Estonian Genome Project Ahead of Schedule

December 19, 2002 LONDON (Reuters Health) - A genome project set up by the tiny European country of Estonia is accelerating plans to take blood samples from three quarters of its population.

Professor Andres Metspalu, head of the Estonian Genome Project (EGP), says a pilot project involving 10,000 Estonians in three areas of the country has gone well enough to enable it to be extended to the whole country earlier than planned.

"Family physicians are gradually getting their databases registered at the Estonian Data Protection Agency, a prerequisite for them to get involved in the EGP. So far, the only thing we had to improve was information technology solutions since doctors had different hardware and software which we had to accommodate into the system," Metspalu told Reuters Health.

In the wake of a pioneering gene-banking scheme set up in Iceland 5 years ago, large-scale projects to link genes and disease have been gaining popularity. A new 10-year genome project was approved by the Latvian parliament in June 2002, while on a smaller scale, Wisconsin's Marshfield Clinic has started enrolling volunteers for a proposed biobank of 40,000 volunteers.

In Britain, the UK Biobank, currently in the planning stage, will include up to 500,000 volunteers aged between 45 and 69. A small number of regional centers are expected to be in place by spring 2003.

But Estonia's project, which plans to take blood samples from 1 million of its 1.4 million population, promises to be the biggest. Its creation was allowed after a law was passed by overwhelming majority in the country's parliament in 2000. Sample collection began in October this year and the project is expected to take around 5 years.

Those behind the project make much of the population's suitability as a model. Historic migration and invasion have left the population genetically heterogeneous, which makes the Estonian biobank a useful tool for targeting the increasing number of drugs with efficacy problems and issues with adverse reactions.

Metspalu points to a 1998 research paper in the Journal of the American Medical Association (news - web sites) that showed nearly 5 million adverse drug reactions among US hospital patients in 1994 as a justification for Estonia's approach.

This differs markedly from Iceland, which surprised the world with the grant of an exclusive license to deCODE Genetics to harness the country's unique heritage.

While the attraction of Estonia's population is its heterogeneity, the appeal of Iceland's is its homogeneity. The country has a virtually unbroken genealogical record stretching back some 1,100 years, and the population is descended from a small number of original families.

deCODE is correlating this information with the country's health records and a database of DNA samples to facilitate population-wide linkage studies of common diseases.

Rather than looking for the genes behind disease, scientists involved in the Estonian project are focusing on how genes influence individuals' response to medicines. They say the first outcome of the scheme will be a pharmacogenomic study of the antidepressant citalopram.

Dr. Kalev Kask, chief executive of EGeen International, the commercialization arm of the EGP, told Reuters Health the study is likely to be the first of many studies of antidepressants using data gathered from the population of this tiny eastern European country.

The study of citalopram, marketed as Cipramil in Europe and Celexa in the US, will use software from California-based Prediction Sciences that associates patient chart information and single nucleotide polymorphism (SNP) profiles with outcome of treatment. The idea is to use the product in the clinic as a predictive indicator of the likelihood a patient will respond to treatment.

Prediction Sciences is also developing products for predicting response to ACE inhibitors, antidepressants and treatments for bipolar disorder.

By Mark Frary