GeneLink BioSciences, Inc., MEMO 
July 17, 2000

To: John R. DePhillipo
Date: June 17, 2000 Chairman/CEO 

From: Sue Ricciardi, M.D. Medical Consultant
Re: Patients with Alzheimer's Disease should bank their DNA 

Dear John:

You have asked me to render an opinion as to whether or not I believe that the banking of DNA obtained from Alzheimer's (and other dementia) patients would be appropriate and/or useful. To this inquiry I can only respond with a resounding, "Yes"! I offer the following rationale for this sentiment:

Alzheimer's Disease may be linked to other diseases.
Patients of any age or sex can and do get more than one disease. Those occurring with familial predisposition can be genetically "linked" in one fashion or another. For example, we have high suspicion that breast and ovarian cancers may be related in this way. The same may also be the case for other conditions and malignancies in the realm of, for example, cardiovascular, gastrointestinal, collagen vascular, musculoskeletal and integumentary diseases. Genetic testing will determine these linkages, and the occurrence of Alzheimer's Disease or any other disease, for that matter, certainly does not preclude the coexistence or linkage of established or as yet undiagnosed health problems in any given individual. 

Other heritable disease in Alzheimer's patients may go undetected.
Patients afflicted with Alzheimer's Disease, particularly those in late or terminal stages, may not be "worked up" or diagnosed for the development of other diseases (including malignancies) due to things like non-recognition of signs or symptoms which cannot be effectively communicated by the patients, or due to poor prognoses for meaningful, comfortable and dignified survival. In addition to this we sometimes consider dementia patients to be poor candidates for diagnosis and treatment of other serious or life-threatening processes because of suffering which can be imposed upon afflicted individuals by testing and therapies required to establish diagnoses and ameliorate or cure these diseases. Patients with dementia are often unable to understand and recall the principles, needs or processes of evaluation and treatment, which can be frightful and complex. Thus, we must consider patients with Alzheimer's and other dementias also have conditions, known or unknown, which are not specifically "linked" to the degenerative neurological process itself. It is, therefore, just as important (or even more so) to have DNA from these patients available for testing as it is to have the same from patients in the general population. Let us suppose that the elder of three children of a deceased Alzheimer's or other patient becomes diagnosed with a heritable cancer. In addition to direct management of the afflicted individual, we would also turn our attention toward the early detection of, or diagnosis and management of, predisposing factors for development of the same disease in the other siblings. For this we need reference DNA from the afflicted or possibly afflicted but undiagnosed parent or grandparent (who may or may not have had Alzheimer's Disease). 

Family DNA will provide a complete genetic profile for Alzheimer's Disease.
It is our understanding that for the presenilin test used in the detection of early-onset Alzheimer's Disease, family DNA is required. Given this fact, and since late-onset Alzheimer's testing can only derive probabilities at this point in time, DNA from afflicted individuals should be stored for tests in evolution which will detect late-onset disease, paralleling current methods of evaluation. 

I hope that this information will be of some use to you. Thanks. 

SOURCE: GeneLink BioSciences, Inc.