A biotech start-up in Chennai is offering genetic screening for diseases like diabetes and obesity, and advising those at risk on what they can do to prevent them. Those with a family history of such diseases really stand to benefit
S ome years ago, S Bala met with a nasty accident. The marketing research analyst, who had an active lifestyle and loved sports, had to be given steroids. They played havoc with his weight which doubled to 125 kg in no time. Desperate to get back to shape, Bala started gyming and dieting. It didn’t help. He consulted doctors, nutritionists, tried out alternative medicines like ayurveda and even hired a personal trainer. Nothing worked. “I don’t consume liquor and have always been vegetarian. I am physically active and follow a disciplined lifestyle. Yet, I couldn’t shed even a kilogram,” says the 39-year-old.
It was as if nobody could put a finger on what his body needed. And then he heard of Xcode Life Sciences, a biotech start-up which had launched a DNA-based programme that could assess his genetic makeup and tell him why he was obese and what he needed to do differently to lose weight.
The programme, Lifelong Wellness, takes a sample of the person’s DNA through the saliva and based on genetic factors, assesses the individual’s risk of chronic health disorders. It also analysis the body’s metabolism to find out whether the person can burn fat or carbohydrates faster — both of which can lead to obesity and diseases if they accumulate in the body.
The premise it works on is simple: DNA does not have to be a person’s destiny. This unique code that puts an individual at a high or low risk to various diseases can also give a direction to minimising them.
“DNA assessment helps identify a person’s genetic predisposition for certain diseases,” says Saleem Mohammed, CEO and co-founder of Chennai-based Xcode. As of now the programme screens for eight (mainly lifestyle-related) conditions: type 1 and type 2 diabetes, obesity, cardio-vascular diseases (heart attack, sudden cardiac arrest, atrial fibrillation, coronary heart disease and hypertension), and stroke. Once the person knows that he is genetically at risk to a disease, lifestyle and dietary changes can help prevent, delay or reduce its magnitude.
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Those wanting to avail the service can place an order with Xcode online (http://xcode.in), though the company also gets walk-ins from Chennaites. A kit with a container in which to deposit the saliva is couriered to the user. “It’s a non-invasive test,” says Saleem. “Saliva is easy to collect and unlike blood, there is no storage constraints.” The kit is later collected from the user’s house and sent to a laboratory in Hyderabad for genetic testing. Once it gets the results, Xcode runs them on its statistical model — an in-house algorithm developed after years of research — which is based on existing scientific literature. “We screen the data for changes or mutations in an individual’s gene(s) which can tell whether the person is predisposed to a particular disease,” says Saleem, 35, who holds a PhD in bioinformatics from the University of Nebraska, USA. There are multiple changes related to one disease. “For example, there are 80 variations linked to diabetes alone,” says Saleem.
An assessment costs Rs 10,000. It’s one-time and takes into account the individual’s current and future lifestyle changes. It takes four to six weeks for the result to reach the user. Sometimes a lay user may not be able to easily decipher the result. And if interpreted wrongly, it can lead to a great deal of anxiety. “So, we have genetic counsellors who take the individual through the report and explain what the results mean,” says Saleem. Then come counselling sessions with a nutritionist who advises on the kind of food and lifestyle that can help counter the genetic propensity to a particular disease.
In Bala’s case, it emerged that his diet needed 40 per cent of low carbohydrate food. Carrot in any form was good for him. So the nutritionist gave him different recipes with carrot as the key ingredient — such as carrot chutney, carrot with cauliflower and beans, etc. He was also guided about how to cook them to suit his body’s needs. Bala has been following this regime for about a month now. He knows it will be another month or two before he sees any visible difference. “But I am feeling lighter,” says Bala. “The heaviness in my stomach which had become a constant in these last few years is gone.” Unlike quick-fix methods like bariatric surgery, this is a long-drawn process which calls for sustained lifestyle changes.
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Genetic risk assessment isn’t new to India. Doctors routinely conduct these tests on pregnant women to screen for a possible congenital disease in the foetus. However, screening adults for predisposing genes that could lead to a disease in the future and then suggesting personalised nutrition or medicine to preventive it are yet to catch on.
Internationally, some companies offer genetic screening for various forms of cancers. A panel at Xcode is also looking for mutations and markers that can indicate a genetic risk for common cancers such as those of the prostate, lung, breast and cervix.
“But not everybody needs such genetic screening,” says Ratna Puri, consultant at the Centre of Medical Genetics at Sir Ganga Ram Hospital, New Delhi. “Just because a person has a predisposing gene does not mean that he will develop the disease in his lifetime. These are multi-factored disorders. For example, if I have a family history of diabetes, then it makes sense for me to check if I also have a predisposing gene. In that case, I can take preventive measures in my diet and lifestyle,” says Puri. As genetic studies have shown, Indians are highly predisposed to type 2 diabetes, so genetic testing for diabetes in high-risk individuals can prove helpful.
Priya, who is in her early thirties, opted for the test after she heard about it from her friends. She has a desk job with an information technology firm, keeps long hours and has seen some of her relatives dealing with lifestyle diseases. “I wanted to know the risk that I carry,” she says. It emerged that her caffeine metabolism was low, so the amount of caffeine she was consuming had to be brought down. “Caffeine retention in the body is linked to heart diseases. The heart condition develops over a period of time from constant abuse,” says Saleem.
Xcode gets a lot of people like Priya — aged 30 to 45 — who lead busy, high-stress lives, compromise on meals and don’t have the time to exercise. But the test can also be conducted on children as young as five to assess their genetic risk and make diet and lifestyle changes early on.
Xcode was initially incubated in the Vellore Institute of Technology, which provided infrastructure for research and operations, and was funded by the Department of Science and Technology. Now, Shead Holdings, a US-based micro-venture capital fund, and R Narayanan from Chennai Angels (a group of investors that helps early stage companies with funds) have invested $250,000 in it.
Names of patients have been changed on request
