23andMe to create a skin disorders treatment with Almirall

is 23andme pivoting its business?

You Paid $99 for 23andMe to Analyze Your DNA. Now, Your DNA will be Used for Treatments. 

23andMe, the world’s leading health-related DNA test kit manufacturer, recently announced that it has licensed a therapeutic treatment for skin inflammation – based on the DNA data it has collected from its 10 million customers.  While 23andMe does give you the option to opt-out of research efforts, nearly 80% of customers opt-in. This means that 23andMe has a pool of nearly 8 million DNA samples to analyze and draw conclusions from! (AncestryDNA Vs. 23andMe comparison shows they are the global leaders in terms of customer numbers). 

With this data, 23andMe has been able to create a theoretical treatment for skin disorders. Let’s take a look at how this treatment was discovered, who it might help, and how this may be a critical transformation of 23andMe’s business structure!

The Journey from Genetic Data to Treatments

23andMe started with 8 million DNA samples, from customers who have agreed to be a part of scientific research. At roughly $100 per test, this represents nearly $800 million!

With all that money, 23andMe was able to hire massive amounts of geneticists and data scientists to start analyzing the millions of samples. For this particular therapeutic intervention, 23andMe researchers started looking at patients who have severe inflammation in their skin – such as people with psoriasis or eczema.

The researchers narrow in on a group of naturally produced molecules called “cytokines”.

Cytokines and Immune Function

Cytokines comprise a large variety of molecules that cells use to send signals between each other. When a cell experiences a traumatic event – such as the invasion of a virus – it releases a bunch of chemicals meant to excite the immune system into action.

Of these chemicals, scientists have previously recognized the cytokine family “interleukin-36” (IL-36) as being particularly important in recruiting immune cells to the site of infection. The IL-36 family has only a few members – all of which have been implicated in psoriasis and other inflammatory skin conditions.

Essentially, in these skin conditions, the IL-36 molecules are overproduced. Immune cells are recruited to the skin, where they begin attacking and destroying healthy skin cells. As more skin cells are damaged, more cytokines are released, leading to an even stronger immune reaction. This is what creates the red rashes and inflammatory plaques associated with many different skin conditions.

In effect, your body is accidentally attacking itself.

How to Create a Therapy from DNA Data

After previous researchers found the IL-36 cytokine family as the ultimate culprit behind many inflammatory diseases, 23andMe had a good target to try and develop a counter-measure.

First, the company started by identifying the portion of DNA that codes for the specific IL-36 cytokines. Since cytokines are simply small protein molecules, they are created in the same way all proteins are created. The DNA code is “read”, transcribed into RNA, then translated into a protein.

23andMe, with over 8 million DNA samples, were able to identify the genes that code for the IL-36 proteins. More importantly – 23andMe was able to identify many of the most common variations within these proteins. 

Last Step…. Making an Antibody

If you know exactly which molecules are causing the problem, the easiest solution is to remove or inhibit those molecules in the body. In the case of skin inflammation, the common is most often the IL-36 proteins.

An antibody is exactly what it sounds like: a molecule that binds to a “body” or another molecule, effectively making it inactive. In order to combat the cytokines that commonly cause skin inflammation, 23andMe quickly started developing the perfect antibody.

Because of their massive database of genomes, 23andMe was able to design their antibody based on the many different forms of IL-36 proteins that are present within the global population. In effect, this means that their antibody treatment should work for almost everyone, regardless of their genetics. 

The antibody designed by 23andMe is capable of binding to every form of IL-36. Theoretically, if a large amount of these antibodies were injected into the human body or applied to the skin, they would bind to the cytokine molecules and stop the immune reaction. In turn, this would reduce or eradicate the inflammation and rashes caused by several skin conditions!

What’s Next? The Future of Medicine and 23andMe

While much more testing needs to be done before this antibody treatment makes it way to the healthcare market, 23andMe has taken a huge step forward by licensing the antibody to Almirall – a leading pharmaceutical company focused on medical dermatology. 

Almirall will begin creating and testing the antibodies, and if successful will begin selling the antibody treatment to people around the world suffering from many skin conditions caused by an overreactive immune system. First, the therapeutic antibody regime will have to go through many different safety and efficacy tests.

The Upside

This treatment is likely to be an effective cure for many people, for several reasons. First, antibodies are very specific. This means that if the antibody was designed right, it should not bind to any “non-target” molecules. Thus, the antibody is likely to do exactly what it was intended to do.

While researchers and safety experts will still have to determine an appropriate dose and safety guidelines for use, antibody treatments are often effective. Plus, this entire development pathway – starting with DNA and moving to a targeted antibody – is likely going to earn 23andMe a ton of money in the coming years. Antibodies, when targeted right, can be extremely effective and are not likely to have any severe side-effects.

Plus, the IL-36 family of cell-signaling has been implicated in asthma, irritable bowel syndrome (IBS), cancer, arthritis, and lung inflammation! So, potentially, this antibody treatment may be a feasible treatment for protecting people from the “cytokine storms” that lead to pneumonia in diseases like the coronavirus and flu!

However, there are also many hurdles this treatment must make before it hits the mainstream. 

The Downside

While antibody treatments may be effective for many people, there are still many questions surrounding this treatment that need further exploration. The main reason: IL-36 proteins have more functions than just the immune reaction.

For example, IL-36 molecules have been implicated as being very important in the innate immune response. Potentially, administering antibodies for IL-36 could shut down your immune response – allowing infective agents to spread wildly through your body. Essentially, regularly receiving these antibodies may leave you immunocompromised!

Plus, IL-36 and other immune signaling molecules are very important during pregnancy. This means that it will be very important to test this antibody treatment during pregnancy to ensure that it is safe and that it does not interfere with the mother’s or child’s natural immune responses and development. 

A Change to the DNA-Testing Business Model?

If this antibody development pathway becomes successful, 23andMe will be making money on both ends of its production line. First, it will be making money from selling its DNA kits. Then, it could make massive amounts by selling the therapeutics and drugs it develops from user’s data.

This begs the question: Should 23andMe (and other DNA testing companies) charge to analyze your data?

Think about it: you paid nearly $100 to give your DNA information to 23andMe. Now, they are using that DNA data to develop and sell new products. 

For many people, the answer is “no” to the above question. While we will have to wait and see how much money 23andMe actually makes from this antibody treatment, it is looking more and more likely that many companies will start offering free DNA tests to consumers in exchange for their DNA data. 

Some companies – like Nebula Genomics – are already working toward this model. While a test from Nebula costs $300, the test sequences your whole-genome. This gives them way more information than 23andMe is currently collecting. After your test, Nebula allows you to enroll in specific studies where researchers pay you for using your DNA. Theoretically, you could already be making money with your DNA data!


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