Fields most affected by genomics?

April 1, 2009 9:36 AM

What field(s) of medicine is/are most likely to benefit from new genetic technology?

What with the decreasing price of genome/transcriptome sequencing and microarrays, it seems pretty likely that genomic medicine will be a big part of the future. But I assume that some specialties are more likely to utilize new technology and findings than others. Any thoughts as to who's more likely to integrate new stuff into their practice?

posted by greatgefilte to health & fitness (2 comments total)

The big problem right now is that even if we can identify genomic disorders, we don't have treatments for most of them yet. So, naturally, the first impact will be a better list of potential drug targets, so that we can get to work on designing drugs.

Next will come genetic screening, which will allow parents to know if they're carriers for specific diseases at not. If they are, then they'll have the option to move on to embryonic and/or pre-natal screening. I think you'll see shifting attitudes about carrying babies to term that have untreatable health problems. Society will begin to have less sympathy for parents that choose to bear children with Huntington's disease or Down's syndrome, when they could have avoided the problem all together.

We'll also see better targeted treatments, and this is an across-the-board kind of advance. Cancer treatments will probably be among the first. There are already some clinics using tumor profiling to choose the best treatment. It's becoming commonplace to use trastuzumab to treat breast tumors that overexpress Her2+. You'll see many more cases like this.

Later, you'll see genetic profiling being applied to more everyday drugs, like statins for lowering cholesterol. We're already seeing drugs like BiDil that are approved for use only in African-americans. Soon we'll be able to go beyond simple racial stratification, and identify the specific genomic variants that govern response to specific drugs. Then you can choose the right drug for the right person.

Hell, this is even going to affect things like anesthesia. We already know that different people require different doses because they metabolize the drugs at different rates. There may very well be SNPs that predict dosage response to Propofol that can take much of the guesswork out of putting someone under.

So yes, you're right that the next 10-20 years will be transformatory. You're going to see most of this stuff introduced in the University hospitals first, as part of academic clinical trials, and then they'll slowly trickle out into general practice. One of the major hurdles is going to be educating doctors, and designing intelligent software systems that can feed doctors the right information.
posted by chrisamiller at 10:25 AM on April 1 [1 favorite]

Genetics is a really young science and it's difficult to know exactly how far we're going to go with, though my guess is we're going to stop short of GATTACA. chrisamiller covered a lot of ground, in particular with genetic screening. A couple might not even need to worry about carrying a baby to term if they have their genomes screened ahead of time and then avoid even having a baby in the first place. Or if they do, they can do it in vitro and screen zygotes to see if everything is normal so far. I know, it sounds like science fiction, but this is the future!

Check out DNA Microarrays for some fairly new advances in gene screening.

If protein folding can be further worked out, we can tell from DNA exactly what proteins one person is going to synthesize and how they are different from a "normal" person's. This could prevent things like Wilson's Disease and others that have to with proteins.

If you want to stick to the question of "Fields most affected by genomics?" though, I'd say genomics and proteomics, in that order.
posted by battlebison at 11:11 AM on April 1