Lapho ukuhlolwa kofuzo (DTC) kwezakhi zofuzo kubonakala kuqala emakethe, umagazini we- Time wawagubha njengokwakhiwa konyaka ngo-2008. Nokho, cishe eminyakeni eyishumi kamuva, ukusetshenziselwa kwabo okuqhubekayo kusaphikisana kakhulu. Ubuchwepheshe bezempilo buyingxenye yomuthi okwenziwe ngabanye. Ithembisa ukuqonda ngokuphathelene nezakhi zofuzo zempilo yethu, kanye nokusisiza ukuthi senze izinqumo ezingcono.
Inamba ekhulayo yezinkampani emhlabeni jikelele ihlinzeka ngamakethi e-DNA wezimo nezifo ezahlukene. Abasebenzisi manje bakwazi ukufinyelela ulwazi lwabo lofuzo ngaphandle kokubandakanya udokotela kanye / noma inkampani yomshuwalense. Kodwa, ukwanelisa isifiso sethu ngokuhlolwa kwe-home-genetic isinqumo esihle?
Nakuba ukuhlolwa kwekhaya ekhaya kuyindlela ehamba phambili enezinzuzo eziningi, ochwepheshe nabo baxwayisa ngezingozi kanye nokulinganiselwa kwawo. Ngokuvamile, lezi zivivinyo ziveza ulwazi olungaphelele noma olungalungile. Lokhu kubangele kakhulu kusukela abathengi bengaboni ngaso sonke isikhathi imiphumela yabo futhi bangenza izinqumo zempilo eziyinkimbinkimbi ngaphandle kwesiqondiso sobuchwepheshe. Ngaphezu kwalokho, izivivinyo zofuzo zihlinzeka ngokuqonda okuyingxenye kuphela.
Ukuze siqonde kangcono ukutholakala kwethu nesifo, ezinye izici kudingeka zibhekwe njengemvelo, umlando, umlando womndeni, kanye nokukhetha kokuphila. Iningi lezazi zivuma ukuthi izivivinyo zokubikezela, ezinikezela abasebenzisi ulwazi mayelana nobungozi bokuthuthukisa isimo sempilo, banikeza amanoveli, izindlela zokudemokhrasi zokuhlolwa kwezakhi zofuzo.
Noma kunjalo, insimu ihlala igcwele imininingwane ephikisanayo , futhi izingxabano ezishisayo phakathi kwezinkampani nezinhlangano zokulawula ziyaqhubeka.
Ukusuka Ezivivinyweni Zokuzala Ezivivinyweni Zokuqokwa
Esikhathini esidlule, sasijwayele ukuhlolwa kofuzo lokuzala, okwanikeza ulwazi mayelana nengozi yengane yesikhathi esizayo.
Manje, ukuvivinya komuntu siqu kanye nokuhlolwa kwesimo sezinto kuyafana. Izivivinyo ze-Presymptomatic zinikeza ulwazi mayelana nesimo esizuzwe njengefa esingaba khona kubantu abathwala isakhi ezithile. Isibonelo, cishe bonke abantu abanokuphindaphinda okungama-40 noma ngaphezulu kwengxenye ye-CAG esakhiweni se-Huntington bayodala isifo sikaHuntington (ukungena okuphelele). Ukuhlolwa kwesimo sokudalwa , ngakolunye uhlangothi, tshela ngengozi eyengeziwe yokwakha isimo ngenxa yokuguquka kwesakhi sofuzo; akukho ukuqiniseka ukuthi umuntu ovivinywa uzokwakha lesi simo esikhathini esizayo.
Ukuhlolwa kwe-DNA ekhaya-kumakethe kudayiswa njengezivivinyo zombili zokuhlolwa kanye nokuhlelwa kwesimo futhi kwenziwa ngaphandle kwesistimu yokunakekelwa kwezempilo kazwelonke. Uma uthatha lezi zivivinyo, udinga ukuqaphela ukuthi imiphumela kaningi ayimnyama nomhlophe. Ngokuyinhloko, abasebenzisi bazo (kuphela) bafunde ngezingozi zabo siqu. Ngokusho kwemiphumela, bangase bafune ukulungisa ukuziphatha kwabo (isib. Badle ama-fatty acids ama-omega-3 ngaphezulu) noma bahambisane nokungenelela kwezokwelapha (isb.
Ukuhlolwa Kwama-Genetic Ekhaya Kusebenza Kanjani?
Ngemuva kokuthi uthenge ukuhlolwa kofuzo lwe-DTC, i-protocol yokuhlola ngokuvamile idinga ukuthi uthathe isampula ematheni akho noma i-swab ngaphakathi kwesigama sakho.
Ngaphandle kwalokho, ungadinga ukuvakashela umtholampilo wezempilo ukuze unikeze isampula segazi. Isampula ithunyelwa emuva kwenkampani yokuhlola futhi ezinsukwini ezimbalwa kuya emavikini ambalwa, uthola imiphumela yokuhlaziywa kwe-DNA yakho ngendlela yombiko.
Ukuhlolwa kwe-DNA ekhaya-ekhaya kungakwazi ukunikeza ulwazi oluthe xaxa, kusukela ekuhloleni kwakho kuya kwesifo nasesimweni sokuthwala (ingozi yokudlulisela isifo enzalweni) ekubikezelweni kokuhlunga nohlobo lwe-earwax. Ukuvame kakhulu ukuhlolwa kwe-nutrigenetic, okukunika ukudla okubhekwa ngokufanelana nawe ngokusekelwe ku-DNA yakho.
Izindleko zokuhlolwa kwe-Genetic ziyancipha
Nakuba ukulandelana kohlobo lwe-genome (WGS) kusengabizi, izinketho ezingabizi kakhulu ziyatholakala.
Ngokwesibonelo, kungenzeka ukuba ukhethe ukukhiqizwa kwe-nucleotide polymorphism (SNP) eyodwa ebiza izindleko, okuyinto amabalazwe kuphela izindawo ze-genome ezihlobene nezifo. I-SNP i-genotyping inganikeza ukulinganisa kwengozi yakho yokuthuthukisa izimo ezithile.
Abahlaziyi bezeMvelo bamazwe omhlaba babikezela ukuthi ngo-2018, imakethe yomhlaba wonke yokuhlolwa kwe-hometic gene izofinyelela ngaphezu kwezigidi ezingama-233 wezigidi. Izinkampani ezintathu zokuhola i-DTC zokuhlola izakhi zofuzo zibhekwa njenge-23Me, I-Family Tree DNA, ne-Ancestry. Ngonyaka ka-2017, mina-23 nginguye owokuqala ukuthola imvume ye-FDA ukwenza ukuhlaziywa kwe-DNA ngezimo ezingu-10 ngaphandle kokubandakanyeka kukadokotela.
Izinkampani ze-DTC ikakhulukazi zikhuthaza izinsizakalo zabo zozalo. Amaphakheji alolu hlobo lwenkonzo angatholakala ngaphansi kwe $ 100. Ukufaka ulwazi lwezokwelapha ngokuvamile kuletha izindleko, isibonelo, 23ngamanje unikeza inguqulo yezokwelapha + ye-$ 199. Izinkampani eziningi ze-DTC azinikezi izilinganiso eziphelele ze-WGS.
Izivivinyo Zomzimba Zasekhaya-Ukuhlolwa kuHhovisi leDokhumenti
Enye inzuzo yezindleko zasekhaya eziheha abathengi abaningi ukuthi aziwaziwa. Imiphumela ayifuni ngokuzenzakalelayo ibe yingxenye yerekhodi lakho lezokwelapha. "Ukucwaswa ngokobuzwe" into engakaqondakali kahle. Ngokufanele, abanye abantu bakhathazekile ngengozi yokucwaswa okungenzeka ukuthi lolu hlobo lwamavivinyo luthwala (isib. Ukusetshenziselwa ukwandisa amaphrimiyamu omshwalense wokuphila). Kusukela ngo-2009, uMthetho we-Genetic Information Nondiscrimination Act ubelokhu useMelika, kodwa kube khona izingcingo zakamuva zokuziqinisa. Ngakho-ke, abaningi babona ukuhlolwa okuzimele njengendlela yokugcina ulwazi lwabo lwezofuzo luyimfihlo.
Ukuhlolwa kwe-DTC kuye kwathengiswa njengendlela engakunika ukulawula ngaphezu kokhetho lwakho lwezempilo. Kodwa-ke, ucwaningo lubonisa ukuthi abantu bangakwazi ukuqaphela ukuhlolwa kofuzo okungenziwanga ngabaqeqeshiwe bezempilo abaqashwe ezifundeni zombuso. Ukuntuleka komthetho kahulumeni kanye nokuchazwa okungaqondakali kolwazi lwezakhi zofuzo kuye kwashiwo njengezingcingo ezimbili zezinkinobho ze-DNA ekhaya. Futhi, ukuvikeleka kwabathengi kusanda kuba ukukhathazeka. Abathengi bakhombisile ukuthi ukwesaba ukuthi idatha yabo ingatholakala kwezinye izinkampani noma isetshenziselwe ukucwaninga okuqhubekayo ngaphandle kolwazi lwabo.
Hlangana noProfesa Christine Critchley wase-Swinburne University e-Australia kanye nabalingani bakhe abavela eNyuvesi yaseTagmania bahlola isimo sengqondo somphakathi wase-Australia ngokuhlolwa kwe-DTC. Babenesithakazelo sokwazi ukuthi abantu bayabheka yini ngokufanayo nezivivinyo zofuzo ezilethwe ngabachwepheshe babo bezempilo. Imiphumela yabo ibonisa ukuthi abantu ngokuvamile babelana ngokukhathazeka kochwepheshe bezakhi zofuzo mayelana nokuhlolwa kwe-genetic ye-DTC futhi akunakwenzeka ukuthi bahlele eyodwa. Abathengi kulolu cwaningo babenenkathazo ehlanganisa ukuphulwa kwemfihlo kanye nokuntuleka kokululekwa, kanye nokunemba okuphansi uma kuqhathaniswa nezivivinyo zofuzo ezibekwe odokotela. Ngakolunye uhlangothi, izifundo zangaphambilini e-United States naseRussia zabonisa isimo sengqondo esihle ngokuthenga ukuhlolwa kwezakhi zofuzo. AmaMelika namaRussia abonakala sengathi angase ahlele ukuhlolwa okunjalo ku-intanethi.
U-Andelka Phillips ovela e-Faculty of Law yaseYunivesithi yase-Oxford naye ubhala ngezinselele ezingokomthetho zokuhlolwa kwe-genetic based genetic okusemhlabeni jikelele. UPhillips uyaphawula ukuthi noma yikuphi ukuthuthukiswa kokuvikeleka kwedatha nokuphepha kolwazi kuzodinga ukubambisana kwamazwe ngamazwe.
Ukunemba Nokuphepha Ukuhlaselwa Okubalulekile Kwezilingo Zomzimba Zasekhaya
Ikhono lokubikezela ngokunembile nokwethembeka ukukhona (noma ukungabikho) kwesifo sekuyikhathalela enkulu mayelana nokuhlolwa kwekhaya. Abanye abathengi babika ukuthi bathola imiphumela ehlukene ezinkampanini ezahlukene ze-DTC. Ithimba labososayensi bezakhi zofuzo ezivela kuJ. J. Craig Venter Institute kanye neScripps Translational Science Institute yenza ukuqhathaniswa okuzimele kwamasampula amahlanu ahlaziywe ngu-23 kanye noMeyi-Navigenics.
Ngenkathi imiphumela yabo ibonisa ukuthi ukunemba kwemiphumela eluhlaza kwakuphakeme, lezi zinkampani ezimbili zahluke ekubikezelweni kwezinhlekelele zabantu abafanayo. I-Navigenics kanye no-23Me bavumelana kuphela kokubili kwezintathu zokubikezela mayelana nesengozi esiqondene nesimo. Isivumelwano sokubikezela sasingcono kwezinye izifo kunezinye. Ngokwesibonelo, izinkampani zombili zavumelana lapho zibikezela ingozi yesifo se-celiac . Ngokuphambene, izifo eziyisikhombisa-kuhlanganise nesifo sikaCrohn, uhlobo lwe-2 lwesifo sikashukela nesifo senhliziyo-isivumelwano saba amaphesenti angu-50 noma ngaphansi.
Abacwaningi bathi lokhu kungavumelani nesethi yamakaki inkampani ngayinye esebenzayo ekubaleni kwabo. Imigomo yamakaki okubandakanya ingahlukahluka; Ngakho-ke, imiphumela ayifani ngokufanayo. Kwezinye izimo, lezi zibikezelo zaziphezu kwamanye amazwe-inkampani eyodwa yabikezela ingozi eyengeziwe yokwenza isimo, kuyilapho omunye ephakamisa ingozi.
Iningi le-DTC abahlinzeki bokuhlola izakhi zofuzo lisebenza ngaphandle kwesistimu yokunakekelwa kwempilo kazwelonke. Ama-Labs abo awalawulwa futhi ezimweni eziningi, imiphumela ayinalo ukufaneleka kwemitholampilo nokusebenza. Ukungalungi kungaba nemiphumela ebalulekile. Isibonelo, ukubikezela okungekho engcupheni kungakunikeza umqondo wokuphepha wamanga, ube nomthelela omubi ekukhethweni kwakho kokuphila. Asikaqondi kahle izakhi zofuzo ezibangelwa ingozi yesifo, ngakho-ke ukucabanga ukuthi omunye endaweni ephephile kungaba yingozi. Ngakho-ke, ochwepheshe basikisela ukuthi esikhathini esizayo, kufanele kube khona ukubandakanyeka okwengeziwe kwabaqeqeshiwe bezempilo kanye nolwazi olungaphezulu lukahulumeni lokukhulisa ukuphepha nokuthembeka.
Indlela Yokubhekana Nezimo Ezimbi
Uma ukuhlolwa kofuzo kuyalwe udokotela, isiguli ngokuvamile sithola ukwelulekwa kwangaphambi kokuhlolwa kokuhlolwa. Naphezu kwalokho izinkampani zokuhlolwa zofuzo ze-DTC zivame ukukhangisa kumawebhusayithi abo, ukwesekwa okwanele kochwepheshe ngokuvamile akunikeziwe kumakhasimende abo.
Abanye abacwaningi baye bakhulume ngokukhathazeka ngokuthinta kwengqondo nokuziphatha kokuhlolwa kofuzo. Isibonelo, ukuthola ukuthi unengozi yokwanda komdlavuza kungakwenza ukhathazeke noma ucindezeleke (nakuba ungalokothi unomdlavuza). Imiphumela yokuhlola ingabonisa ulwazi nakwamanye amalungu omndeni angase angafuni ukwazi.
Kodwa-ke, ezinye izifundo zibonisa ukuthi ukuthola imiphumela emibi kungase kungabangeli ukulimala kwengqondo. UDkt. Lidewij Henneman waseYunivesithi yaseVrije e-Amsterdam waphetha ngokuthi ukuhlolwa kofuzo kuhlotshaniswa nokucindezeleka okuncane nokuthi emva kokuthola, abantu bayabuyela esimweni sengqondo sabo sangaphambilini. U-Henneman uphakamise ukuthi ukufunda nokufunda impilo kusekhona phakathi kwabathengi. Abanye abantu bangase baqede amathuba okuthola isifo, okubhekisela kuso ngokuthi "isifo sofuzo."
Izwi elivela
Iningi labachwepheshe bezokwelapha lisho ukuthi ukuhlolwa kofuzo kufanele kwenziwe kuphela uma kunesibonakaliso sezokwelapha; isibonelo, umlando womndeni we-disorder noma ube nomlingani ophethe inkampani. Imibuzo yokuziphatha ihambisana nokuhlolwa kofuzo kwabantwana, isibonelo, ukuhlolwa okuthandwa kakhulu kwamakhono wezingane. Ngokusho kwe-European Society of Human Genetics, ukuhlolwa kofuzo kumuntu ongakwazi ukunikeza kufanele kwenziwe kuphela uma kunomhlomulo oqondile kuye. Ngakho-ke, ukuhlolwa okuqaphile kwengane kufanele kwenziwe kuphela uma kukhona ingozi eyaziwayo yokuzuza isifo futhi, noma kunjalo, kuphela uma ukhetho lwezokwelapha noma lokuvimbela lukhona. Abanye bathi lezi zindinganiso zokuziphatha kufanele zisebenze kubantu abadala ngezizathu ezifanayo.
> Imithombo:
> Imininingwane ye-Ajunwa I. Genetic kanye namalungelo omphakathi. I-Harvard Civil Rights-I-Civil Liberties Law Review , 2016; 51 (1): 75-114
> Critchley C, Nicol D, Otlowski M, Chalmers D. Ukusabela komphakathi ekuhloleni okuhloswe ngqo kumthengi: Ukuqhathanisa isimo sengqondo, ukwethemba kanye nezinhloso kubo bonke abahlinzeki bezentengiselwano nabavamile. Ukuqonda Umphakathi Wezesayensi , 2015; 24 (6): 731-750.
> Ng P, Venter J, Murray S, Levy S. I-ajenda yezokwelapha ezizimele. Uhlobo , 2009; 461 (7265): 724-726.
> Phillips A. Ukuchofoza kuphela - i-DTC izakhi zofuzo, impilo, uthando ... nokunye: Umbono wezwe lebhizinisi nelokulawula. I-Genomics esebenzisiwe nokuhunyushwa , 2016; 8: 16-22.
> I-Su P. Ukuvivinya kwe-Genetic-Consumer Genetic: Ukubuka okuphelele. I Yale Journal of Biology and Medicine . 2013; 86 (3): 359-365.
> Vrecar I, Peterlin B, Teran N, Lovrecic L. Ukuhlolwa kwezakhi zofuzo eziqondile kuya kubathengi eSlovenia: ukutholakala, ukuhlukunyezwa kwemithetho kanye nemithetho. I-Biochemia Medica , 2015; 25 (1): 84-89.