14 November 2008. A firm that offered ApoE genotyping to consumers online under the product name Alzheimer’s Mirror has shut down, according to a news report in the October 30 issue of Nature. The Philadelphia company, Smart Genetics, had reported an uptick in requests for the test after the passage of the Genetic Information Nondiscrimination Act (GINA) earlier this year (see ARF related news story), but according to the Nature story, the firm has since discontinued offering the test, and has apparently gone out of business. Duke University, the patent holder on the test, had challenged the marketing of the Alzheimer’s Mirror service to healthy consumers, saying its license stipulated that the test only be used in people with dementia.
ApoE genotyping to assign AD risk in healthy people is not generally recommended by experts, since the test is probabilistic and no ApoE-specific or preventive treatments are available (see ARF live discussion on this topic). The view on ApoE testing may change once new medicines are approved to treat AD, especially if treatments show differential activity in people with different ApoE genotypes.
Even though the Smart Genetics service is shut down, consumers can still learn their ApoE status, and more, through genomewide scans now being offered by 23andMe in California and deCODE Genetics in Iceland. For personal genomics enthusiasts, it may not be long before anyone with enough cash can have his or her own genome completely sequenced (see ARF related news story). That may open up consumers to problems of privacy and discrimination. Mark Rothstein of the University of Louisville School of Medicine in Kentucky considers the issues in an article in the September issue of Scientific American. He concludes that legislative solutions embodied in GINA and the older HIPAA do not go far enough. So, where direct-to-consumer genetic testing is concerned, customer beware may remain the best policy at present.—Pat McCaffrey.
Hayden EC. Alzheimer's tests under fire. Nature. 2008 Oct 30;455(7217):1155.
Rothstein MA. Keeping your genes private. Sci Am. 2008 Sep;299(3):64-9.