Femina

Beauty Health Documentary

"A predictive measure, prior genetic testing can give a fair assumption regarding your predisposition to a certain skin concern"

BY Sukriti Shahi

Anti-ageing is the current buzzword in the global beauty industry. With large investments being pumped into this segment, brands are going all out to cater to different needs, with many even opting for the customisation route. According to a research by Global Industry Analytics Inc, the global anti-ageing market is expected to cross $260 billion by 2020. The research also states that the Asia-Pacific anti-ageing market is the fastest growing one, globally. The Indian antiageing industry too is witnessing consistent growth. But do these products actually deliver results?

Skin ageing and concerns are greatly influenced by genetics. According to studies, a human body houses around 25,000 different genes, out of which 1,500 may impact skin health. These genes, to a great extent, are responsible for the skin behaviour like determining skin type (oily, dry, or combination), skin concerns (acne, pigmentation, or blemishes) and ageing (wrinkles, fine lines, or crow’s feet). This is the reason why some people start to show signs of ageing in their twenties while some have younger-looking, healthy skin even in their late forties.

“Our skin goes through intrinsic ageing as we get older. It varies from person to person based on the genetics and the body’s internal processes. Things like the quality of skin, elasticity, acne, dark circles, hair quality as well as quantity, body hair, stretch marks are all predetermined by our genes,” explains Dr Jamuna Pai, cosmetic physician, author, and founder of SkinLab.

GENETIC TESTING

To make informed health choices based on one’s genetic makeup, experts from FutureMed explain why genetic testing is beneficial. Genetic testing uses laboratory methods to look at your genes, which are DNA instructions you inherit from your parents. Genetic tests may be used to identify increased risks of health problems, to choose treatments, or to assess responses to treatments. Understanding the science behind genetics helps people make informed choices. A single nucleotide polymorphism (SNP) is simply a point in our DNA where a biologically meaningful variation occurs in greater than one per cent of the population. This deviation can range from having no effect at all to completely changing the way proteins in the body operate. SNPs act as ‘biological markers’ that help scientists analyse genetic differences associated with human health and disease. It’s these variations which affect the body's response to nutrients, exercise, medications and more. Study of these genes, SNPs and variations allows for more detailed and actionable reports. Decisions regarding dietary habits, fitness, nutrition, and weight management benefit from genetic testing.

ROLE OF GENETICS IN SKIN AGEING

Genetics has a major role in determining healthy skin. However, it’s not the only factor. When it comes to ageing, genetics coupled with external factors decide the rate at which you start showing the first signs of ageing. “Skin ageing is part genetics, and rest are external factors such as sun exposure, stress, and lifestyle choices,” adds Dr Pai. This means that the genes you are born with do have an impact on the ageing process but their mutation over time affects the ageing rate. “All genes do not affect in the same way; there are recessive and dominant traits. Ultimately the traits in the offspring may not behave in the same pattern and deviate substantially,” explains Dr Apratim Goel, dermatologist and laser surgeon, Cutis Skin Solution, Mumbai.

The change in genetic makeup is attributed to the body’s will to fight free radicals and external factors like environment and lifestyle. “Studying genetics for skin ageing is not a definitive but predictive step. This history helps dermatologists assess skin and hair concerns in patients. It helps to understand the chances for a patient to develop certain skin conditions like acne, scars, stretch marks, freckles, sun spots, vitiligo, and alopecia,” adds Dr Goel.

Genetics also help dermatologists understand the body’s ability to produce collagen, certain hormones, and proteins that are responsible for skin and hair ageing. In short, genetics can help predict signs of ageing early on, but external factors are responsible for aggravation or prevention of these signs. “Take a look at your parents’ skin to see how you will age. I have seen young adults in their twenties with deep laugh lines because it’s a family trait. Likewise, one of the most common and also an irreversible reason for hair loss and premature balding is genetics, passed down from either your mother’s or father’s side of the family,” adds Dr Pai

STEPS TO TAKE

While genes determine the skin’s ageing process, it doesn’t mean you inherit the same skin concerns as your mother or grandmother. A predictive measure, prior genetic testing can give a fair assumption regarding your predisposition to a certain skin concern. “Typically, we go back two generations, if the information is available, and map for certain skin conditions. Barring genetic skin disorders, which have a certain pattern of inheritance, most of the other skin concerns respond to early prevention remedies,” says Dr Goel. However, genetic testing doesn’t mean the effect can be reversed, it just ensures timely redressal to the skin concern.

Public opinion

We asked a few people about beauty hacks they borrowed from their mothers to fight signs of ageing. Here’s what they have to say: Simran Desai Marathe, a patissier by profession says, “My mother has lovely thick eyebrows. She used to follow a few home remedies when she was in college. Although, I am blessed with long, arched brows similar to hers, I still follow her hack of applying castor oil on my brows and lashes. It does make a difference. She also applies homemade masks to maintain flawless skin. I use a mix of lemon juice, aloe vera, and vitamin E for clear, supple skin.” Stay-at-home mother of a seven-year-old, Ruchi Kulkarni, says, “My mother asked me to stay away from chemicals. Instead, she convinced me to use a homemade mask—a mix of honey, turmeric, saffron and few drops of milk. This has helped me achieve smooth and healthy skin like her. The mask removes tan, and gives you an instant photo-ready face.” School teacher Shefali Bathla who’s blessed with problem-free skin, credits her mother for passing on the genes to her. She, however, adds, “It’s also because I followed the same home remedies that worked for her. I still wash my face with milk at least thrice a week. Also, my mother dealt with premature greying of hair in her twenties. Therefore, she was careful with me and washed my hair with shikakai and amla (Indian gooseberry). Thanks to that, I have healthy and long hair now.”

Express Healthcare

Pharmacogenomics - Essential to end the era of trial and error medicine

FutureMed elucidates on the impact that trial and error has had on patients earlier, but in today’s age adverse drug reactions is considered to be the fourth leading cause of death worldwide and has almost doubled in India in the last three years

BY Chandni Luthra, Co-Founder

Doctors always want to get it right the first time when treating their patients, but in reality the strategy to making it “just right” is more like Goldilocks approach. When a patient comes in for a diagnosis, the doctor has the following options- aggressive, mild or standard. Most patients have prescribed a standard treatment, some may do well while others do not get any benefit or may even experience severe side effects. In such cases, new medicine will be recommended and the same cycle will continue. This trial and error may have been acceptable earlier, but in today’s age when adverse drug reactions are considered to be the the fourth leading cause of death worldwide and has almost doubled in India since the last three years, clinicians need to do better especially when the stakes are high, the advance of the disease is rapid and cost-effectiveness is a must.

Most of the drugs that are currently available are one-size fits all but there is no guarantee that they will work the same way for everyone. It is estimated that on an average 15-35 per cent of patients have an adequate or no response to beta-blockers while 10-20 per cent of patients do not respond to antipsychotic therapies initially (Indian Journal of Human Genetics, 2011). Studies conducted by JIPMER, SGPGI and Gangaram Hospital (Delhi) also indicate that 30 per cent of Indians are sensitive to certain drugs such as clopidogrel, an anti-platelet agent widely used to treat cardiovascular diseases, subjecting both patients and their doctors to greater uncertainty, often entailing huge costs- physical as well as financial especially for the patients.

How an individual responds to a particular drug – positive or negative, is determined by a number of factors such as gender, age, lifestyle, environment, state of health, organ function, drug-drug interaction as well variations in the genetic make-up, which accounts for nearly 95 per cent of the variability in drug metabolisation and its effect. Thus information from pharmacogenetic testing is imperative, not only to understand how well the body responds to the drugs but also the exact dosage that is needed to treat the ailment.

When a medicine is taken, the body needs to absorb it, distribute it to the intended area, metabolise it and finally excrete the non-utilised part either through urine, bile or sometimes exhalation. Genetic variations influence each and every aspect of this process including how well your body breaks down a particular drug. So if an individual has a mutation that breaks down a drug very quickly the body will use the drug faster and the person will require a higher dosage of the medicine to be effective. Similarly, if the body breaks down the drug slowly a lower dosage would be advisable

Research has shown that more than 85 per cent of patients tend to have significant genetic variations in the most important cytochromes, responsible for metabolising half of the medicines in clinical use. For instance, the CYP2D6 gene helps to breakdown and terminates the actions of certain beta-blockers, antidepressants, neuroleptics and antiarrhythmics drugs but approximately seven per cent of the population have a variant that makes them an intermediate or poor metaboliser, while 35 per cent are carriers of nonfunctional allele of this gene, increasing the risk for toxicity and adverse reactions even on low dosage. Therefore if a doctor is prescribing citalopram or amitriptyline to treat depression it is advisable that they ask their patients to undergo pharmacogenomic testing to decide the correct dosage or choose a different drug for greater efficacy and safety.

doctors can also use pharmacogenetic testing to determine the correct treatment for various types of cancers. For instance, breast cancer can be treated by the T-DM1 drug, which works by attaching itself to the HER2 receptors on the cancerous cells. A sample of the tumour can be tested to determine whether there is a mutation that produces too much of HER2. If the the test is positive and the tumour has a high amount of HER2, only then T-DM1 should be prescribed because if the tumour does not have HER2 the T-DM1 drug will not work well for the patient.

Pharmacogenomics can redefine the way drugs are developed and chosen for the patients. By understanding, the genetics behind a patient’s response to therapy doctors can not only reduce adverse drug reactions but also significantly lower healthcare costs by reducing the duration the patients are on medications as well as the number of medications a person might take to find an effective treatment. To this end and to make precision medicine a reality FutureMed offers pharmacogenetic tests for cardiology, neurology, psychiatry and cancer to help doctors support their patients with accurate information and the best possible course of action.

Express Healthcare

Knowing your genes solves the puzzle of life

FutureMed highlights how genetic tests can help identify health risks, choose course of treatments and assess the response to them

BY Chandni Luthra, Co-Founder

Are the medicines prescribed to treat your illness causing more harm than help, do you want correct early diagnosis for better treatment. Not able to lose those extra kilos to keep obesity and heart problems at bay? Confused about which supplements to take? Still figuring out how to tackle such issues? Fear not as help is already here. Your DNA holds the answer to the above questions.

DNA is the basic building block of the human body containing all the information necessary to make you, run you and repair you. No two people, except for identical twins, are genetically identical. These variations lead to different processes in our body and affect how our body responds to different macro-nutrients, vitamins and minerals, exercise and certain medications. Genetic tests may be used to identify increased risks of health problems, to choose treatments, or to assess response to treatments. Early diagnosis through clinical genomics can help to identify risk of certain types of cancer and cardiovascular diseases. This means that your genes can determine all the answers necessary for achieving a healthy body and truly knowing yourself and what works for you in terms of nutrition as well as the medications needed to treat certain conditions. For example, specific variations in gene MTHFR lead to high homocysteine levels and low metabolism of folate in the body. Individuals with these specific mutations need supplements because their body cannot convert folate to methyl folate, resulting in higher homocysteine levels, which in turn leads to atherosclerotic vascular diseases or thrombosis.

Unlocking the secrets of one’s genetic code used to be expensive and confined to very few laboratories worldwide, but advancement in next-generation sequencing (NGS) and genotyping technologies have brought the costs down and has enabled the business of DNA to help medical professionals make recommendations for a person’s food intake, dosage of medications to avoid adverse drug reactions as well as providing all the information a person needs for proactive and preventive health planning. The aim is to move from one size fits all approach to something that is highly personalised and as such completely changes how people perceive their overall health and well-being.

These genetic tests areas common as pathology tests in the US and many countries in Europe. But in India, the genetic testing market is still in the nascent stage. According to ICMR, the addressable market for these tests is 500,000 people but actually should be in millions. Any person can take the test. The younger the better as the test provides all the information that can help you to play to your genetic strengths or sidestep some of your inherited challenges.

Innovation is a driving change in the healthcare industry in India. Your genes are not your destiny but can certainly determine the health of your future. To this end, I believe that there is a gap in the market for personalised wellness solutions including bespoke skin products, as well as nutrition and fitness programmes because if you can tailor your clothes and shoes, why can’t you tailor your wellness solutions. Therefore apart from the tests Futuremed is also the first company in India to offer nutritional supplements that will be customised according to an individual’s DNA.

Traditionally, nutrition management has focussed on a stop-n-go strategy wherein individuals consume mega doses of a particular macro-nutrient for a short period of time. However, such an approach poses a risk of toxicity and is ineffective when it comes to maintenance of the body’s internal environment to fortify cellular protection, repair and regeneration and to support the renewal process.

Sometimes the Recommended Daily Allowance (RDA) defined as the non-toxic dose that should be consumed on a daily basis to maintain healthy plasma concentration of nutrients and is not enough because genetic variations may predispose an individual to have a decreased level of macronutrients. Such individuals require a more personalised approach to nutrition management.

Futuremed as a company with their highly skilled team of molecular biologists, bioinformaticians, accompanied by a scientific data-driven approach and state of the art laboratory is helping in creating awareness among clinicians and wellness experts to offer smart and efficient solutions to individuals. The company is providing genetic tests not only in the wellness space of nutrition, weight loss, fitness and skin but is also helping people determine their risk for developing diseases ranging from cancer, neuro to cardiovascular and various other conditions. In addition tests are also offered in the field of pharmacogenetics / precision medicine and autoimmune diseases. The aim is to make inroads in this nascent market with the target of making these tests accessible and affordable for all thus making genetic screening a routine part of health care in India.

livemint.com

Genetic resource helps develop base- line data on ethnic groups for disease susceptibility

The aim is to improve disease management with more genetic labs & trained personnel

BY Neetu Chandra Sharma July 16 2019

NEW DELHI: The government is exploring recreational genetics, a new area in the field of genome testing, for reducing India’s disease burden.

Private DNA testing laboratories offering recreational genetics tests are already burgeoning in India. Now, the department of biotechnology (DBT) has initiated a programme called human genetics and genome analysis in which the country’s genetic resource is being utilized to develop baseline data initially on various ethnic groups for disease susceptibility.

“We are focusing on improving human health by promoting the development and dissemination of genomic methodologies and tools for prediction and prevention of human disease, and for therapeutic intervention. The aim is to improve disease management through lifestyle modulation, improvement in public health, reduction of disease burden, and lowering of treatment cost with more genetic laboratories and trained personnel in the area," said Renu Swarup, secretary at DBT. Several private laboratories are using recreational genetic tests to offer a tailor-made lifestyle, diet, weight loss, and disease prevention plan for each individual for maintaining optimal health and fitness.

While recreational genetic tests are common in the US and several European countries, in India the genetic testing market is still at a nascent stage. The addressable market for recreational genetic tests is 500,000, according to the Indian Council of Medical Research (ICMR). This could actually be in millions, industry experts claim. “As genetic testing can reveal how one’s genes behave and respond, personal genetic information can provide data that can help people make more informed health-related decisions about their lifestyle, goals, dietary habits, fitness, nutrition and weight management," said Chandni Luthra, director and co-founder, FutureMed, a Delhi-based biotechnology company.

Research is also on to establish the link between genetics and obesity. “At present, we are not ready for genetic tests to predict weight loss. However, there are some encouraging leads and, for the first time, we are doing research on this issue in India," said Anoop Misra, chairman, Fortis-C-DOC Centre for Diabetes, Metabolic Diseases and Endocrinology and National Diabetes, Obesity and Cholesterol Foundation.

Companies such as FutureMed are offering genetic tests for skin, hair, detox, pharmacogenomics, a branch of genetics used to determine the likely response of an individual to therapeutic drugs and diagnostic of diseases such as cancer. The company also offers customized vitamin supplements based on an individual’s nutritional genetic profile.

“Genetic screening, especially in the wellness space, is a new concept," said Luthra .Another diagnostics laboratory chain in India, specializing in genetics, CORE Diagnostics, offers recreational genetic tests such as geneCORE Predict, where sequencing and analysing the genome of an individual, a geneticist can predict the risk, genetic carrier status of 22 types of cancers, and the likelihood of passing it on to the next generation.

Similarly, in liquiCORE test, helps patients decide the drugs and medical approaches suitable for them. “Diverse purposes of genetic testing have already been identified, like screening for genetic diseases in newborns, children and adults. The cost of genetic testing varies between₹5,000 and ₹5 lakh. However, the more important aspect is the counselling session with the healthcare provider that can help zero in on the correct test out of the plethora of choices," said Zoya Brar, MD and founder of CORE Diagnostics.

“An important part is to visit a genetic counsellor or a healthcare professional as they are trained professionals who play a key role in helping patients get the care that’s right for them. They work with patients to help them understand genetic testing, guide them through the process and make informed choices based on their results," said Brar.