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Playing Genetic Roulette | Nigel Laing | TEDxUWA


when each of us was born our parents

when each of us was born our parents played genetic roulette when my wife and

played genetic roulette when my wife and

played genetic roulette when my wife and I had our two boys we played genetic

I had our two boys we played genetic

I had our two boys we played genetic roulette

roulette

roulette and when any of you in the audience have

and when any of you in the audience have

and when any of you in the audience have children in the future

children in the future

children in the future you too will play genetic roulette

you too will play genetic roulette

you too will play genetic roulette unless the Health System changes so what

unless the Health System changes so what

unless the Health System changes so what do I mean when I say genetic roulette

do I mean when I say genetic roulette

do I mean when I say genetic roulette well one of the two major forms of

well one of the two major forms of

well one of the two major forms of genetic or inherited diseases is

genetic or inherited diseases is

genetic or inherited diseases is recessive disease and in recessive

recessive disease and in recessive

recessive disease and in recessive disease you have to inherit two bad

disease you have to inherit two bad

disease you have to inherit two bad copies of the same gene one bad copy

copies of the same gene one bad copy

copies of the same gene one bad copy from your mom and one bad copy from your

from your mom and one bad copy from your

from your mom and one bad copy from your dad and then you have the disease your

dad and then you have the disease your

dad and then you have the disease your mum and dad only have one bad copy of

mum and dad only have one bad copy of

mum and dad only have one bad copy of the gene so they’re called carriers and

the gene so they’re called carriers and

the gene so they’re called carriers and they are unaffected so in recessive

they are unaffected so in recessive

they are unaffected so in recessive human disease two unaffected people have

human disease two unaffected people have

human disease two unaffected people have an affected child the recessive disease

an affected child the recessive disease

an affected child the recessive disease that’s usually talked about in schools

that’s usually talked about in schools

that’s usually talked about in schools is cystic fibrosis so a lot of you may

is cystic fibrosis so a lot of you may

is cystic fibrosis so a lot of you may have heard about that but there are

have heard about that but there are

have heard about that but there are hundreds of recessive diseases that we

hundreds of recessive diseases that we

hundreds of recessive diseases that we humans can have and many of them have a

humans can have and many of them have a

humans can have and many of them have a much more severe effect on the child

much more severe effect on the child

much more severe effect on the child than cystic fibrosis one of these is

than cystic fibrosis one of these is

than cystic fibrosis one of these is called spinal muscular atrophy in spinal

called spinal muscular atrophy in spinal

called spinal muscular atrophy in spinal muscular atrophy the nerves that make

muscular atrophy the nerves that make

muscular atrophy the nerves that make our muscles move die and disappear so an

our muscles move die and disappear so an

our muscles move die and disappear so an affected child has great difficulty in

affected child has great difficulty in

affected child has great difficulty in actually moving the most severe form of

actually moving the most severe form of

actually moving the most severe form of spinal muscular atrophy are babies born

spinal muscular atrophy are babies born

spinal muscular atrophy are babies born almost incapable of moving now the

almost incapable of moving now the

almost incapable of moving now the carrier frequency for spinal muscular

carrier frequency for spinal muscular

carrier frequency for spinal muscular atrophy is 1 in 40 people so that means

atrophy is 1 in 40 people so that means

atrophy is 1 in 40 people so that means that in this room

that in this room

that in this room right now it’s highly likely that three

right now it’s highly likely that three

right now it’s highly likely that three of us are carriers of spinal muscular

of us are carriers of spinal muscular

of us are carriers of spinal muscular atrophy and if two of those carriers get

atrophy and if two of those carriers get

atrophy and if two of those carriers get together because they fancy each other

together because they fancy each other

together because they fancy each other their students at UWA and that sort of

their students at UWA and that sort of

their students at UWA and that sort of thing happens then they have a one in

thing happens then they have a one in

thing happens then they have a one in four chance of having a child with

four chance of having a child with

four chance of having a child with spinal muscular atrophy now what happens

spinal muscular atrophy now what happens

spinal muscular atrophy now what happens to a couple to a family when we have a

to a couple to a family when we have a

to a couple to a family when we have a child with one of these severe genetic

child with one of these severe genetic

child with one of these severe genetic disorders so to illustrate that for you

disorders so to illustrate that for you

disorders so to illustrate that for you I want to try and take us all back in

I want to try and take us all back in

I want to try and take us all back in history to early 1995 now now this is

history to early 1995 now now this is

history to early 1995 now now this is what I want some audience participation

what I want some audience participation

what I want some audience participation all of those of you who weren’t born in

all of those of you who weren’t born in

all of those of you who weren’t born in 1995 can you put your hands up farming

1995 can you put your hands up farming

1995 can you put your hands up farming there’s no need to be shy path leads so

there’s no need to be shy path leads so

there’s no need to be shy path leads so if you weren’t born in 1995 it’s really

if you weren’t born in 1995 it’s really

if you weren’t born in 1995 it’s really hard to think back to 1995

but but to try and help you with this

but but to try and help you with this 1995 was before Facebook it was before

1995 was before Facebook it was before

1995 was before Facebook it was before Twitter it was before snapchat it was

Twitter it was before snapchat it was

Twitter it was before snapchat it was before social media how did we survive

so you’re talking about moments that

so you’re talking about moments that change our lives

change our lives

change our lives so I’m sitting in my office early 1995

so I’m sitting in my office early 1995

so I’m sitting in my office early 1995 the gene for a spinal muscular atrophy

the gene for a spinal muscular atrophy

the gene for a spinal muscular atrophy had not been phoned then the telephone

had not been phoned then the telephone

had not been phoned then the telephone calls at the other end of the line is

calls at the other end of the line is

calls at the other end of the line is one of the West Australian mothers who’d

one of the West Australian mothers who’d

one of the West Australian mothers who’d had a child died from spinal muscular

had a child died from spinal muscular

had a child died from spinal muscular atrophy and she said to me Nigel

atrophy and she said to me Nigel

atrophy and she said to me Nigel we hear our gene has been found now

we hear our gene has been found now

we hear our gene has been found now finding genes finding disease genes is

finding genes finding disease genes is

finding genes finding disease genes is what I do for a living we still do it on

what I do for a living we still do it on

what I do for a living we still do it on the seventh floor of this building

the seventh floor of this building

the seventh floor of this building I had heard nothing from the science

I had heard nothing from the science

I had heard nothing from the science science community but she was right a

science community but she was right a

science community but she was right a few weeks later the disease gene that’s

few weeks later the disease gene that’s

few weeks later the disease gene that’s mutated in spinal muscular atrophy was

mutated in spinal muscular atrophy was

mutated in spinal muscular atrophy was published by a group in France so

published by a group in France so

published by a group in France so somehow free social media the news had

somehow free social media the news had

somehow free social media the news had got from France to the families in

got from France to the families in

got from France to the families in Western Australia that were at risk and

Western Australia that were at risk and

Western Australia that were at risk and I’ve always felt that somehow the news

I’ve always felt that somehow the news

I’ve always felt that somehow the news had got from the families that have

had got from the families that have

had got from the families that have participated in the study in France it

participated in the study in France it

participated in the study in France it had got ran the world to here now if

had got ran the world to here now if

had got ran the world to here now if you’re a couple who’ve had one child

you’re a couple who’ve had one child

you’re a couple who’ve had one child with a severe genetic disease what you

with a severe genetic disease what you

with a severe genetic disease what you most want is not to have another

most want is not to have another

most want is not to have another child with that disease and we can’t

child with that disease and we can’t

child with that disease and we can’t help couples with that until we know the

help couples with that until we know the

help couples with that until we know the precise gene that’s the problem in that

precise gene that’s the problem in that

precise gene that’s the problem in that family so the gene for spinal muscular

family so the gene for spinal muscular

family so the gene for spinal muscular actually have been discovered to help

actually have been discovered to help

actually have been discovered to help couples avoid having another affected

couples avoid having another affected

couples avoid having another affected child you do prenatal diagnosis you test

child you do prenatal diagnosis you test

child you do prenatal diagnosis you test the unborn child and you do that at 12

the unborn child and you do that at 12

the unborn child and you do that at 12 weeks and basically it felt like 12

weeks and basically it felt like 12

weeks and basically it felt like 12 weeks after the gene was published in

weeks after the gene was published in

weeks after the gene was published in France we were doing pre mental

France we were doing pre mental

France we were doing pre mental diagnosis for the families in Western

diagnosis for the families in Western

diagnosis for the families in Western Australia basically they had a put off

Australia basically they had a put off

Australia basically they had a put off having any further children until their

having any further children until their

having any further children until their gene had been found and we could help

gene had been found and we could help

gene had been found and we could help them avoid having further affected kids

them avoid having further affected kids

them avoid having further affected kids so spinal muscular atrophy is just one

so spinal muscular atrophy is just one

so spinal muscular atrophy is just one of these severe recessive disorders

of these severe recessive disorders

of these severe recessive disorders there’s hundreds of them and the numbers

there’s hundreds of them and the numbers

there’s hundreds of them and the numbers are worked out in the mid 1950s by one

are worked out in the mid 1950s by one

are worked out in the mid 1950s by one of the godfathers of Human Genetics

of the godfathers of Human Genetics

of the godfathers of Human Genetics Newton Morton each single one of us is a

Newton Morton each single one of us is a

Newton Morton each single one of us is a carrier of three to five lethal

carrier of three to five lethal

carrier of three to five lethal recessive diseases so that means each of

recessive diseases so that means each of

recessive diseases so that means each of us is a carrier of a disease which if we

us is a carrier of a disease which if we

us is a carrier of a disease which if we get together with someone who’s carrying

get together with someone who’s carrying

get together with someone who’s carrying one of those three to five we will have

one of those three to five we will have

one of those three to five we will have a child who will not live long enough to

a child who will not live long enough to

a child who will not live long enough to have children of their own and that’s

have children of their own and that’s

have children of their own and that’s why I say whenever any of us have

why I say whenever any of us have

why I say whenever any of us have children we play genetic roulette

children we play genetic roulette

children we play genetic roulette because basically most of us have no

because basically most of us have no

because basically most of us have no idea which three to five lethal

idea which three to five lethal

idea which three to five lethal recessive diseases we are carrying so

recessive diseases we are carrying so

recessive diseases we are carrying so what can we do about this

well one of the things we can try and do

well one of the things we can try and do is we can try and find the carriers of

is we can try and find the carriers of

is we can try and find the carriers of these recessive diseases before they

these recessive diseases before they

these recessive diseases before they find out their carriers but having an

find out their carriers but having an

find out their carriers but having an effective child and finding carriers is

effective child and finding carriers is

effective child and finding carriers is called pre conception carrier screening

called pre conception carrier screening

called pre conception carrier screening and in Australia we are way behind

and in Australia we are way behind

and in Australia we are way behind world’s best practice in preconception

world’s best practice in preconception

world’s best practice in preconception carrier screening for certain specific

carrier screening for certain specific

carrier screening for certain specific communities that have high incidence of

communities that have high incidence of

communities that have high incidence of recessive diseases preconception

recessive diseases preconception

recessive diseases preconception carriers screening programs have been in

carriers screening programs have been in

carriers screening programs have been in place for decades and what always

place for decades and what always

place for decades and what always happens is that the incidence of those

happens is that the incidence of those

happens is that the incidence of those recessive diseases goes down hugely so

recessive diseases goes down hugely so

recessive diseases goes down hugely so diseases in the Ashkenazi community

diseases in the Ashkenazi community

diseases in the Ashkenazi community fellows Semien Mediterranean countries

fellows Semien Mediterranean countries

fellows Semien Mediterranean countries the incidence has dropped way down the

the incidence has dropped way down the

the incidence has dropped way down the most comprehensive an amazing carrier

most comprehensive an amazing carrier

most comprehensive an amazing carrier screening program in the world is in

screening program in the world is in

screening program in the world is in Israel

Israel

Israel it’s government-funded is freely

it’s government-funded is freely

it’s government-funded is freely available to everybody they screen for

available to everybody they screen for

available to everybody they screen for over 90 different recessive diseases

over 90 different recessive diseases

over 90 different recessive diseases they’re screening 60 to 70 thousand

they’re screening 60 to 70 thousand

they’re screening 60 to 70 thousand people a year who wish to be screened in

people a year who wish to be screened in

people a year who wish to be screened in Australia we don’t have that so there

Australia we don’t have that so there

Australia we don’t have that so there are a number of us around this chair who

are a number of us around this chair who

are a number of us around this chair who are interested in preconception carrier

are interested in preconception carrier

are interested in preconception carrier screening and what we could do here in

screening and what we could do here in

screening and what we could do here in this country and last year we thought

this country and last year we thought

this country and last year we thought we’d hold a conference here in Western

we’d hold a conference here in Western

we’d hold a conference here in Western Australia but we decided we instead we’d

Australia but we decided we instead we’d

Australia but we decided we instead we’d have a satellite meeting of a meeting in

have a satellite meeting of a meeting in

have a satellite meeting of a meeting in Europe because it’s quite expensive to

Europe because it’s quite expensive to

Europe because it’s quite expensive to bring people all the way to Westminster

bring people all the way to Westminster

bring people all the way to Westminster and being Scottish we like to do things

and being Scottish we like to do things

and being Scottish we like to do things on the cheap Helen

on the cheap Helen

on the cheap Helen so we decided the thing to do was to

so we decided the thing to do was to

so we decided the thing to do was to hold the satellite meaning of a meeting

hold the satellite meaning of a meeting

hold the satellite meaning of a meeting in Europe where everyone is going to be

in Europe where everyone is going to be

in Europe where everyone is going to be anyway so we held this meeting in

anyway so we held this meeting in

anyway so we held this meeting in Glasgow and scope works well it’s my

Glasgow and scope works well it’s my

Glasgow and scope works well it’s my accent it fine

and we brought together people from

and we brought together people from North America from Europe and my

North America from Europe and my

North America from Europe and my favorite guy the guy in Israel would put

favorite guy the guy in Israel would put

favorite guy the guy in Israel would put their programme together we locked

their programme together we locked

their programme together we locked ourselves in a room for a day and we

ourselves in a room for a day and we

ourselves in a room for a day and we talked and I was amazed that at the end

talked and I was amazed that at the end

talked and I was amazed that at the end of the day we had a consensus and the

of the day we had a consensus and the

of the day we had a consensus and the consensus that we came to was that for

consensus that we came to was that for

consensus that we came to was that for recessive diseases that were lethal by

recessive diseases that were lethal by

recessive diseases that were lethal by age 4 people felt there was no ethical

age 4 people felt there was no ethical

age 4 people felt there was no ethical or disability rights impediment booting

or disability rights impediment booting

or disability rights impediment booting such a program in place so what I would

such a program in place so what I would

such a program in place so what I would like to see in the future in Australia

like to see in the future in Australia

like to see in the future in Australia is preconception of carries being

is preconception of carries being

is preconception of carries being available to everybody the people that

available to everybody the people that

available to everybody the people that will benefit the most probably are those

will benefit the most probably are those

will benefit the most probably are those of you who put up your hands to say that

of you who put up your hands to say that

of you who put up your hands to say that you weren’t born in 1995 it’s a bit late

you weren’t born in 1995 it’s a bit late

you weren’t born in 1995 it’s a bit late for my wife and life so my vision for

for my wife and life so my vision for

for my wife and life so my vision for the future is that no couple in

the future is that no couple in

the future is that no couple in Australia should have a child with a

Australia should have a child with a

Australia should have a child with a severe recessive disease unless they

severe recessive disease unless they

severe recessive disease unless they want to thank you very much

”

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