccines, for all sorts of low-income nation problems, for all sorts of… You know bottom billion disease.

Well, the more you know about something, the easier it is to address it and human DNA is a lot easier now to find than it was in the past. Just explain to us how a citizen, (a normal citizen) could in fact, get hold of their DNA and apply it for medical purposes?

Well, there are a couple of ways, clinically, now where people do some DNA testing and don’t even really recognise it as such, so a woman who goes in who’s pregnant to get a chemosynthesis. That’s a form of DNA testing. A lot of cancer testing now that goes on, even in the era before big DNA sequencing and ex-generation sequencing. Somebody has breast cancer – the way that we classify that breast cancer is based on gene expression. That’s a DNA test. In the U.S. right now, there’s a consumer product, there’s actually several different ones, where you can go ahead and send in a sample of your spit and they pull the cells out, get the DNA, and they’re able to go ahead and look and say ‘here are interesting things about you and your health that you might not know’. Some of its disease prevalence, some of it is how you would react to different kinds of drugs. Some of it is just fun/silly things, like your genes that code for your eye colour. Is that really what you’ve got or what do your grandparents and great-grandparents, what’s your ancestry? What does that look like?

And that does seem to be a rather popular pursuit by people in the United States. What does it cost?

In the Unites States, right now, just $99, to do it. In England and Canada, they have a version of it for about $200 to $300, equivalent, where it’s actually kind of supported by those governments and those health systems, to help people get some information about their genetics.

And that would help, presumably, to address certain diseases that may or may not happen to you?

Yes, the idea that if you know that you’re at a greater risk for, say a certain kind of cancer, and instead of just being worried about it. That you would go and get more regular screenings for that cancer and having the health system work with that. That’s a fantastic idea. It should pay for itself and should make a real dent in early detection of these diseases.

I love the story you gave to the audience today about AMD, your own story.

Yes, one of the surprises for me, whenever I first tried out some of these tests on myself, there’s a prevalence in my family that I didn’t even know about, for developing AMD, Age Related Macular Degeneration. It’s a form of blindness that has an onset later in life but it was really worrying to me. My risk of that was four to five times the average risk, and I had never even heard of it before, so I went ahead and tried to find some ways that I could address this worrisome condition that may happen to me.

What were they?

A lot of it was…  I did what any scientist does, whenever they get worried about something. You read a lot of things, and so from my reading I found out, you know, some of the pieces that people have done to prevent this supposedly and preventable disease. Taking vitamins, wearing special glasses with UV filters, so you don’t get your eyes damaged by the sun, not smoking, and some things like that but the biggest thing I really did was go and talk to a research ophthalmologist.  Instead of going to the mall to get your glasses, which I always did, I went and said, “Hey, can you help me out and tell me more about this and what can I do?” That is where I got a lot of information.

And forewarned, in your case, was forearmed? 

Very definitely, you know, I’ve actually got quite a few years before it’s probably a real threat, if it is at all, but it’s been amazing to me the evolution of just what’s happened in the field. This disease that used to be incurable and untreatable is now just considered unpreventable, and even there I found preventions for it. There are a lot of different treatments available.  At least two major ones now.

Medical revolution, Raymond McCauley is the biotechnology and bioinformatics specialist at Singularity University, and this special Podcast was brought to you by Barclays Africa.

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