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Human Genome Project and cystic fibrosis--a symbiotic relationship.

When Watson and Crick determined the structure of DNA in 1953, a biological revolution began. One result of this revolution is the Human Genome Project. The primary goal of this international project is to obtain the complete nucleotide sequence of the human genome by the year 2005. Although molecular biologists and geneticists are most enthusiastic about the Human Genome Project, all areas of clinical medicine and fields of biology will be affected. Cystic fibrosis is the most common, inherited, lethal disease of white persons. In 1989, researchers located the cystic fibrosis gene on the long arm of chromosome 7 by a technique known as positional cloning. The most common mutation (a 3-base pair deletion) of the cystic fibrosis gene occurs in 70% of patients with cystic fibrosis. The knowledge gained from genetic research on cystic fibrosis will help researchers develop new therapies (e.g., gene) and improve standard therapies (e.g., pharmacologic) so that a patient's life span is increased and quality of life is improved. The purpose of this review is twofold. First, the article provides an overview of the Human Genome Project and its clinical significance in advancing interdisciplinary care for patients with cystic fibrosis. Second, the article includes a discussion of the genetic basis, pathophysiology, and management of cystic fibrosis.

Chromosome Mapping↗

The Human Genome Project: applications in the diagnosis and treatment of neurologic disease.

The Human Genome Project (HGP), an international program to decode the entire DNA sequence of the human genome in 15 years, represents the largest biological experiment ever conducted. This set of information will contain the blueprint for the construction and operation of a human being. While the primary driving force behind the genome project is the potential to vastly expand the amount of genetic information available for biomedical research, the ramifications for other fields of study in biological research, the biotechnology and pharmaceutical industry, our understanding of evolution, effects on agriculture, and implications for bioethics are likely to be profound.

Brain Diseases↗

Human Genome Project and cancer: the ethical implications for clinical practice.

The Human Genome Project has far-reaching implications for the entire spectrum of cancer care. An understanding of fundamental gene biology clarifies the role of genetics in cancer causation. The scientific advances of genetic screening for cancers have also given rise to problems such as employment and insurance discrimination, adverse psychosocial effects, and the ethical dilemma of "to screen or not to screen."

Adaptation, Psychological↗

The Human Genome Project and gene therapy: a genetic counselor's perspective.

The Human Genome Project (HGP) and clinical trials of gene therapy create an expanded role for genetic counselors, nurses, and other health care practitioners. Translating fundamental advances in genetics into a benefit of clinical practice can be challenging. In addition to patients, the public and other professionals, including judges and lawyers, need to be educated about genetics and genetic testing and the potential for genetic intervention. The article provides an overview of the HGP, explains the concept of gene transfer, provides examples of clinical trials for specific diseases, and addresses practical issues related to the role of the coordinator in clinical trials of gene transfer.

Ethics, Nursing↗

The Human Genome Project: an overview of ethical issues and public policy concerns.

The possibilities of advancement from the Human Genome Project seem endless. But even though we are amazingly similar genetically to other animals, including the mouse, we are uniquely human. And our humanness is our greatest gift. The knowledge of genetic linkages and of how life works does not diminish our religious beliefs or our value system. Understanding the mechanics of human physiology does not decrease the power and beauty of human life. Quite the contrary, this knowledge helps to chart the course in a quest to understand what it means to be human. Let us honor the beauty and uniqueness of human life by making ethically sound decisions surrounding the advances made in this fantastic journey called the Human Genome Project.

Bioethics↗

The Human Genome Project: ethical and social implications.

This article explores some of the potential moral and social ramifications of the Human Genome Project. Research on the human genome is generating important ethical and social questions of at least three distinct kinds. First, what genetic information should be generated, and who should control its dissemination and use? Improved diagnostic techniques such as presymptomatic testing, carrier screening, and prenatal screening can provide information that poses significant ethical problems for individuals, employers and insurance companies, and the medical and counseling professions. Second, what genetic procedures should be employed? The burgeoning ability to manipulate human genotypes and phenotypes through procedures such as gene therapy and enzyme therapy are leading to difficult questions about which manipulations should be permitted and which should be prohibited. Third, how will this new information change lives? Increasing claims about the relationship of genetics to ethically and politically significant traits and behaviors are challenging human self-understanding and the capacity of social institutions to respond adequately.

Behavior↗

The Human Genome Project in the United States: a perspective on the commercial, ethical, legislative and health care issues.

The Human Genome Project represents a government supported effort to map and sequence the human genome. Governmental support for the Project should include increased emphasis on grants and contracts to industry. This is particularly true for small highly innovative biotechnology companies that can rapidly integrate and use technology as a base for product development. Private industry must be integrated as a partner into the Project, as it will be in Japan and Europe. There is a consensus in industry that the Genome Project is, at this stage at least, a science research project funded by government and not, at present, a commercial project. It is not seriously expected to have any substantial widespread commercial impact in the near future. The ultimate commercial benefits of the Human Genome Project, in terms of definable health care products, may not be realized until well into the next century. Yet, there are a few companies for which the Genome Project affords immediate commercial opportunities in certain niche areas. The Genome Project can be expected to have a significant impact upon medical knowledge and treatment. Though the Genome Project is just beginning, much of the type of medical knowledge expected to be gained from the Project is already present and even being exploited, albeit on a small scale. The application of genetic understanding to practical applications raises ethical, medical and legal issues central to the Genome Project. Unfortunately, emotion and sensationalism sometimes dominate and prevent a constructive discussion of ethical and social issues pertaining to genetics. To answer public concerns about human gene transfer experiments, the medical and biotechnology communities must constructively discuss the medical realities, the benefits to human health and the adequacy of the current governmental oversights. These presentations must be understandable by the lay public and must address their fears. Failure to assuage public fears and concerns, no matter how abstract or unrealistic they may be to the medical/scientific community, will lead to increased governmental controls and regulatory burdens.

Cost-Benefit Analysis↗

Ethical, legal, and social issues of the Human Genome Project: what to do with what we know.

Since fiscal year 1991, the U.S. Human Genome Project has spent $170.6 million in federal funds to help isolate genes associated with Huntington's disease, amyotrophic lateral sclerosis, neurofibromatosis types 1 and 2, myotonic dystrophy, and fragile X syndrome and to localize genes that predispose people to breast cancer, colon cancer, hypertension, diabetes, and Alzheimer's disease. Now comes the hard part. Biology's 21st century megaproject starts to look relatively manageable compared to another challenge facing the enterprise: sorting out ethical, legal, and social issues associated with using this information. "The Human Genome Project," wrote Senior Editor Barbara Jasny in the October 1 Science editorial, stretches "the limits of the technology and the limits of our ability to ethically and rationally apply genetic information to our lives."

Genetic Predisposition to Disease↗

Patents and the human genome project--new claims for old?

The development and application of genomics is set to revolutionize the life sciences. Commercial exploitation of this research will allow the development of novel therapies and diagnostic assays. However, some argue that a 'gold rush' is underway and conflicts have already arisen over the question of filing patents and sharing data. In this article we consider some of the issues that relate to patenting genomic inventions.

Computers↗