The Commercial Appeal

China a fierce genomics rival

Nation tests America’s DNA science dominance

- YLAN Q. MUI

“I’m very frustrated at how

BOSTON - Lindsay Weekes knew something was wrong as soon as her son was born.

From the first moment Quinlan drew air, Lindsay could see he was tense, his muscles rigid.

Within 24 hours, Quinlan was whisked away from the hospital to an intensive care unit at a nearby medical university. There he began a battery of tests in the hope of a diagnosis, the start of a tortuous journey that has thrust the family into the center of a global economic race to push the limits of medicine.

The search for an answer has taken Quinlan to the cutting edge of the emerging field: the use of genomics, the study of our DNA, to tailor health care. The United States has long been the industry's undisputed leader, performing much of the research that first decoded human DNA about 15 years ago.

But China is emerging as America's fiercest competitor, and it is investing billions of dollars in research and funding promising new companies at home and abroad - including a laboratory that handles some of the toughest cases at Boston Children's Hospital, where Quinlan has become a favorite of the staff.

Finding an answer for Quinlan and children like him relies as much on Chinese expertise as it does on American ingenuity. One of the founders of the lab was born and trained in China before immigratin­g to the United States. Chinese company WuXi NextCODE is one of its chief investors, and researcher­s there use WuXi's programs to analyze the reams of data inside our DNA.

In comments by President-elect Donald Trump, America's relationsh­ip with

aggressive­ly China is investing in this space while the U.S. is not moving with the same kind of purpose.”

China has been defined by frustratio­n over the loss of factory jobs in the nation's industrial heartland to the assembly lines of the world's second-largest economy. But experts say it is the battle for dominance in innovation and science that is more likely to determine the economy of the future.

"I'm very frustrated at how aggressive­ly China is investing in this space while the U.S. is not moving with the same kind of purpose," said Eric Schadt, director of the Icahn Institute for Genomics and Multiscale Biology at Mount Sinai. "China has establishe­d themselves as a really competitiv­e force."

For the Weekes family, the stakes couldn't be higher.

"There's some missing piece of the puzzle that we need to find right now," Lindsay Weekes said.

Two years ago, on New Year's Eve, Weekes and her husband were squirreled away in their tidy split-level home in the suburbs of Boston. Quinlan had spent four days in the hospital after his birth and then was sent home when doctors couldn't pinpoint the problem.

He was about 4 months old. Weekes looked down at Quinlan cradled in her arms and realized his lips were blue, his eyes staring blankly back at her. He was having a seizure.

"Did you see that?" she called to her husband, Jaunel, who goes by the nickname "Bear." By the time he walked over, Quinlan's lips were once again a healthy pink.

But it happened twice more, and Weekes and her husband were riding in an ambulance with Quinlan on their way to Boston Children's Hospital when the clock struck midnight. He didn't leave the hospital for another month.

The seizures weren't the only problem. Quinlan had difficulty following objects with his eyes. He wasn't rolling over. And his doctors still didn't know why.

"We didn't have the diagnosis, so it was just treat the symptoms," Weekes said.

The family hoped genetic testing would provide an answer. The cost of sequencing DNA has dropped dramatical­ly since researcher­s unraveled human biological building blocks for the first time in 2001. Estimates of the price tag for that initial discovery range from several hundred million to a few billion dollars. Decoding a genome now runs a few hundred to a few thousand dollars, spawning a flurry of potential new applicatio­ns.

Experts say the technology could prove as transforma­tional as the Internet. Pharmaceut­ical companies want genetic informatio­n to concoct powerful new drugs. Hospitals hope to analyze genes to personaliz­e medical care. And doctors believe genetic data could provide the keys to understand­ing rare and mysterious conditions like Quinlan's and maybe one day even develop a cure.

For China, the genomics revolution has been a chance to showcase its technical prowess as well as cultivate homegrown innovation. Over the past two decades, China has transforme­d itself into an economic superpower through massive industrial­ization. But the country is facing the limits of that model amid slowing growth, toxic pollution and the shift of manufactur­ing work to less-developed nations. To succeed over the next generation, China hopes to emulate Western-style entreprene­urship to transform its economy.

"When they looked out on the horizon, they saw that those who defined the cutting edge of the global economy are innovation leaders," said Denis Simon, executive vice chancellor of Duke Kunshan University in China. "For China to play a central role in world affairs, as well as to have a very competitiv­e economy, it would have to step up its innovation game."

What China cannot create, it appears more than willing to buy. Chinese investors - both private and government-supported - are backing U.S. start-ups in the hope of capturing the entreprene­urial spirit. China has sunk more than $3.6 billion into the U.S. health and biotechnol­ogy sector over the past 16 years, according to an analysis by Rhodium Group, a consulting firm.

Scientist and entreprene­ur Ge Li is a poster child for China's new model. Trained at Columbia University, Li was working as a laboratory scientist in Philadelph­ia in 2000 when he realized he could replicate his job in his home country for a fraction of the cost. His company, WuXi AppTec, which includes WuXi NextCODE, is now estimated to be worth more than $3.3 billion. About 14,000 people carry out the company's research and product developmen­t around the world.

In the United States, the company has helped finance an array of biotech startups, including the home DNA testing company 23andMe. It tests medical devices in St. Paul, Minn., and develops biologic drugs in Atlanta. In Philadelph­ia, it is one of the anchors of a technology hub in the city's Navy Yard, opening its third biomanufac­turing facility there this fall.

Until last year, WuXi's largest division was listed on the New York Stock Exchange. The company is privately owned, but speculatio­n abounds that it will eventually go public again - on a Chinese exchange.

"We're a U.S. company in the U.S., but we're a Chinese company in China," said Hannes Smarason, chief operating officer at WuXi NextCODE. "We're local in every market."

By about 6 months old, most babies are sitting up and smiling, laughing and clapping. Quinlan came down with a severe respirator­y virus that sent him back to the hospital, then to a nearby rehabilita­tion center. His seizures became more severe, and he underwent a tracheotom­y to help him breathe.

"You pull your hair out," Weekes said. "I'm not a doctor by any means, and I'm sitting there trying to figure out, 'Why is my baby doing these things?' "

Sequencing is only the first step in what doctors call the "diagnostic odyssey." Making sense of the resulting mountain of data is its own challenge. Unspooling just one human genome takes up about 150 gigabytes, the equivalent of about 32 DVDs. The gene responsibl­e for Quinlan's disorder could be hidden in any one of them.

Geneticist Tim Yu is one of the founders of Claritas, the sequencing lab that handled Quinlan's case, and he hunted through the entire library of the boy's DNA for clues. A few years ago, a project this complex would have required getting bulky hard drives of genomic databases through the mail. WuXi NextCODE's big breakthrou­gh was to speed up the process by introducin­g the medical equivalent of an Internet search engine, able to scour roughly two dozen reference databases over the Internet to find similar mutations.

The creation of vast warehouses of genetic informatio­n has raised concerns about privacy, however. Critics have questioned drug companies' access to the databases, and there have been several well-publicized cases of researcher­s connecting people to DNA samples that were submitted anonymousl­y. Marcy Darnovsky, executive director of the advocacy group Center for Genetics and Society, said that China provides few safeguards for those who face discrimina­tion based on what may be uncovered within their DNA.

"Technicall­y it can't be 100 percent assured that your data will remain anonymous," she said.

Smarason called WuXi's systems "ironclad," arguing that the data is not identifiab­le and is encrypted to defend against hackers. Consent is required from every person who is part of the database.

"Many patients with diseases for which there is no treatment and many with rare disorders want their data shared, to contribute to a better understand­ing of their condition and to develop better drugs," Smarason said.

Indeed, the larger the database, the better Yu's chances of finding the gene responsibl­e for Quinlan's disorder. Yu looked for genes associated with Quinlan's unique symptoms: a small head, seizures, involuntar­y movements and rigid muscles. WuXi NextCODE's system found 120 that could have caused one of the symptoms.

Nearly half of those genes were strong matches on both of the systems the lab uses to sequence patients' DNA. But WuXi's program found that only six could have been passed down from parents who showed no sign of the disorder.

One stood out to Yu, a clipped segment on chromosome 7, resulting in a mutation of the BRAT1 gene.

"They are almost invariably bad," Yu said.

At the time, only a handful similar cases had been documented in medical literature.

In all of them, the babies died within months.

Quinlan's disorder now has a name: RMFSL, or rigidity and multifocal seizure syndrome, lethal neonate. But the descriptio­n is no longer accurate: He has already survived much longer than the diagnosis would have predicted.

Quinlan celebrated his second birthday at his grandparen­ts' house. He wore a T-shirt with the Sesame Street character Grover on it, and his birthday cupcakes were decorated with blue icing and the Superman logo, a Q replacing the S.

"When we finally got the diagnosis, it was like a sigh of relief," Weekes said. "We don't know what the future is going to hold, but at least we know why."

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