Op-Ed: Why we need to step up our study of genetics
February 10, 2006 2:15 pm
This Op-Ed originally appeared in the February 10, 2006 edition of the Chicago Sun-Times (Chicago, Il) and the February 15, 2006 edition of the Dallas Morning News (Dallas, Tx)
In President Bush's budget submitted to Congress this week, $40 million was devoted to the "Genes and Environment Initiative," whose goal is "to accelerate discovery of the major genetic factors for diseases that have a substantial public health impact."
This follows closely on the heels of an announcement of a three-year, $100 million pilot project to identify and catalog the genetic changes in cancer ("the cancer genome").
Given the continual announcements of new genetic discoveries over the past decade or so, Congress and the public may be asking whether we really need another genomics project. The answer to this presumptive question is yes -- and for two major reasons.
First, common diseases are genetically quite complex. Heart disease, for example, likely results from the interaction of hundreds of genes with our environment -- the sum of which is different for each one of us. Simple studies have not, and will not, provide the answer to these complex problems.
Second, the toll that common diseases are taking on the economy and our lifestyle requires new insights that only a project of this magnitude can provide.
Consider the complexity of our complete genetic make-up known as our genome. Each of our cells contains 3 billion chemical units arranged in a unique order resulting in more than 20,000 genes -- more parts than even the most complex man-made machines. Then, depending on the cell type -- muscle, heart, brain -- different genes have different functions. Furthermore, depending on our environment -- whether we smoke, eat fatty foods, forget to exercise -- our genes respond accordingly to meet our body's needs and keep us going. And on top of that, each of us is unique in our genetic make-up and lifestyle.
Today, we are just beginning to sort out the complexity of our genome, and how exactly our genes interact with our environment. While scientists have had success uncovering the genes that cause diseases that run in families and are not typically influenced by environmental factors, understanding how the interaction between genes and the environment leads to common, chronic diseases has remained a mystery.
Through the Genes and Environment Initiative, critical information will be gathered that will help unravel the causes of common disease. In this project, thousands of healthy people as well as thousands affected with diseases like Alzheimer's, diabetes and heart disease will have their genomes and information about their lifestyle and health status analyzed together. If we can identify which genetic variants and environmental exposures in combination lead to disease by comparing healthy individuals to individuals affected with a particular disease, we can begin to put together the pieces of the puzzle.
Though the amount of money for this type of study may seem daunting, consider these facts. Almost 21 million people in the United States have diabetes and about 71 million are affected with one or more types of cardiovascular disease. In 2002, about $132 million was spent for diabetes care; for 2006, the estimated cost of cardiovascular diseases and stroke is $403 billion. This type of study has the potential not just to further our understanding of the biological processes behind common diseases, but can lead to new diagnostic tests, preventive measures and treatments.
This is more than just another project to sequence some genes. In fact, it's as much an environmental study as it is a genomics study. Twenty-six million dollars of the $40 million initiative will go to identifying the genetic variants across the genomes of people with and without disease. The remaining $14 million will be spent on developing new tools to measure environmental exposures that may increase a person's risk for disease. Because all of our health problems are the combination of two factors (our genes and our environment), our genes must be studied in the context of the environment or the data will be of limited value.
The era of genomics brings to mind the goals and impact of the U.S. space program of the 1960s, '70s and '80s -- a daunting challenge aimed at discovery and exploration that had a profound effect on our technology, innovation, industry and economy. But in contrast to NASA's more recent strategic plan of "faster, better, smaller," the National Institutes of Health's mantra should be "faster, better, bigger." Genomics has spurred innovation, bioinformatics and biotechnology, and substantially advanced our understanding of basic biology over a very short time. Given the enormous complexity and cost of common diseases affecting our nation's health, big ideas will continue to be needed to solve big problems.
Susanne B. Haga is a senior policy analyst with the Institute for Genome Sciences & Policy at Duke University. Geoffrey S. Ginsburg is the director of the Center for Genomic Medicine at the Institute for Genome Sciences & Policy.