The concept of personalized medicine seems to be trending as
one of the “next big things” when it comes to advances in medical treatment.
The principle is simple: each individual has a different genetic background, so
everyone will have a slightly different susceptibility to different diseases or
different responses to different treatments. Basically, the same reasons that
make me a 5’4” white female with athletic build and brown eyes (call me!) and
you something else – our genes – are the same reasons that we may each develop
a different kind of cancer, need different doses of pain medication (or
alcohol) to take care of a headache, or have different symptoms when exposed to
the same allergen or flu virus. (Yes, there are environmental factors involved.
But I would argue that even those, eventually, come back to the genes – the way
the body responds is all about the genes).
There are tests currently available that can identify
specific genetic markers (for example, the so-called “breast cancer gene,” BRCA)
that are used by physicians to advise treatment or preventative courses of
action. In fact, testing kits can be mailed to any curious individual – simply
swab your cheek, send your spit to a testing company, and you will be provided
with your very own genome sequence! Of course, what you do with that
information is slightly unclear (and controversial), so it seems more prudent
to get your doctor somehow involved in things that involve, you know, your
health.
A recent push for developing relatively fast and cheap
methods to sequence genes has led to a huge increase in technology to make
whole-genome sequencing technically possible for laboratories. That said, the
day of submitting a blood sample to your doctor to be run through a machine and
immediately spitting out your own personal profile is far away. Which is
probably a good thing; I’m not sure health insurance as we know it would be
able to handle it (as opposed to the stellar job it does now).
Another wrinkle in the whole personalized medicine concept
is the fact that it’s not just a patient’s genes that are important. Your genes
make all the bits and pieces of your cells that make up you – and it’s not
uncommon for, say, a protein to be affected without there being a difference in
the gene that makes that protein. So, tests wouldn’t just need to decipher your
genetic makeup, but also the make up of all those “bits and pieces.” This is
where the field of “omics” comes in.
“Omics” has turned into a catch-all suffix that basically
means “all the things" and, when applied rigorously, how all these things
interact. Genomics = all the genes and how they interact with each other.
Proteomics = all the proteins and how they interact with each other.
Proctrastanomics = all the stuff you were supposed to be doing while you played
Words with Friends and how that interacts with the likelihood of you being
productive. Like any meme that infiltrates the internet – cat videos, “Shit
so-and-so says,” and Tebow-ing spoofs – the “omics” suffix causes varying
degrees of reactions, from the exuberant “OMG that's so awesome, ROTFL!” to the
more subdued “LOL” to the outright annoyed “WTF I’m blocking your posts.” Count
me in the camp that thinks that “omics” tends to be overused and misused as a
buzzword. I mean, “Pharmacomicrobiomics investigates the effect of variations within the human microbiome on drugs.” Seriously?
However, when used correctly, the concept can be powerful,
as it was in the recent Cell publication by Rui Chen and colleagues. This study
analyzed various “omics” of one individual over 14 months to see how all those
bits and pieces changed over time. (I say individual and not patient because
the subject was healthy and not hospitalized.) The scientists tested the
individual’s blood for what genes were turned on and off, what proteins were
being made, what antibodies were being produced, and what metabolic processes
were occurring. During the course of the study, the individual had a couple of
infections and developed signs being at risk for Type 2 diabetes.
(Parenthetically, after the study was published, the subject revealed himself to be the lead investigator of the report, Dr. Michael Snyder of Stanford. He now joins the ranks of such self-experimentalists as Jonas Salk, who gave himself the polio vaccine, Albert Hoffmann, who synthesized and
then took LSD, and Dr. Jekyll, who transformed himself into Mr. Hyde.)
Throughout it all, a picture of the subject’s “omic” profile
was painted (referred to as iPOP – talk about a meme), revealing the potential
strength this kind of analysis would have in personalized medicine. The fact that
the subject began the study healthy was also of interest: not only should
patients be analyzed after becoming sick, but the normal workings of a person’s
“omics” should also be monitored – the onset of diabetes in the experimental
subject may not have been observed if not for this study. The analysis also
showed what happened to the “omic” profile over the course of an infection and
treatment regimens, which also provides information as to how the infections
progress and how they can be treated most effectively.
Now, we can’t all have a group of dedicated scientists
analyzing our blood for all these bits and pieces every day. Even though the
costs of doing such analyses are decreasing, spending a few thousand dollars
every time one of the tests is run is still not exactly chump change. That, and
it’s not like you can just call up these guys and have them repeat all of this
on your blood. They probably have other things to do. But, this study is a
fantastic proof-of-principle of the potential value of acquiring this amount of
data from individuals.
