Spokes of Success
With unprecedented support from the Lilly Endowment, the Indiana
University School of Medicine is in a position to contribute significantly
to progress in genetics, genomics, proteomics and bioinformatics,
all of which are at the foundation of the Indiana Genomics Initiative.
But not all of the work related to genetics and genomics is being
conducted on the Indianapolis campus. Our dean, Craig Brater, often
has said that the regional Centers for Medical Education are important
spokes in the wheel of INGEN-related research.
Bloomington’s Medical Sciences Program makes use of INGEN
core facilities in its studies of breast cancer mastectomy and ovarian
cancer patients. Bloomington faculty also are involved in the educational
component of INGEN, training students in doctoral and combined degree
programs.
At the IU Northwest center in Gary, Roman Dziarski, PhD, professor
of microbiology and immunology, discovered a new family of human
genes involved in innate immunity to bacteria and cloned three of
them. He also made a knockout mouse for one of those genes, allowing
him to study gene function in vivo.
At the Evansville center, we propose to use genetic information
to individualize drug therapy. One possible cause of adverse drug
reactions is genetic variation in how individuals metabolize drugs.
A primary benefit of pharmacogenomics is the potential to reduce
adverse drug reactions by modifying drug selection or dosing in
patients with poor ability to metabolize a drug because of genetic
variations.
Drug-metabolizing enzymes, located primarily in the liver, are
the predominantly known cause of genetic variability in drug responses.
For each gene encoding a drug-metabolizing enzyme, variant alleles
(called polymorphisms) may exist. Our initial focus will be on drug-metabolizing
enzymes with known variant alleles that cause poor metabolism, because
these are most relevant to adverse drug reactions.
The genotyping laboratory at the Evansville center will be a commercial
enterprise, analyzing individual pharmacogenomic profiles for profit.
Further, it will move beyond the initial drug metabolizing genes
to other genes known to be related to psychiatric illness, cancer,
cardiovascular disease, diabetes and other disorders. One day, we
hope to know enough about a patient’s genotype to predict
not only predisposition to common diseases but also how he or she
will respond to environmental stresses and medical treatments. This
will offer the ultimate in individualized patient health care.
Indeed, the Indiana Genomics Initiative holds great promise for
the future of medicine and how it is delivered. Each campus of the
IU School of Medicine is an important spoke in the wheel to ensure
the initiative keeps rolling forward.
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