By Joe Markman
LA Times

The Genetic InformationNondiscrimination Act, the most sweeping anti-discrimination law innearly 20 years, prohibits employers from hiring or firing based on aperson's genetic makeup.

Reporting from Washington - The mostsweeping federal anti-discrimination law in nearly 20 years takeseffect today, prohibiting employers from hiring, firing or determiningpromotions based on genetic makeup.

Additionally, healthinsurers will not be allowed to consider a person's genetics -- such aspredisposition for Parkinson's disease -- to set insurance rates ordeny coverage.

Not since the Americans With Disabilities Actof 1990 has the federal government implemented such far-reachingworkplace protections. Stuart J. Ishimaru, acting chairman of the EqualEmployment Opportunity Commission, said in a statement that the lawreaffirms the idea that people have a right to be judged solely onmerit.

"No one should be denied a job or the right to betreated fairly in the workplace based on fears that he or she maydevelop some condition in the future," he said.

The NationalFederation of Independent Business, a nonprofit lobbying group forsmall businesses, filed a number of concerns in April with the EEOC,which oversees the law. The concerns included whether employers who"innocently discover" genetic information about their workers may beheld liable for having that information in their files, the "confusing"interplay of other federal statutes, and the lack of an exception forpublicly available genetic information on the Internet.

Thebusiness group is seeking to teach its members that under the law, anypiece of medical history -- whether an employee's own or that of afamily member -- constitutes genetic information, said ElizabethMilito, senior counsel at the federation.

Robert Zirkelbach, aspokesman for the industry group America's Health Insurance Plans, saidthat his association originally supported the bill, but that theresulting regulations ultimately would disrupt efforts to stay healthythrough wellness and disease-management programs.

"If a patientis at risk for a particular condition, they are a good candidate to domore preventive screenings, and this would prohibit some of thatinformation even being gathered," Zirkelbach said.

There is nota lot of evidence that this kind of discrimination has been takingplace. As of May, no genetic-employment discrimination cases had beenbrought before U.S. federal or state courts, according to the NationalHuman Genome Research Institute. The government filed suit in 2001against the Burlington Northern Santa Fe Railway Co. under the ADA forsecretly testing some workers for a genetic defect that some believecan predispose a person to carpal tunnel syndrome. The railway settledthe EEOC suit for $2.2 million.

Peter Bennett, an attorney inMaine who specializes in employment law, said he knew of no pendinggenetic discrimination cases, but expects them to pile up soon, in whathe called a "kabuki dance" of litigation to sort out who is liable forwhat.

The Genetic Information Nondiscrimination Act, signed byPresident Bush in May 2008, is a huge victory for proponents ofpersonalized medicine, which includes using genetic tests to aid in thediagnosis of disease and the selection of medicine.

"Thepsychological security regarding employment and insurance was astumbling block to the advancement of personalized medicine," saidEdward Abrahams, executive director of the Personalized MedicineCoalition.

"Moving that boulder from the train tracks was a major accomplishment."

Stereotactic radiosurgery (SRS) offers a less invasive way to eliminatetremors caused by Parkinson's disease and essential tremor than deepbrain stimulation (DBS) and radiofrequency (RF) treatments, and is aseffective, according to a long-term study presented November 2, 2009,at the 51st Annual Meeting of the American Society for RadiationOncology (ASTRO).

Source: American Society for Radiation Oncology

"Thestudy shows that radiosurgery is an effective and safe method ofgetting rid of tremors caused by Parkinson's disease and essentialtremor, with outcomes that favorably compare to both DBS and RF intremor relief and risk of complications at seven years aftertreatment," Rufus Mark, M.D., an author of the study and a radiationoncologist at the Joe Arrington Cancer Center and Texas TechUniversity, both in Lubbock, Texas said. "In view of these long-termresults, this non-invasive procedure should be considered a primarytreatment option for tremors that are hard to treat."

Parkinson'sdisease is a slowly progressive neurologic disease that causes tremors,in addition to other symptoms. Essential tremor is the most common ofall movement disorders and causes uncontrollable shaking of the hands,head, and sometimes other parts of the body.

Stereotacticradiation is a specialized type of external beam radiation therapy thatpinpoints high doses of radiation directly on a confined area in ashorter amount of time than traditional radiation treatments.Stereotactic radiosurgery, or SRS, refers to a single or severalstereotactic radiation treatments of the brain or spine. SRS isdelivered by a team involving a radiation oncologist and aneurosurgeon. This radiation treatment is often called by the brand
namesof the manufacturers, including Axesse, CyberKnife, Gamma Knife,Novalis, Primatom, Synergy, X-Knife, TomoTherapy and Trilogy.

Between1991 and 2007, 183 patients underwent stereotactic radiosurgerythalamotomy, for hard-to-treat tremors caused by Parkinson's diseaseand essential tremors. A thalamotomy is a procedure that destroystissue at a particular spotthe Ventralis Inter-Medius nucleuson thethalamus of the brain which influences movement.

With a medianfollow-up of seven years, 84 percent of patients had significant orcomplete resolution of tremors. In patients with Parkinson's disease,83 percent had near or complete tremor resolution, while those withessential tremor had 87 percent of this degree of tremor resolution.

Science Daily
Working like an architect, Prof. HagitEldar-Finkelman of Tel Aviv University's Sackler School of Medicine is"building" a new drug, L803-MTS, to treat a number of central nervoussystem (CNS) diseases like Alzheimer's. In pre-clinical studies, italso shows promise against Parkinson's, Huntington's and diabetes.

L803-MTSis based on the physical structure of the GSK3 protein, which plays acausative role in insulin resistance and Type II diabetes. Working withchemists, biotechnologists and 3-D modelists, Prof. Eldar-Finkelman andher colleagues built -- like engineers constructing a building -- adrug that locks onto the GSK3 protein, rendering it harmless and unableto wreak havoc inside the body.

Recent research findings on theL803-MTS drug have been published in the Journal of Molecular Biology(2008) and Current Pharmaceutical Design (2009, currently in press).

An innovative approach

SinceProf. Eldar-Finkelman linked GSK3 to insulin resistance in diabetesmore than ten years ago, a race has been on among drug manufacturers tofind a drug that can potentially turn off the harmful effects of GSK3.But rather than build on existing drugs, Prof. Eldar-Finkelman and hercolleagues worked from the ground up. "I decided to take a completelydifferent approach from all the big drug companies rushing to find theultimate drug," says Prof. Eldar-Finkelman. "I designed my own."

Pre-clinicalresults have been positive, and the new drug does not exhibit dangeroustoxic side effects, a problem with existing formulations. WhileL803-MTS cannot reverse the onset of a CNS disease once it has started,Prof. Eldar-Finkelman believes it can slow down the devastating effectsof CNS diseases, like impaired memory and depression, orinsulin-resistance.

"Ours is the first lab that showed theimportance of GSK3 as a target in Type II diabetes, and was among thefirst to introduce a specific inhibitor against the GSK3," she says."Our approach became so popular that today many pharmaceuticalcompanies, big and small, are competing to work on a GSK3 inhibitor."

A new competition

Withseed money from Ramot, Tel Aviv University's technology transfer arm,Prof. Eldar-Finkelman has taken her basic research to the next step,seeking a strategic partner to guide the research through the clinicalprocess and eventual commercialization.

"One important thing tonote is that our drug acts differently than other compounds," she says."Most GSK3 inhibitors are developed on the basis of ATP competitors.Ours are substrate competitors, meaning that they bind to a differentsite at the surface of the protein. This strategy is completelydifferent, and yields a better and safer compound."

Prof.Eldar-Finkelman is now conducting additional pharmacological andtoxicological tests on the new compound. She believes it will be a leadcompound for treating CNS disorders, "because it was based on rationaldrug design. We started from scratch and thought through the design ofa specific compound that would be safe and effective. Our aim is toslow the progression of CNS diseases, but the new drug might also beused as a preventative therapy," she adds.