'Personalized Medicine' Goal of Human Genetics Initiative
02/11/08 Portland, Ore
OHSU effort, launched today during National DNA Day, will meld genetics and clinical care
A woman sees her doctor with a severe cough. Diagnosed with pneumonia, she's put on a standard antibiotics regimen. If she has a negative reaction to the drugs, the treatment is stopped.
But the long-term effects of that negative reaction could be life altering, if not deadly, especially if it's due to a preexisting genetic anomaly. A team of physicians and scientists at Oregon Health & Science University hope to prevent such problems with a major initiative that will meld sophisticated genetics with clinical care, and forever change the way health care is delivered at OHSU.
Susan Hayflick, M.D.
OHSU today is launching the Human Genetics Initiative (HGI), an effort that brings together the university's vast array of genetics research resources and brainpower, and applies them in a health care setting. It will allow the university to seek new ways of understanding the role of genetics in common disorders like obesity, hypertension, osteoporosis and diabetes.
The goal of HGI is to accelerate the translation of scientific knowledge to patient care by recruiting new geneticists, building a campuswide bank of advanced technology, developing new educational programs for the next generation of health care providers, and, eventually, establishing a novel delivery model for genetics health care.
Officials say that the timing is right for the initiative, as genetics becomes a more critical part of all aspects of medicine. OHSU President Joseph E. Robertson, Jr., M.D., M.B.A., said the HGI represents a new era of research, education and patient care for OHSU.
"OHSU’s Human Genetics Initiative advances our strategic goal of integrating our missions, departments and units," he said. "HGI offers a cross-disciplinary, academic model that supports innovations in genetics in our community and worldwide."
Today's launch of the OHSU Human Genetics Initiative coincides with the fifth annual National DNA Day, organized by the National Institutes of Health's National Human Genome Research Institute to commemorate the completion of the Human Genome Project in April 2003 and the discovery of DNA's double helix in 1953.
HGI director Susan Hayflick, M.D., professor molecular and medical genetics in the OHSU School of Medicine, said the initiative creates the launching pad for OHSU's full-scale foray into "genomic medicine."
"It's an opportunity to integrate OHSU's research community into what's going to be the medicine of tomorrow, which is personalized medicine," Hayflick said.
Personalized medicine is a concept that involves identifying a patient's genetic risk factors for specific diseases and potential "idiosyncratic" reactions to therapies before a physician chooses a treatment. The idea already is being applied in many cancer treatments, in which the genetics of each patient, and his or her tumor, are determined before chemotherapy is administered to assure the drugs are most effective and won't cause dangerous side effects.
"You're testing the tumors to decide how to treat them, but you're also testing the patients to make sure they're not going to have an adverse drug event from your choice of therapeutics," Hayflick said. "It’s a way of tailoring the care you give for the person sitting in front of you."
She added that the traditional way of determining side effect risk – examining family history – is like "trying to find a contact lens from a helicopter."
The collection of technology and laboratory services the Human Genetics Initiative has at its disposal is massive. Researchers have their choice of nearly a dozen in-house DNA sequencing, nucleotide synthesis, polymorphism detection, gene expression and cytogenetics laboratories, including precision robotic microarray or "gene chip" equipment, and have access to more than 80 genome catalogs and database mining tools.
"Anything that makes DNA or reads DNA, all of those resources on campus are available," Hayflick said. The initiative is "a freely accessible resource open to anyone at OHSU."
A challenge of taking genetics knowledge from bench to bedside is the need to build out existing educational paradigms. A part of the Human Genetics Initiative will be to create a national model for integrating genetics training into subspecialty medical education.
"The potential of genetics in practice is limited to some extent by too few appropriately trained medical geneticists. A goal of the OHSU Human Genetics Initiative will be to help close the gap between education and clinical practice," said Mark Richardson, M.D., M.B.A., dean of the OHSU School of Medicine.
Among the initiative's educational offerings is a predoctoral program in OHSU's Department of Molecular and Medical Genetics that offers a range of training opportunities in molecular, cellular, developmental and human genetics. The department also offers a medical genetics residency, a two-year clinical and research training experience for physicians with an interest in the diagnosis, counseling and management of patients with inherited disorders.
The initiative is supported by funds from the OHSU School of Medicine, the Department of Molecular and Medical Genetics, the Oregon Opportunity, and the Oregon Clinical and Translational Research Institute (OCTRI), the research partnership between OHSU and Kaiser Permanente's Center for Health Research that was funded by the National Institutes of Health in October 2006. Eric Orwoll, M.D., OCTRI's director, said the diversity of support speaks to the "inherently multidisciplinary" nature of the initiative and genetics in general.
"It will collaborate with a variety of investigators, clinicians, and departments," said Orwoll, professor of medicine (endocrinology, diabetes and clinical nutrition) and director of the Bone and Mineral Unit, OHSU School of Medicine. "The Oregon Clinical and Translational Research Institute has devoted considerable resources to genetics research and will work in close partnership with HGI."
HGI's resources in both animal and human genetics offer the potential to develop translational research, the area of study that emphasizes rapid movement of discoveries – compounds used in drug therapies, for example – from the laboratory to clinical care, and back again.
"If we are to be part of the development of the field, we must add some critical resources, and coordinate our talent and technologies. The HGI will do that," Orwoll said.
Dan Dorsa, Ph.D., OHSU vice president for research and professor of physiology and pharmacology, called the initiative a "strategic investment of Oregon Opportunity funds." The Oregon Opportunity is a $500 million biomedical research funding initiative supported by a public-private investment.
"OHSU's Human Genetics Initiative recognizes today's reality in which genetic information plays a critical role not only in cutting-edge research, but also in our ability to deliver the highest quality heath care to all Oregonians," Dorsa said.
For more information on HGI, visit www.ohsu.edu/hgi.