July 9, 2014

Genetics: Preventive Medicine's Next New Frontier

"Right now, in this part of the century, the most exciting scientific and medical work is going on since the Enlightenment. And that is: we're setting the stage so that people can know where they stand genetically, to prevent the four big diseases that prevent you from being healthy after the age of 75." 

--Dr. Rudy Tanzi, Harvard Medical School, Massachusetts General Hospital

Today marks this blog's fourth appearance by Dr. Tanzi in the past few weeks. And it won't be the last. I've become fascinated with his work, and recently detailed his impressive credentials.

Before, I focused on his positive comments about the supplement ashwagandha, a recommendation that encouraged me to give it a try. But the main body of his work is much more significant. He's not another Dr. Oz touting new miracle pills or diets. Far from it.

Tanzi is pursuing genome research to identify genes associated with Alzheimer's disease and autism. The details of that work are too technical for me to fully grasp. Still, Dr. Tanzi has a unique talent for describing his work in a way a layman like me can understand.

You'll see an example of that talent if you click on the following link. You may have to cut and paste it into the URL bar if clicking doesn't work. It's well worth watching: http://on.fb.me/1zlc3JT

Personalized  Medicine
Dr. Tanzi talks about the exciting prospects for genetic research to bring about a new era in preventive medicine. Others describe it as "personalized medicine," the emerging practice of using individual genetic profiles to guide decisions about prevention, diagnosis, and treatment of a disease.

Today, drugs and treatments are first tested on broad populations, then prescribed using statistical averages. For example, prescription drugs now typically work for about 50 percent of users. Among cancer patients, the effectiveness rate falls to 25 percent. Antidepressants work for about 62 percent of the people who take them.

Ideally, personalized medicine will allow healthcare providers to:
  • shift the emphasis in medicine from reaction to prevention
  • predict susceptibility to disease, improve disease detection, and preempt disease progression
  • customize disease prevention strategies
  • prescribe more effective drugs and avoid prescribing drugs with predictable side effects
  • reduce the time, cost, and failure rate of pharmaceutical clinical trials
  • eliminate trial-and-error inefficiencies that inflate healthcare costs and undermine patient care
Hopefully, doctors and genetic counselors will be able to craft lifelong health maintenance strategies tailored to their patients' unique genetics.

A start-up company headed by the (estranged) wife of Sergey Brin, co-founder of Google, launched a campaign to enlist a million people for a test that would provide genetic details -- and susceptibility to over 200 diseases -- for each participant. Those reports were being sent directly to the subjects, without involving doctors or genetic counselors. For the time being, the FDA has put a stop to the project.

I'll report on that development tomorrow.  

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