When Julian Awad’s grandfather was diagnosed with Alzheimer’s disease in his 60s, his memory began to fade. One thing he never forgot, though, was his grandson’s name.
"That really had an impact on me as a teenager," Awad, 34, said. "I was very close to him. Now, I have other relatives with early symptoms. The disease has had such an impact on my family, it really grabbed me."
In fact, the experience would stick with him and play into his livelihood. Nearly three years ago, Awad was accepted into the Wharton School of Business’ entrepreneurship program to launch his own startup with friend and Penn research specialist Richard Watson, who both make their respective homes near the 20th and South streets area.
Watson has a degree in molecular biology and would talk with Awad — who always had a interest in science — about genetic research and development. Of particular interest was Watson’s work on HIV resistance, specifically testing for two genes that may slow down the progression of AIDS.
A light bulb went off for the two.
They did extensive research on Watson’s method and on published medical and scientific testing done on Alzheimer’s, a progressive and fatal deterioration of brain cells that effects five million Americans. After culling available data on the latest genetic testing and developments they determined something huge: People could, in the privacy of their own homes, test themselves for their risk of developing late-onset Alzheimer’s.
The test, called Alzheimer’s Mirror, is designed for healthy individuals ages 18 and up interested in knowing what allele — alternative forms of a gene, in this case three, occupying the same position on paired chromosomes and controlling the same inherited characteristic — of the APOE gene, which will show the level of increased, decreased or neutral risk for developing the disease that they have. The test is not for those with symptoms or who have been diagnosed, which must be determined by doctors, because those individuals don’t need access to this information. For all others, Awad said the world is ready to know their future.
"I’m not so sure that society was ready for that information," he said of the years when his grandfather was a young man.
He feels now is the time and place for Smart Genetics, the Naval Yard-based company Awad and Watson co-founded when they began their work with Wharton in 2005. The former serves as the company’s chief executive officer; the latter, the chief technology officer.
Alzheimer’s Mirror is set to be available on the company’s Web site, www.alzheimersmirror.com, in early spring and will be distributed nationwide.
Awad and Watson combined their educational backgrounds to form Smart Genetics, but also attribute a great deal of its growth to research and collaborations with expert advisors, a board of directors and Athena Diagnostics, a company who licensed the APOE gene at Duke University 14 years ago and discovered its correlation to late-onset Alzheimer’s.
Watson and Awad weren’t the first to approach Athena for use of the license. However, they are the first to offer the complete approach to detecting the disease — private testing, education and counseling. What makes Alzheimer’s Mirror different than any other attempts genetic companies have made to license the APOE gene — the marker identified as the strongest indicator of developing Alzheimer’s — is the complete approach.
"We realized education was the major factor there. Once we educate folks on what the test means, we can determine who it’s beneficial for," Watson, 30, said. This means some applicants may be turned away.
"Other companies wanted to sell [similar tests] to anyone. Our process requires a strong education in the beginning. Results are [given] over the phone with a genetic counselor who’s trained in crisis management," Awad said.
Both said the test is not for everyone, as determined by an online questionnaire.
"It’s a very personal decision. We want them to think, ‘Is this the right time?’ ‘Do I want to know this information?’ ‘Would this be beneficial?’ Those are questions we’ll ask," Watson said.
Information on the product — which had to undergo a series of tests to determine it is safe for sale and use — has spread through word-of-mouth, mainly from Smart Genetics employees and doctors who’ve heard about the company. Nationwide marketing will begin when Alzheimer’s Mirror is released, but for now, the only way to get the $399 test not currently covered by insurance is to sign up online, which Awad said an undisclosed number of people already have.
The test kit contains a saliva sample collection device about the size of a contact lens case participants fill and seal. The sample is mailed to Aethna’s Worchester, Mass., CLIA-certified laboratory in a prepaid envelope for DNA testing. Once sent, participants can schedule an appointment online three weeks later to get their results.
With a large population of aging Americans, Awad said the disease is getting a lot more attention, hence the niche for Alzheimer’s Mirror.
"People are becoming more aware of [the disease’s] impact, even those who don’t have a personal experience. A lot of people want to know their predisposition," he said. "I saw the opportunity to do [testing] in the right way, making sure information was made available but done in a socially responsible way."
No testing is done onsite, but the South Philly location the company moved to last fall from Wharton with its 25 full- and part-time employees is a space both needed and appreciated. It was made available through state tax incentives and funding from the Benjamin Franklin Technology Partners, which owns the company’s building.
According to Watson and Awad, knowing the results from Alzheimer’s Mirror is more than just insight into the future of one’s health, it’s a motivational tool that could spark a lifestyle change and a communication tool to prepare friends and family for what the results mean.
"For someone who has a family history [of the disease] and they are concerned that they will develop it, the tests can provide a coping strategy," Watson said. "It helps to remove the uncertainty."
"There are clinical studies showing the specific lifestyle changes that may decrease the lifetime risk for Alzheimer’s," Awad said, citing diet, cardiovascular activity, cognitive therapy and keeping socially active being shown as things that may delay the onset.
It is the company’s goal, then, to prevent families from the hardships of Alzheimer’s by providing a means of knowledge and a method to cope and prepare.
"The concept of Smart Genetics is we want to have people see themselves a little more clearly," Awad said. "That process to us was like looking into a mirror — you get to see yourself."
To contact Staff Writer Caitlin Meals, e-mail firstname.lastname@example.org or call ext. 117.